Optimizing Medicaid Reimbursement Rates as Changes in Condition Occur


Safe Haven Healthcare

Pocatello, Idaho

Scott Burpee, President

Rebecca Taylor, CFO


Safe Haven Health Care is a division of CareFix, Inc., a health care consulting and management firm. Lead by Scott Burpee and Rebecca Taylor, who have 40 years of combined experience with skilled nursing, assisted-living, and mental wellness, and with facilities throughout central and southeast Idaho. 


Safe Haven Health Care operates 12 assisted living communities in Southern and Eastern Idaho. The residents are predominantly funded by Medicaid and Safe Haven management was looking for a way to make sure they were being properly reimbursed as resident acuity increased.

Vitals Role and Resolution

Safe Haven Health Care was able to provide the actual assessment used by Medicaid and have Vitals replicate it into an automated format within the interface. As Medicaid funded residents have a change in condition that increases their service level, Safe Haven is now able to perform their own re-assessment in Vitals to determine if there is an increase in acuity that would warrant a higher reimbursement rate. Once this is determined, Safe Haven proactively contacts the Medicaid office to request a formal re-assessment.

This process improvement gave Safe Haven an improved tool to manage their residents’ changes in condition. It also reduced the amount of time it took to have a formal Medicaid re-assessment completed and ultimately optimized their Medicaid reimbursement rates accordingly.



  • Replicated the Medicaid assessment in Vitals so internal re-assessments could be performed in real time

  • Determined if a resident’s change in condition warrants a formal request for a Medicaid re-assessment

  • Improved Medicaid re-assessment timeframe

  • Reduced delays in reimbursement rate increases from Medicaid

  • Optimized Medicaid reimbursement rates in real time as resident care levels increased