How ClarkLindsey Is Preparing for CMS’s Shift to the RCS‑I Payment Model
- ClarkLindsey
- Apr 19, 2018
- 2 min read
CMS’s upcoming Resident Classification System (RCS‑I) will fundamentally change how skilled nursing facilities are reimbursed, shifting away from therapy‑minute billing toward payments based on patient complexity and quality outcomes. At LeadingAge Illinois, experts urged providers to redesign care models now. ClarkLindsey is already restructuring operations, adjusting therapy partnerships, and expanding its Medicare census to stay ahead of the transition.
What Happened
At the LeadingAge Illinois conference, Elisa Bovee of HealthPro Heritage warned that the RCS‑I model will require skilled nursing providers to rethink their approach to therapy and reimbursement. Instead of relying on high volumes of therapy minutes, facilities will be rewarded for treating more complex patients and achieving strong quality metrics.
Most providers currently do little or no group therapy, even though it will become increasingly important under the new model. Bovee emphasized that providers should begin shifting practices now to avoid a disruptive transition when RCS‑I takes effect, likely in late 2019.
ClarkLindsey CEO Deb Reardanz shared how the organization is preparing. The community split its post‑acute and long‑term care units into separate operations, each with its own director of nursing, to preserve a home‑like environment in long‑term care while strengthening the clinical focus of post‑acute rehab. ClarkLindsey also changed therapy partners, selecting HealthPro Heritage after evaluating which companies demonstrated a clear strategy for the coming reimbursement changes.
The organization further analyzed local hospital pain points and billing code challenges to better align with referral partners. As of April 1, ClarkLindsey increased its Medicare‑reimbursed beds from 25 to 37, filling all available slots immediately.
Why This Matters
RCS‑I represents one of the most significant shifts in skilled nursing reimbursement in decades. Facilities that continue relying on therapy‑minute volume will face financial strain, while those that redesign care around complexity, outcomes, and interdisciplinary approaches will be positioned to thrive.
ClarkLindsey’s proactive steps—operational restructuring, strategic therapy partnerships, and Medicare census expansion—illustrate how forward‑thinking providers can prepare for the new landscape.
Key Details at a Glance
New Model: RCS‑I shifts reimbursement from therapy minutes to patient complexity and quality.
Industry Impact: Providers must redesign care and expand group therapy.
Expert Insight: 85% of providers currently do not offer group therapy.
ClarkLindsey Actions:
Split post‑acute and LTC units
Selected a therapy partner aligned with RCS‑I strategy
Analyzed hospital referral needs
Expanded Medicare beds from 25 to 37
Timing: RCS‑I expected to take effect in late 2019.
Broader Context
The shift to RCS‑I reflects CMS’s broader move toward value‑based care. Skilled nursing facilities must demonstrate clinical sophistication, strong outcomes, and efficient use of therapy resources. Providers that adapt early will be better positioned to attract hospital referrals, manage complex patients, and maintain financial stability.
ClarkLindsey’s approach highlights the importance of strategic planning, data‑driven decision‑making, and alignment with referral partners as the industry enters a new era of reimbursement.
Source Attribution: Based on reporting originally published by Senior Housing News.
