How Focused Post Acute Care Partners Reduced Medicaid DSO to 19 Days

Focused Post Acute Care Partners (Focused) is a Texas-based skilled nursing operator with 25 facilities. For several years, Focused Post Acute Care Partners faced significant write offs from the Medicaid Pending line of business. Their challenges stemmed from two core operational issues: late submission of Medicaid Pending applications and growing list of held claims due to billing issues.

Before CoreCare, documentation for Focused’s Medicaid applications lived across emails, physical files, and spreadsheets, making it difficult to track the status of each application, especially when staff turnover occurred. “When someone left a building, all their knowledge went with them. There was no easy way to pick up where they left off,” said Jeannie Carlson, VP of Revenue Cycle at Focused.

Additionally, their Medicaid billing process was highly manual. Billers and business office staff had to compare each patient’s TMHP (Texas Medicaid & Healthcare Partnership) or SimpleLTC Medicaid eligibility record, often printed out in bulk, with PointClickCare (PCC). Any discrepancy in RUG levels, patient
liability, or personal data could delay billing or result in claims denials. Their team was often spending more than four full days preparing for each billing cycle and working overtime on billing days.

Focused also faced ongoing challenges with tracking and managing 3618 forms across facilities. Teams manually verified each submission through TMHP, leading to missed updates and gaps that put Medicaid billing at risk.

Focused Post Acute Care Partners implemented CoreCare to automate revenue cycle and business office operations, streamline Medicaid billing and 3618 tracking, and ensure accurate calculation of patient-applied income.

The impact was immediate.

“Our billers used to stay until 8 p.m. on billing days – with CoreCare, they were out by 3:30 and no one’s stressed.” The platform enabled automatic cross-checking of Medicaid eligibility data against PCC records, with real-time alerts for errors in data mismatches, RUG levels, patient liabilities, or missing information. “Everyone can see what’s missing, follow up faster, and work together without the back-and-forth emails. That’s the beauty of it.”

Focused also implemented bi-weekly Medicaid Pending meetings across the organization, using CoreCare as the central platform to track applications, share notes, and hold staff accountable. According to Carlson, “CoreCare is the bible. You have to use it. It’s the only way to know what’s going on.”

The improvements enabled Focused to slash its Medicaid DSO. In 2021, the organization was averaging 35 days; by the end of 2024, that figure had dropped to just 20. By 2025, DSO had reached a low of 19. Perhaps the most striking improvement was the reduction in Medicaid Pending write-offs. After implementing CoreCare, Focused was able to slash write-offs by 60% for Medicaid Pending recipients, a $1M+ impact to the bottom line. This allowed them to increase census and accept more Medicaid residents – ensuring that the filing of 3618 forms consistently occurred so reimbursement was never at risk.

“The difference is massive,” according to Carlson. “Now we have notes, visibility, and accountability. If I want to check on a patient, I just go into CoreCare. I don’t need to send an email or wait for someone to respond. We were even able to reduce our team from four billers to three without any loss in productivity. And with nursing now using the system too, we have clinical and financial documentation in one place.”

In addition to the product itself, Carlson attributes CoreCare’s customer support to the success of the implementation. “The help button is like a genie. Someone always responds immediately. Out of all the systems I’ve worked with in 26 years, CoreCare has the best customer service I’ve ever experienced.”