Clinical reimbursement has become one of the most strategic functions within skilled nursing. As providers navigate evolving Minimum Data Set (MDS) requirements, increasing regulatory oversight, Medicare Advantage complexities, Quality Measures, and growing documentation expectations, reimbursement leaders are playing an increasingly critical role in protecting both resident outcomes and organizational performance.
Recent findings from the U.S. Department of Health and Human Services Office of Inspector General reinforce these challenges. A June 2026 report found that while Medicare Advantage organizations denied 12% of skilled nursing facility admission requests, 95% of appealed denials were ultimately overturned, highlighting the importance of accurate documentation, interdisciplinary collaboration, and reimbursement expertise in today’s post-acute care environment.
Recognizing the growing importance of clinical reimbursement leadership, Everest Management Solutions (EMS) has promoted Kristin Crouch, RN, RAC-CT, to Vice President of Clinical Reimbursement.
Since joining Everest in December 2024 as Director of Clinical Reimbursement, Crouch has become an integral member of the organization’s leadership team, helping providers strengthen reimbursement accuracy, regulatory compliance, clinical documentation, Quality Measures, and survey readiness.
With more than 20 years of long-term care experience, Crouch began her career as a certified nursing assistant before becoming a Registered Nurse in 2008. A RAC-CT-certified professional, she has spent more than a decade specializing in MDS and clinical reimbursement, leading reimbursement optimization initiatives, navigating Additional Documentation Requests (ADRs), improving documentation practices, and educating interdisciplinary teams across multiple states. Her operational background allows her to bridge clinical excellence with financial performance, helping providers build sustainable processes that improve both resident outcomes and reimbursement integrity.
“Kristin exemplifies the type of leader we strive to build at Everest,” said Elizabeth Thornton, Chief Operating Officer of Everest Management Solutions. “Her clinical knowledge, operational perspective, and commitment to educating others have had an immediate impact on our clients and our team. She approaches every engagement with integrity, collaboration, and an unwavering focus on helping providers succeed while improving outcomes for the residents they serve. This promotion is well deserved, and I look forward to seeing the continued impact she will make in this new leadership role.”
As Vice President of Clinical Reimbursement, Crouch will continue leading Everest’s clinical reimbursement services while expanding education, operational support, reimbursement strategy, and regulatory consulting for skilled nursing providers nationwide.
“From the beginning, Everest was built on the belief that our clients deserve experienced operators who have lived the challenges they face every day,” said Issac Perlstein, Founder of Everest Management Solutions. “Kristin exemplifies that philosophy. Her deep clinical reimbursement expertise, combined with her commitment to developing leaders and strengthening operations, has made her an integral part of our team. As reimbursement models and regulatory expectations continue to evolve, Kristin’s leadership will further enhance our ability to help providers achieve clinical excellence, operational stability, and long-term financial success.”
Everest Management Solutions provides operational leadership, clinical consulting, regulatory support, turnaround management, due diligence, and strategic advisory services for skilled nursing, senior living, and post-acute healthcare organizations nationwide.