Accounting Letter — Page 2

Type I proves controls exist on paper; Type II proves they actually work over time.

Improper payments now top $5.6 billion as documentation gaps, not fraud, drive SNF coding errors.

Median SNF margins sit at 0.4%, hidden payer shifts can erase them overnight.

Medicaid pending and payer transitions drive aged receivables more than bad debt does.

PDPM's six-component structure complicates both billing and revenue recognition.

Five years after PDPM launch, spending soared while patient outcomes stayed flat.

Improper payments at nursing homes tripled in three years; here's how to prepare.

Improper payments at SNFs have doubled, driven mainly by documentation gaps.

Shorter retroactive eligibility window shifts how SNFs value Medicaid pending receivables.

Thin margins mean SNF survival depends on controlling cash timing, not cutting costs.

SNFs funnel billions to affiliates, raising compliance questions across accounting frameworks.