Long Term Care CFO — Page 2

FFS Medicare's outsized margins now subsidize Medicaid losses.

Coding errors in SNF assessments now trigger a sequence of escalating CMS audits and OIG referrals.

The 3.2% payment bump masks facility-specific variation in wages, case-mix, and compliance.

Low-performing facilities lose millions to VBP penalties that erase rate increases.

Medicare cost report settlements can take 18 months or longer to finalize.

How SNFs can qualify for Medicare reimbursement on uncollected resident deductibles.

Medicare oversight of related-party costs on SNF reports has been nearly absent.

How Medicaid pending status distorts receivables, patient days, and cost report rates.

How Medicare Advantage denial accounting errors distort both GAAP and cost report rate-setting.

Documentation gaps, not policy disputes, drive most MAC adjustments SNFs face on appeal.

OIG audits reveal specific, preventable errors that repeatedly trigger cost report reopenings.