It’s fitting that the most-read Skilled Nursing News story of 2022 was about rethinking the MDS coordinator role, because this article combines two themes that dominated the year: staffing and payment.
Much SNN coverage this year focused on the extent of the staffing crisis, initiatives to overcome challenges, how various job roles are changing, and the potential effects of a federal staffing minimum floated in the Biden Administration’s sweeping package of proposed reforms.
Payment is always a hot topic, but historically high inflation and a “shocking” proposed Medicare cut raised the stakes in 2022. Providers breathed a sigh of relief when CMS decided to phase in PDPM cuts — but it was a winding saga.
The stories below recap these issues and others that arose during a tumultuous year, and help set the stage for what is to come in 2023.
1. Staffing Shortages Lead Nursing Homes to Rethink MDS Coordinator Role
Publish date: May 15
Key quote:
“If you peek into the MDS Coordinator Facebook groups, you’ll find several groups, and hardly a day goes by that somebody isn’t asking questions about how to get a remote job or how to convince their their owner-operator administrator that they could do a better job from home because of the distractions in a facility.” — Wendy Strain, Director of Consulting Services, Polaris Group
Further reading:
Some SNFs ‘Months Behind’ on MDS Assessments as New Opportunities to Outsource Role Grow
All Hands on Deck: How Staffing Pressures Have Challenged Overextended MDS Coordinators
‘It’s Just Transformative’: MDS Changes Raise Medicaid Payment Questions
2. Biden’s Call For Marijuana Reform Could Be Turning Point for Skilled Nursing Facilities
Publish date: October 31
Key quote:
“I think that by reclassifying it, it would significantly open the door to insurers covering it. And we would see an increase in its use in our population.” — Hebrew Home at Riverdale Medical Director Zachary Palace
Further reading:
Marijuana Shows Early Promise in Skilled Nursing, and Future Residents May Expect Access
3. Members of Congress Urge White House to Investigate Price Gouging From Staffing Agencies
Publish date: January 26
Key quote:
“Providers have had no choice but to turn to direct care staffing agencies due to the workforce crisis, and agencies are exploiting the situation by charging exorbitant rates. We implore the federal government to investigate this matter urgently.” — AHCA/NCAL letter
Further reading:
Nursing Homes Struggle with Cost Inflation, Other Effects from Staffing Agency ‘Gold Rush’
Majestic Care Removes ‘Agency Crutch’ with Aggressive Staffing Campaign, Worker Pool
Nursing Homes See Movement on Staffing Agency Reform
Nursing Homes Pay ‘Exorbitant’ Agency Costs to Comply With Staffing Minimums
Pennsylvania SNF Operators to See New Staffing Agency Regulations After Bill Becomes Law
4. Nursing Homes Fill the Skills Gap Left By Training Shortfalls, Accelerated Programs
Publish date: June 23
Key quote:
“They’re coming to us and they’re terrified because they’ve literally never had any experience outside the classroom. I can’t even begin to imagine what that would feel like as a new nurse, never having seen a patient in the bed until now. They’re suddenly expected to have a few days of orientation and then take care of people.” — Cheryl Townsend, senior director of clinical education at Brickyard Healthcare
Further reading:
Wisconsin’s $6M CNA Training Investment Could Serve as Model For Other States
Addressing the Nursing Home Workforce Shortage by Returning Training Flexibilities to TNAs
‘Proof is There’: Successful Skilled Nursing Staffing Initiatives By the Numbers
Publish date: November 21
“You’ve got it on both ends. You’ve got the younger leaders who aren’t necessarily being driven out of the profession, but they’re being asked to do twice as much as they had expected when they first came in. Then you have the others that have been through quite a bit of battles over the years and this is just the straw that broke the camel’s back, so to speak.” — Bob Lane, president and CEO of the American College of Health Care Administrators (ACHCA)
Further reading:
Nursing Home Administrator Hiring, Retention Challenges Deepen Industry Labor Struggles
Providence Group CEO: Nursing Homes Must Become a ‘Destination Location’ For Leaders
6. CDC: Some Nursing Homes Can End Indoor Mask Requirements
Publication date: September 25
Key quote:
“After more than two years, residents will get to see more of their caregivers’ smiling faces, and our dedicated staff will get a moment to breathe.” — Holly Harmon, AHCA/NCAL Senior Vice President of Quality, Regulatory & Clinical Services
Further reading:
SNF Operators Cautious Over CDC Mask Changes Amid Regulatory Whiplash, Fatigued Staff
Publication date: April 11
Key quote:
“We think [the] PDPM cut, if implemented, would weigh on SNF margins for the next 18 months, and is particularly ruinous for operators that are already struggling.” — Stifel analysts
Further reading:
Proposed Medicare Funding Cuts ‘Exponentially Shocking’ to SNF Operators
Congressional Leaders Urge CMS to Phase-In Proposed Medicare Cuts to Nursing Homes
[UPDATED] CMS Final Rule Gives Nursing Homes 2.7% Pay Bump, PDPM-Related Cuts to Be Phased In
8. [UPDATED] White House Unveils Major Nursing Home Reform Package, Targets Private Equity Ownership
Publication date: February 28
Key quote:
“Too often, the private equity model has put profits before people — a particularly dangerous model when it comes to the health and safety of vulnerable seniors and people with disabilities.” — White House fact sheet
Further reading:
‘Stop Blaming Nursing Homes’: Biden’s Proposed Reforms Garner Mixed Reactions
CMS in ‘Full Court Sprint’ to Carry Out Biden’s Nursing Home Reforms
CMS Works to Further Reduce Inappropriate Medication Use in Nursing Homes as Part of Biden Reforms
Biden Nursing Home Agenda Progresses as Industry Prepares for 2023
Forbes’ Gleckman: Biden’s PE Ownership Scrutiny is ‘Two Beats Behind’
9. Why Skilled Nursing Providers Must Embrace the DON of Tomorrow
Publication date: May 19
Key quote:
“The DON of tomorrow that is trying to move past Covid really needs to take a step back and take a look at work practices … not being afraid to take a risk every now and then, an intelligent risk – trying something new to provide that better care.” — North Shore Healthcare Chief Clinical Officer Tina Belongia
Further reading:
Future of the CNA: Nursing Home Reform Efforts, Staffing Crisis Drive Changes in Key Role
The Workforce Linchpin: Nursing Home LPN Role Weaves Together Resident Knowledge, Clinical Expertise
LPNs Are Asking For Leadership Positions and Staff-Strapped Operators Are Happy to Comply
Rethinking the Role of the Nursing Home CEO
10. The Case For And Against a Nursing Home Industry Crisis
Publication date: July 25
“[It’s] easy in this industry, because there are so many stresses from many directions, to feel like you’re always in crisis.” — Cantex Continuing Care Network Principal and Managing Partner Peter Longo
Further reading:
As Labor Crisis Complicates Care Transitions, Hospitals Work to Alleviate SNF Referral Backlog
Nursing Home Staffing Shortage is a ‘Crisis on Top of a Crisis’
‘We’re Hurting Big Time’: Medicare Therapy Cut Worsens SNF Staffing Crisis, Care Access
Nursing Home Closures Hit Smaller Markets as Financial, Staffing Crisis Deepens Across Industry
