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Long Term Care CXO Summit Fall 2013 - Interview with: Don Chapin, CELA, President, National Eligibility Solutions
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Long Term Care CXO Summit Fall 2013 - Interview with: Don Chapin, CELA, President, National Eligibility Solutions



Long Term Care CXO Summit Fall 2013 - Interview with: Don Chapin, CELA, President, National Eligibility Solutions

Long Term Care CXO Summit Fall 2013 - Interview with: Don Chapin, CELA, President, National Eligibility Solutions



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Long Term Care CXO Summit Fall 2013 - Interview with: Don Chapin, CELA, President, National Eligibility Solutions Long Term Care CXO Summit Fall 2013 - Interview with: Don Chapin, CELA, President, National Eligibility Solutions Document Transcript

  • Interview with: Don Chapin, CELA,President, National EligibilitySolutionsMany long-term care (LTC) facilitiesare now turning down Medicaid pendingcases, but when 80 percent of thepopulation is middle class and could fallinto that group, it does not makebusiness sense to do so, says DonChapin, CELA, President, NationalEligibility Solutions (NES). Nursinghomes have to maintain their paymentswithout interruption, and without relyingon the families of residents or thegovernment, he adds.A healthcare consulting firm, NES is asolution provider at the marcus evansLong-Term Care CXO Summit Fall2013, in Palm Beach, Florida, July25-26.What are the challenges on thefinancial side of the LTC business?The government is lowering Medicareand Medicaid reimbursement for LTCservices while regulations are becomingfar more complex. Facilities get paidwhen residents are insured, can affordprivate pay or are on Medicaid, but for80 percent of residents who are middleclass, they cannot determine how theywill get paid for their services.If the resident does not have savings orLTC insurance, which only about eightpercent of people do, Medicare andMedicaid are the only options left. ForLTC, Medicare is limited to 20 days ifthere is a rehab, with a maximum of 80additional days. These Medicare daysare accessible if the patient is admittedto the hospital for three billing periodsand on an inpatient status. However,nobody will have this information untilthe patient gets to the nursing home.How could facilities ensure they getpaid for services?They need access to real timeinformation to understand how they canget paid for the newly entered resident.How many weeks of private pay canthey afford? Are they insured? Howwere they admitted to the hospital? IsMedicaid available once private pay isexhausted? If the family gave the houseaway to a church or universityendowment, it will be penalized fromMedicaid.No matter the length of stay or level ofwealth of residents, nursing homesmust make sure they will get paid. NESis able to provide the knowledge basefacilities need, with state-by-stateinformation on the rules andregulations, and help with whatquestions admissions officers need toask.Does this require a culture change?How would this guarantee the long-term viability of the business?The current culture in nursing homes isto wait and wait until the family reportsthat there is no money left andsomeone gives them a Medicaidapplication.When the nursing home does that, it isessentially delegating its cash flow, thelifeblood of its business, to a family whoknows nothing about the system and isafraid of the Medicaid officer. Theapplication is likely to be delayed andeven denied several times before theyget it right. In the meantime, thenursing home has a bad debt of three tofour months because of that.They must apply for Medicaid in the firstweeks of residency, which requires aculture change in the nursing home.They care about residents’ dentures andhearing aids, but not about paymentissues. It is not in the mentality of careworkers to ask tough questions, butthey should.Medicaid pending cases are a bigliability for nursing homes. Addressingthe issue would have a very positivefinancial impact, increasing theprofitability of the facility.Medicaidpendingcasesare a bigliabilityfornursinghomesIncreasing the Profitability of LTC Facilities
  • marcus evans Summits deliverpeer-to-peer information onstrategic matters, professionalt r e n d s a n d b r e a k t h r o u g hinnovations.Please note that the Summit is aclosed business event and thenumber of participants strictlylimited.About the Long-Term Care CXO Summit Fall 2013This unique forum will take place at The Ritz-Carlton, Palm Beach, Florida, July25-26, 2013. Offering much more than any conference, exhibition or trade show,this exclusive meeting will bring together esteemed industry thought leaders andsolution providers to a highly focused and interactive networking event.www.longtermcaresummit.comContactSarin Kouyoumdjian-Gurunlian, Press Manager, marcus evans, SummitsDivisionTel: + 357 22 849 313Email: press@marcusevanscy.comFor more information please send an email to info@marcusevanscy.comAll rights reserved. The above content may be republished or reproduced. Kindlyinform us by sending an email to press@marcusevanscy.comAbout National Eligibility SolutionsNational Eligibility Solutions, LLC (NES) is a national health care consulting firm assisting the long term care industry by helpingeach nursing home facility make sure they will be paid for each resident. NES operates in all 50 states. We educate and empowerlocal BOM’s to be more effective. We handle case referrals for Medicaid eligibility which raises census and reduces Medicaid Pendingcases.www.TrustNES.comAbout marcus evans Summitsmarcus evans Summits are high level business forums for the world’s leading decision-makers to meet, learn and discussstrategies and solutions. Held at exclusive locations around the world, these events provide attendees with a unique opportunity toindividually tailor their schedules of keynote presentations, case studies, roundtables and one-on-one business meetings.For more information, please visit: www.marcusevans.comUpcoming EventsNational Healthcare CFO Summit - www.nhcfosummit.comNational Healthcare CNO Summit - www.nhcnosummit.comNational Healthcare CXO Summit - www.nhcxosummit.comTo view the web version of this interview, please click here: www.longtermcaresummit.com/DonChapin