Gravity Healthcare Consulting

Gravity Healthcare Consulting Gravity Consulting provides the stability, resources and customized strategies

Gravity Consulting helps senior living communities and home health agencies solve the problems that hold them back. Whether you're launching new services, fixing what’s broken, or filling critical leadership gaps, our team brings deep operational experience, regulatory insight, and hands-on support that gets results. From interim roles like Administrator, DON, or MDS Coordinator to full-scale turn

arounds and growth strategies, Gravity is your partner for getting unstuck and moving forward—with confidence.

05/06/2026

SNF Leaders: Bring Data to the Proposed Rule Conversation

The FY 2027 SNF Proposed Rule is not just another incremental rule.

It is something SNF executives need to model.

If CMS is asking for feedback on case mix creep and potential PDPM adjustments, operators should be ready to show exactly what those changes would mean at the facility level.

That means going beyond:

“We disagree.”

And showing:

• How the proposed case mix adjustments would affect your bottom line
• What the impact would be on staffing and services
• How those changes could affect resident care
• Whether CMS assumptions line up with actual utilization
• Why your facility’s data tells a different story

This is where advocacy becomes much stronger.

Facts and data give CMS something to respond to.

Melissa Brown breaks down what SNF leaders should be watching in the newest episode of Gravity Healthcare Hacks.

05/06/2026

Now Is the Time to Audit Your MDS Coding

If CMS is talking about targeting certain PDPM coding patterns, operators should pay attention.

Because that is often a signal.

If payment reductions, audits, or denials are coming, the first place they may look is the same place they are already discussing:

MDS coding.

That means now is the time to review the areas that could create risk or missed opportunity:

• Depression coding
• Speech-related conditions
• Malnutrition
• Swallowing disorders
• Comorbidities
• Diagnoses tied to reimbursement
• Supporting documentation
• Staff training around PDPM accuracy

The goal is not to code more aggressively.

The goal is to make sure what you are coding is accurate, supported, and defensible.

Melissa Brown breaks this down in the newest episode of Gravity Healthcare Hacks, including what SNF leaders should be reviewing now as CMS evaluates case mix patterns under the FY 2027 SNF Proposed Rule.

05/04/2026

SNF Operators: Don’t Sit Out the Proposed Rule Comment Period

The FY 2027 SNF Proposed Rule could have a serious impact on skilled nursing operators.

And this is not the moment to stay quiet.

If the proposed changes would affect your building, your reimbursement, your therapy program, your nursing resources, or your ability to care for residents, CMS needs to hear that from you.

But general frustration is not enough.

The strongest comments will be backed by real facility-level data:

• Therapy minutes
• Nursing hours
• Actual comorbidities
• Cost increases
• Utilization patterns
• The operational impact of potential cuts

Let the data speak for you.

The comment deadline is June 1, 2026.

If you operate SNFs, this is not optional.

Watch the full episode of Gravity Healthcare Hacks to hear Melissa Brown break down the FY 2027 SNF Proposed Rule and what operators should be watching now.

04/10/2026

👉 Most healthcare AI isn’t improving the bottom line.
👉 And most operators don’t realize why.

Everyone is talking about AI in healthcare right now.

But here’s what we’re actually seeing on the ground:

Most of it isn’t improving the bottom line.

Not because AI doesn’t work—but because most of what’s being sold as “AI” isn’t built to change behavior.

It gives you data.
It gives you dashboards.
It gives you insights.

But it doesn’t tell your team what to do next.
And it doesn’t make sure they actually do it.

That’s where it breaks.

We’ve seen organizations invest in multiple AI tools…
only to have them used for a few weeks, then completely ignored.

Meanwhile, nothing changes operationally.

If the data doesn’t lead to action, it doesn’t matter.

In this video, Melissa breaks down:

Why most healthcare AI tools fail to improve ROI
The difference between data and actionable insight
What to look for before investing in any AI platform

Curious—what AI tools have you tried that didn’t deliver?

03/03/2026

Is your rehab program truly performing — or just getting by?

In this month’s episode of Gravity Healthcare Hacks, Melissa and Carly break down what we’re seeing inside therapy departments right now — from declining functional outcomes and underused group therapy to the real risks of going in-house without proper oversight.

If you’re questioning your contract therapy model, considering an in-house transition, or simply wondering whether rehab is aligned with your strategic goals, this episode will give you practical insight.

02/27/2026

PDPM Medicaid changed more than reimbursement.
It changed therapy timing.

Screening and referral strategies that made sense before can now work against your reimbursement and documentation.

For many organizations, the biggest shift is how Section GG impacts CMI.

In most states, Medicaid reimbursement is now driven by nursing (and sometimes NTA) — not therapy. That makes accurate functional coding more important than ever.

It also means therapy involvement has to be strategic.

When therapy engages too early, improvements may be resolved before they’re captured.
When it engages too late, declines may be missed.

Timing now matters in a way it never did before.

▶ Watch this to understand how PDPM Medicaid is reshaping therapy screening and referral strategy.

02/25/2026

“Click it and move on” is not an MDS strategy.

In many buildings, documentation flows straight from the EMR into the MDS.
Auto-populated.
Accepted.
Submitted.

But when Section GG data isn’t questioned, reviewed, or understood, problems follow.

Declines get missed.
Improvements get overstated.
Coding errors quietly become reimbursement and care planning decisions.

Savvy MDS coordinators make a huge difference.

When the numbers don’t make sense, they ask questions.
They verify documentation.
They loop in nursing and therapy when something looks off.

Because inaccurate data doesn’t just affect reimbursement —
it affects the resident.

▶ Watch this to see why MDS accuracy and Section GG awareness matter more than ever.

02/23/2026

PDPM changed therapy.
PDPM Medicaid flipped the board.

For many organizations, contract therapy’s last major financial value was its ability to help drive CMI.

That era is ending.

In most states, therapy can no longer meaningfully influence reimbursement on the long-term care side. The model has shifted back to what it was always supposed to be about: the clinical complexity of the resident.

That’s a massive change in incentives.

And it raises an important question for operators:
If therapy is no longer driving reimbursement the way it once did, how should its value be evaluated now?

▶ Watch this to understand why PDPM Medicaid is reshaping therapy strategy across senior living and skilled nursing.

02/20/2026

Yes, therapy minutes needed to change under PDPM.

Most operators understand that.

There was some artificial inflation under the old system.
Minutes were never meant to be a rigid, one-size-fits-all number.

Clinical care lives in a range — not a fixed daily quota.

But what we’re seeing now isn’t just an adjustment.
In many buildings, therapy minutes have been slashed.

Not because residents suddenly need less care.
But because the reimbursement model no longer supports the old contract therapy economics.

And when margins disappear, focus shifts elsewhere — often toward Part B.

The real question isn’t whether minutes came down.
It’s whether they’ve come down too far.

▶ Watch this to understand how PDPM reshaped therapy minutes — and why it matters for skilled patients.

02/18/2026

Here’s a simple therapy gut check.

Do you know your average therapy minutes per skilled patient per day?

If it’s below 30 minutes, you should be concerned.

That doesn’t automatically mean something is wrong — but it absolutely means it’s time to investigate.

And here’s the hard part many operators discover:
Asking your contract therapy provider for more minutes doesn’t guarantee anything will change.

We’ve seen buildings request improvements… hear the right promises… and then see no real difference.

Minutes, outcomes, and incentives have all shifted under PDPM.
If you’re not actively measuring and questioning what you see, it’s easy to assume everything is fine.

▶ Watch this for a practical therapy gut check every operator should know.

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