Client Snapshot
Organization Type
Large Skilled Nursing Facility (SNF) operator with over 100 facilities nationwide.
Scope of Services
• Focused turnaround for Medicaid Pending and Private Pay issues in 4 underperforming facilities
• Training and implementation of oversight team to manage external RCM vendor
• Workflow redesign, admissions screening, and resident engagement
• Strategic oversight of billing partner performance and accountability
The Challenge
The client, a major SNF operator, was facing record-high Medicaid Pending and Private Pay balances. Their third-party RCM vendor lacked the oversight and process rigor needed to manage these complex accounts, leading to millions in aging receivables and ongoing financial leakage. Kaizenleap was brought in to turn around four of the worst-performing facilities and train an internal team to manage the vendor long term.
Our Role: Turnaround + Transition to Oversight Model
Kaizenleap led a dual-track initiative: we implemented immediate hands-on corrections at the facility level while simultaneously building a team to take ownership of the relationship with the billing vendor. By improving coordination, front-end processes, and documentation readiness, we restored cash flow and prevented future exposure.
Key Areas of Focus
Facility-Level Turnaround
• Took direct control of Medicaid Pending and Private Pay workflows at four of the worst-performing facilities
• Initiated weekly meetings with facility staff and the RCM vendor to ensure accountability and real-time problem-solving
Oversight Team Development
• Trained and mentored a new corporate team tasked with long-term oversight of the third-party billing company
• Held separate review sessions to coach the team on red flags, escalation protocols, and process metrics
Admissions Risk Management
• Partnered with the corporate admissions team to screen for Medicaid or Private Pay risk prior to admission
• Developed escalation paths to flag high-risk admits before they became financial liabilities
Resident and Family Engagement
• Met with patients and families to understand delays in Medicaid application submissions
• Identified a key issue: during COVID, many residents were granted blanket approvals, but current renewals now required full reapplication. Many families were unprepared
Proactive Medicaid Preparation
• Audited all current residents to identify those nearing Medicaid renewal
• Started collecting and preparing documentation well in advance, preventing disruptions and denials
What We Delivered
| Deliverable | Impact |
| On-Site Facility Turnaround | Stabilized cash flow and cleaned up Medicaid and Private Pay receivables at 4 facilities |
| Medicaid Application Strategy | Rebuilt workflows to anticipate and manage renewal complexities |
| Internal Oversight Team | Trained corporate staff to manage the RCM vendor long-term and prevent regression |
| Risk-Based Admission Screening | Reduced future exposure by screening and escalating risky admits early |
| Resident Engagement Protocols | Improved family responsiveness and documentation submission rates |
Results
• 10x ROI in 6 Months: Within six months, Kaizenleap helped recover over 10x the cost of our engagement
• Sustainable Oversight Model: Internal team now provides effective oversight of the external billing vendor
• Future-Proofed Medicaid Process: Application delays are now anticipated and proactively managed
• Private Pay Enforcement: Improved collection discipline and early family communication reduced aging balances
• Organizational Insight: Shared key findings with leadership to replicate success across remaining facilities
Why It Worked
Kaizenleap’ s combined approach (direct problem-solving at the frontlines while building corporate capability behind the scenes) created both immediate results and long-term protection. We didn’t just fix the billing breakdown; we helped the operator redesign how it governs its outsourced revenue cycle, preventing future losses at scale.