Posts by Alex Spanko:

  • Skilled Nursing Facilities Rank Low on Operators’ Investment Wish Lists

    Jul 09 2018

    Skilled nursing facilities lag far behind home health and other long-term care settings among providers’ investment outlooks, according to a new survey of major health care providers. Just 12% of organizations surveyed by consulting and advisory firm BDO said they were making investments in skilled nursing care as part of their two-year plan to 2020 Read More

  • Ripples of CVS, Amazon Deals Could Eventually Reach Skilled Nursing

    Jul 02 2018

    The recent megadeals involving popular consumer brands and health care giants haven’t touched skilled nursing yet, but the moves are sending ripple effects through the industry as a whole — and SNF providers would be wise to listen up. When CVS acquired insurance giant Aetna and Amazon teamed up to form a health care company with Read More

  • ‘Big Enough to Matter’: Finding the Sweet Spot of Skilled Nursing Scale

    Jun 28 2018

    If there’s been one overarching philosophy in skilled nursing over the past year, it’s been the rise of regional: the idea that major chains aren’t nimble and and flexible enough to weather the regulatory changes and financial pressures that have gripped SNFs. It’s a theory that has been borne out by reality: Kindred Healthcare (NYSE: Read More

  • How Skilled Nursing Providers Can Win Under Value-Based Purchasing

    Jun 27 2018

    Skilled nursing facilities have until October to prepare for the new Value-Based Purchasing (VBP) model, and the stakes are high: Starting this fall, SNFs will automatically lose 2% of their Medicare funding, which they can earn back by hitting certain key quality benchmarks. Providers that have already participated in risk-based accountable care organizations (ACOs) will Read More

  • ‘There’s No More Money Out There’: Fighting Over a Finite Pool in Managed Care

    Jun 26 2018

    It’s 4 p.m. on a Friday evening, and a patient at an acute care hospital needs a referral to a skilled nursing facility. Even if the hospital has a phone-book-sized list of all the different providers in the area who accept a specific managed care health plan, the reality is much narrower. “Our care management Read More

  • Bundled Payment Lessons Still Relevant for Skilled Nursing Providers

    Jun 25 2018

    In a post-acute landscape dominated by the rise of Medicare Advantage and the looming changes to therapy payments, the Bundled Payments for Care Improvement (BPCI) program has fallen somewhat by the wayside. That’s partially because post-acute providers — including skilled nursing operators and home health agencies — can no longer be episode initiators under the upcoming BPCI Read More

  • CMS Launches New Database Aimed at Breaking IT Barriers Between Providers

    Jun 24 2018

    The Centers for Medicare & Medicaid Services last week announced a new database that its leaders claim will help foster a more seamless transfer of data between post-acute care facilities. The Data Element Library (DEL) will allow the public to access various data points that providers are required to report to CMS — including demographic Read More

  • QCP Sets Date for Welltower Vote, Sees Skilled Nursing Woes Through 2020

    Jun 21 2018

    Quality Care Properties (NYSE: QCP) has set a date for shareholders to vote on its proposed acquisition by Welltower Inc. (NYSE: WELL) and the ProMedica hospital system — and despite rumblings about a potentially better offer, QCP continues to tell shareholders to approve the deal. The real estate investment trust (REIT) will convene a meeting Read More

  • What Skilled Nursing Could Learn from the Manufacturing Sector

    Jun 20 2018

    As skilled nursing occupancy continues to notch record low after record low, strategies to capitalize on the shrinking pool of residents remain top concerns for operators and investors. And at least one analyst says providers should look to the kind of operational improvements that have helped keep afloat another struggling industry: manufacturing. “It’s your labor Read More

  • Ensign Group Buys Office Building in California

    Jun 20 2018

    The Ensign Group (Nasdaq: ENSG) this week announced the acquisition of a new office building for its Service Center employees. The 115,000-square-foot space in San Juan Capistrano, Calif. will replace a leased space in Mission Viejo, Calif., where the skilled nursing provider is currently based. “After considering dozens of possibilities over the last 18 months, Read More

  • SunTrust Sees Upside to Increasing Skilled Nursing Regionalization

    Jun 19 2018

    The Atlanta-based SunTrust Banks (NYSE: STI) last week announced a nationwide expansion of its Aging Services/Senior Living Practice group, with an eye on the emerging trends in the skilled nursing space. First launched on a regional basis in the Southeast about four years ago, the senior-specific group has seen the increasing regionalization of the skilled Read More

  • Data Drives Skilled Nursing Referral Partnerships, But Residents Ignore It

    Jun 18 2018

    As referral networks narrow and skilled nursing providers feel increased pressure to prove their worth to hospitals and doctors, one government agency says residents still frequently miss the highest-quality options in their own areas. In its most recent report to Congress, the Medicare Payment Advisory Commission (MedPAC) asserts that many hospitals discharge post-acute care patients Read More

  • Everything You Know About Skilled Nursing Hiring is Wrong

    May 22 2018

    Hiring and retaining talented skilled nursing employees remains one of the biggest challenges for operators in the industry, especially for key frontline nursing positions. Amid these pressures, hiring managers might be tempted to rely on their instincts when selecting from potential candidates — but two health care staffing experts say in many cases, conventional hiring Read More

  • Report Accuses New Mexico of Nursing Home Woes as Medicaid Lags

    May 22 2018

    The state of New Mexico ranks at the bottom in terms of serious skilled nursing deficiencies per facility, according to a recent analysis conducted by a pair of news organizations. Out of the 74 facilities in the state certified by the Centers for Medicare & Medicaid Services, 36 had “serious deficiencies” between 2015 and 2018, Read More

  • Welltower Updates Investors on Impending QCP, ManorCare Deal

    May 21 2018

    Welltower, Inc. (NYSE: WELL) on Monday provided a brief update to shareholders on the company’s coming acquisition of Quality Care Properties (NYSE: QCP), the real estate investment trust (REIT) primarily associated with struggling skilled nursing provider HCR ManorCare. The update, submitted as a filing with the Securities and Exchange Commission, affirms Welltower’s commitment to ProMedica, Read More

  • Key Skilled Nursing Metrics to Watch as Providers Struggle to Collect

    May 20 2018

    As skilled nursing operators continue to deal with tight reimbursements and high labor costs, financial performance on the individual facility level has taken on greater and greater importance — and having a defined plan is key to success. “It doesn’t matter how much revenue you generate, or how much census goes up, if you don’t Read More

  • State Law Shows Increased Scrutiny of Low-Profile Skilled Nursing Buyers

    May 17 2018

    The state of Vermont recently enacted sweeping changes to the way government officials regulate the nursing home industry, with an eye on scrutinizing out-of-state buyers. Starting July 1, the state’s Agency of Human Services will oversee all nursing home ownership transfers, taking over the responsibility from the Green Mountain Care Board, according to a Thursday Read More

  • Despite Popular Belief, End-of-Life Care Costs on the Decline

    May 17 2018

    The notion that older Americans are driving up health care costs, specifically toward the end of their lives, has become something of a truism in the health policy world. But a new study from Dartmouth has shown that Medicare spending on Americans in their final years actually dropped in the early stretch of this decade. Read More

  • Leaders Declare Senior Care Staffing Crisis in Texas Amid 97% Turnover

    May 16 2018

    Operators of nursing homes in Texas reported 97% turnover for certified nursing assistants, with 90% turnover for other key frontline caregiver positions — promoting leaders in the state to declare a “crisis.” The Texas Health Care Association called for higher Medicaid reimbursement rates to help mitigate the trend in a recent report on its members’ financial Read More

  • Growing Skilled Nursing Operator Sees New Hospital as ‘Beachfront’ Property

    May 15 2018

    Seizing the opportunity to stake out a spot adjacent to a major hospital project, one provider in Maryland decided to build the first new standalone skilled nursing facility that a Washington, D.C. suburb had seen in more than 20 years. The $30 million FutureCare Capital Region facility in Landover, Md. — a town primarily known Read More

  • Five Star’s Skilled Nursing Business Continues to Struggle, Occupancy Tumbles

    May 15 2018

    Five Star Senior Living’s (NYSE: FVE) standalone skilled nursing assets continued to cause headaches for the provider, which saw occupancy and revenues again take a tumble in the first quarter of 2018. Occupancy at the Newton, Mass.-based Five Star’s standalone skilled nursing facilities dropped to 75.7%, or 410 basis points lower than at the same Read More

  • Amid Issues at Home, Genesis Sees Significant Potential in China

    May 13 2018

    Facing headwinds at home, Genesis Healthcare (NYSE: GEN) has embarked on a plan to tap into the nascent post-acute care market in China — with an eye on capturing just a small fraction of the country’s favorable demographic profile. The Kennett Square, Pa.-based skilled nursing provider has been active in China since 2015, when it Read More

  • Genesis: Medicare Advantage Provides Blueprint for New Payment Model

    May 10 2018

    As the skilled nursing industry continues to digest the effects of the new Medicare proposed payment system, one CEO says that Medicare Advantage can provide a path forward. The new Patient-Driven Payment Model (PDPM) isn’t all that different from the way managed Medicare plans expect operators to provide services and bill for their time, Genesis Read More

  • Death of McMaster’s Father Draws Criminal Charges for Rehab Employee

    May 10 2018

    In a case of the skilled nursing and political worlds intersecting, the death of a former Trump administration official’s father has resulted in criminal charges against a nursing home employee. H.R. McMaster Sr., father of former national security advisor H.R. McMaster Jr., died as the result of a fall at a rehabilitation facility at Cathedral Read More

  • $17.5M Mainstreet Facility Faces Foreclosure Before It Opens

    May 09 2018

    An unopened transitional rehabilitation facility developed by Mainstreet is facing foreclosure after the company fell behind on monthly interest payments. Avana Capital, an Arizona-based commercial lender, last week moved to foreclose on the $17.5 million Healthcare Resort of Wichita in Kansas, according to a Wednesday report in the Wichita Eagle. The 94-bed facility had initially Read More

  • Omega Inks New Deal with Signature, Sees Hot Local M&A Market

    May 08 2018

    One day after Sabra Health Care REIT (Nasdaq: SBRA) announced a major restructuring deal with skilled nursing provider Signature HealthCARE, fellow real estate investment trust (REIT) Omega Healthcare Investors (NYSE: OHI) followed with an agreement of its own. The Louisville, Ky.-based Signature had fallen about $25 million behind on its rent payments to Omega by Read More

  • ProMedica-ManorCare Deal May Affirm Skilled Nursing’s Future in Senior Living

    May 08 2018

    The splashiest skilled nursing deal of the year portends better things to come for the industry as a whole, according to the leader of one prominent senior living real estate investment trust (REIT). National Healthcare Investors (NYSE: NHI) CEO Eric Mendelsohn touted the recent $1.95 billion acquisition agreement between Welltower Inc. (NYSE: WELL) and Quality Care Properties (NYSE: QCP) Read More

  • Sabra Restructures Leases with Signature, Extends $12M Loan

    May 07 2018

    After hinting at a possible solution earlier this year, Sabra Health Care REIT (Nasdaq: SBRA) has reached a deal to restructure its lease agreements with troubled tenant Signature HealthCARE. Signature on Monday entered into an 11-year lease with the Irvine, Calif.-based real estate investment trust (REIT), with options for three five-year extensions. Sabra will collect Read More

  • Providers Need to Look Beyond State Borders to Find Workforce Surpluses

    May 07 2018

    As skilled nursing and other long-term care providers continue to grapple with a persistent workforce shortage, one solution could lie in strategic recruitment outside of an operator’s normal footprint. While macro-level trends show a substantial nurse and health care support worker shortage that will only get worse as the population ages, not all markets are Read More

  • CEOs Upbeat About New CMS Skilled Nursing Payment Rules

    May 03 2018

    Industry experts are still sorting out the long-term effects of the Centers for Medicare & Medicaid Services’ (CMS) new payment system for skilled nursing facilities, but early reviews from the CEOs of some top providers have been positive. “I would say the rule that was just published is a positive for the industry,” Genesis Healthcare Read More

  • Ensign Points to Managed Care Growth as Reason for Occupancy Gains

    May 03 2018

    The Ensign Group (Nasdaq: ENSG) reported sunny skilled nursing stats during the first quarter of 2018, with strong gains in both revenue and occupancy. The Mission Viejo, Calif.-based operator pulled in $46.2 million in income from its transitional and skilled services channel, a boost of 45.3% from the first quarter of 2017 and a 15.7% Read More

  • Proposed Medicare Change Would Create Long-Term Care Benefit

    May 02 2018

    A federal lawmaker on Wednesday rolled out a plan to provide a long-term care benefit as part of Medicare, citing the aging U.S. population and skyrocketing costs. Rep. Frank Pallone, a New Jersey Democrat, unveiled the Medicare Long-Term Care Services and Supports (LTSS) Act, a discussion draft of a bill that would expand Medicare coverage Read More

  • Nobody Applies to More than Half of Long-Term Care Jobs in Wisconsin

    May 02 2018

    Long-term care operators around the country have dealt with a lack of qualified workers for some time now, and leaders in one Midwestern state say it’s escalated to a full-blown crisis. Nearly 20% of caregiver positions in Wisconsin are currently unfilled, as compared to about 14.5% just two years ago, according to a report released Read More

  • New Skilled Nursing Payment Plan Shows CMS Listened to Providers

    May 01 2018

    The Centers for Medicare & Medicaid Services (CMS) shook the skilled nursing world last week by rolling out a proposal for a new payment model, replacing the structure that the industry had been anticipating for a year. But several experts say that operators should look at the changes as positive updates made with providers in Read More

  • ManorCare Deal Validates Skilled Nursing’s Future, Highlights Real Estate Troubles

    Apr 30 2018

    Welltower (NYSE: WELL) and ProMedica’s blockbuster deal for skilled nursing chain HCR ManorCare and its landlord cements the setting’s place in the future of long-term care, at least according to one prominent ratings firm. “[The deal] supports Fitch Ratings’ view that skilled nursing will have a place on the continuum of care, despite the subsection’s Read More

  • In a Regional Era, ProMedica and Welltower Go National with QCP, ManorCare

    Apr 29 2018

    The refrain from the top leaders in the skilled nursing space has been that the industry is a regional game: Control a limited number of high-quality facilities in a confined area, the thinking goes, and an operator can win by successfully embedding itself in the local reimbursement and regulatory landscape. Late Wednesday night, two of Read More

  • CMS Overhauls Skilled Nursing Payment Plan, Increases Rate by $850 Million

    Apr 27 2018

    The Centers for Medicare & Medicaid Services (CMS) on Friday unveiled a new proposed model for skilled nursing reimbursements that the agency says will save providers $2 billion over the next decade. The proposed Resident Classification System, Version I (RCS-I) is out, and the Patient Driven Payment Model (PDPM) is in, with an effective start Read More

  • Welltower, ProMedica Look to ‘Reinvent’ Skilled Nursing with QCP Deal

    Apr 26 2018

    After seeing major players like Humana and TPG Capital take billion-dollar bets on vertical health care integration, Welltower Inc. (NYSE: WELL) is getting in on the action as well. Shankh Mitra, the real estate investment trust’s (REIT) senior vice president of investments, specifically cited those companies — which recently teamed up to buy Kindred Healthcare’s Read More

  • QCP Frames ManorCare, Welltower Deals as Best Options Amid Turmoil

    Apr 26 2018

    When Welltower Inc. (NYSE: WELL) and ProMedica announced their deal to acquire Quality Care Properties (NYSE: QCP) — and, by extension, skilled nursing giant HCR ManorCare — the move was a strategic splash designed to shake up the long-term landscape. For QCP, however, it was simply the best way to play a less-than-ideal hand. On Read More

  • Welltower, ProMedica Reportedly Eyeing $2B Acquisition of QCP

    Apr 25 2018

    A non-profit health system and a major real estate investment trust (REIT) are reportedly teaming up to buy Quality Care Properties (NYSE: QCP) for $2 billion. The ProMedica hospital system and Welltower, Inc. (NYSE: WELL) have already made that offer, according to sources that spoke to the Reuters news service — which would value QCP at about Read More

  • Skilled Nursing Can Do It Cheaper, But Reputation and Partner Risks Remain

    Apr 24 2018

    Skilled nursing facilities often bear the brunt of negative press surrounding long-term care, and their place in the future of the continuum could rest on changing that reputation in the minds of the public and lawmakers. “We need to get that reputation back, because we are part of the solution,” Celtic Consulting president Maureen McCarthy Read More

  • Orianna Asks for Hold on Lawsuits Against Omega, Others Amid Bankruptcy

    Apr 24 2018

    Lawyers for Orianna Health Systems last week asked a federal court to include landlord Omega Healthcare Investors (NYSE: OHI) and various other parties in a blanket protection against lawsuits during its bankruptcy proceedings. When the 43-facility skilled nursing chain filed for Chapter 11 bankruptcy protection last month, Orianna by default received a stay against all Read More

  • Long-Term Care Providers ‘Clobbered’ by Managed Medicare

    Apr 23 2018

    While the skilled nursing industry worried about the rise of accountable care organizations (ACOs), managed Medicare plans slowly established a firm foothold that isn’t going anywhere soon. “The growth of ACOs and bundled payments has kind of leveled off,” Jill Kreuger, president and CEO of pharmacy and rehab solutions provider Symbria said at LeadingAge Illinois’s Read More

  • N.Y. Operator to Sell Off a Third of Skilled Nursing Facilities

    Apr 22 2018

    Absolut Care, a skilled nursing operator based in upstate New York, will sell off four facilities, reducing its footprint in the area by a third. New operator Personal Healthcare will take over a pair of 40-bed facilities in Eden and Dunkirk, N.Y., along with a 120-bed nursing home in Salamanca and a 100-bed facility in Read More

  • Providers Must Lay Groundwork Now for Coming Payment ‘Game Changer’

    Apr 19 2018

    The Centers for Medicare & Medicaid Services (CMS) hasn’t yet announced complete details about upcoming changes to therapy reimbursements, but that doesn’t mean skilled nursing facilities should wait for word on the sidelines. “In general, we really need to consider redesign — care redesign — because what you’re doing today, and I say that obviously Read More

  • Seniors Increasingly Open to Medical Marijuana Use

    Apr 19 2018

    An overwhelming majority of older Americans support the use of marijuana as directed by a doctor — despite significant barriers to medically supervised cannabis in long-term care. About 80% of adults aged 50 to 80 told a team from the University of Michigan and AARP that they either strongly or somewhat support doctor-overseen pot use, Read More

  • Providers, Residents Must Be Partners with Technology — Not Just Users

    Apr 17 2018

    With the aging population and the expansion of all kinds of senior living settings, smart technology has frequently been identified as a way to make residents’ and providers’ lives easier. But all too often, commercially available tech isn’t designed with seniors’ needs in mind, one researcher noted — and it’s high time that both residents Read More

  • Skilled Nursing Facilities Lose 13% of Referrals to Competitors

    Apr 16 2018

    Skilled nursing admissions are driven largely by referrals from area acute-care settings, but that doesn’t mean that operators can’t look at their marketing efforts the way private-pay senior living providers do. The vast majority of inquiries and admissions to skilled nursing facilities — 87% and 90%, respectively — came from unpaid referral sources in 2017, Read More

  • Bankruptcy Court Approves QCP’s Takeover of ManorCare

    Apr 15 2018

    A federal bankruptcy judge on Friday approved HCR ManorCare’s plan to emerge from bankruptcy under the ownership of its landlord, Quality Care Properties (NYSE: QCP). Judge Kevin Gross of the U.S. Bankruptcy Court for the District of Delaware gave the sign-off on the prepackaged Chapter 11 plan, which will see the Bethesda, Md.-based QCP lose Read More

  • Genesis to Exit Texas, Divest 24 Skilled Nursing Facilities

    Apr 12 2018

    Post-acute giant Genesis Healthcare, Inc. (NYSE: GEN) will completely exit the skilled nursing space in Texas, selling 23 facilities and transferring operations of a 24th by the middle of this year. The Kennett Square, Pa.-based operator announced the deal late Wednesday night, with the buyer identified as Regency REIT, LLC. That New York City-based real Read More

  • HHS, CMS Object to Ownership Transfers in Orianna Bankruptcy

    Apr 11 2018

    The Department of Health and Human Services (HHS) filed an objection to Orianna Health Systems’ bankruptcy plan, bringing the case into unsettled legal terrain. U.S. Attorney Erin Nealy Cox this week argued that HHS and the Centers for Medicare & Medicaid Services (CMS) have the ultimate control over the legal issues surrounding the transfer of Read More

  • Using Medicare to Pay Care Coordinators — And Reduce Readmissions

    Apr 10 2018

    The role of the care coordinator has frequently been floated as a way skilled nursing providers can navigate the new value-based care landscape. By creating a position that’s solely focused on guiding residents through the transitions that occur on the long-term care continuum, the logic goes, providers can prevent costly hospital readmissions and improve the quality Read More

  • Former Long-Term Care CEO to Lead CMS Innovation Center

    Apr 09 2018

    The Center for Medicare & Medicaid Innovation (CMMI) has a new director. Adam Boehler, founder and former chief executive officer of home health provider Landmark Health, was named CMMI director — a position that also comes with the title of deputy administrator — by Department of Health and Human Services Secretary Alex Azar. Azar has Read More

  • Kindred Shareholders Approve Sale to Humana, Private Equity Firms

    Apr 05 2018

    Shareholders of Kindred Healthcare (NYSE: KND) on Thursday approved the sale of its home health business to insurance giant Humana Inc. (NYSE: HUM) and a pair of private equity firms. The Louisville, Ky.-based post-acute provider announced the $4.1 billion deal last December, a few months after it began its planned exit from the skilled nursing Read More

  • New Therapy Payments a ‘Game Changer’ for Skilled Nursing Industry

    Apr 04 2018

    Changes to the way Medicare reimburses providers of therapy services will change the game for skilled nursing operators, at least according to one industry analyst. The Resident Classification System, Version I (RCS-I) will replace the current fee-for-service Medicare therapy structure with a model that more closely tracks with larger trends toward value-based services, rewarding providers Read More

  • Bacteria Has Nursing Home Facing Down a $278M Fix

    Apr 04 2018

    A recurring Legionnaires’ disease outbreak at an Illinois nursing home for veterans has caused deaths, lawsuits, and political trouble for Gov. Bruce Rauner. And now a preliminary report shows that fixing the problem at the Illinois Veterans Home at Quincy could stick the state with a hefty bill. Task forces convened by the Rauner administration Read More

  • Walmart’s Health Push: First Home Health, Then Skilled Nursing?

    Apr 02 2018

    Rumors that Walmart (NYSE: WMT) may be interested in acquiring a major health insurance provider — and soon-to-be home health care operator — shook up the long-term care industry last week. And at least one observer says there’s no reason why the retail giant’s reach can’t expand to the skilled nursing industry. The Bentonville, Ark.-based Read More

  • Behavioral Health a Barrier to High-Quality Nursing Care

    Apr 02 2018

    As behavioral health becomes an increasing topic of national discussion, a new study reveals that patients with mental health issues are statistically less likely to be admitted at higher-quality skilled nursing facilities. Led by Helena Temkin-Greener, professor emeritus at the University of Rochester’s Department of Public Health Sciences, a team of researchers set out to Read More

  • Instead of Saving $1.7 Billion, ACOs Cost Medicare $384 Million

    Apr 01 2018

    Accountable care organizations (ACOs) are supposed to represent an innovative way to cut costs and improve care. But a new study found that on at least one of those counts, ACOs may be doing more harm than good. The Medicare Shared Savings Program (MSSP) increased federal spending by $384 million between 2013 and 2016, according Read More

  • Skilled Nursing Facilities Rank Near Bottom of Investors’ Wish Lists

    Mar 29 2018

    When asked which types of properties they were most interested in pursuing in 2018, a diverse group of investors ranked skilled nursing facilities near the bottom. Just 14% of respondents in the CBRE (NYSE: CBRE) U.S. Healthcare Capital Markets Group’s annual Investor & Developer Survey said skilled nursing facilities met their acquisition requirements for 2018. Read More

  • AI in Skilled Nursing Facilities Isn’t Just About Robots

    Mar 28 2018

    Ask any forward-looking senior care expert about what the industry will look like in 30 years, and robots will likely emerge as an answer. Once artificial intelligence (AI) technology advances far enough, the logic goes, the skilled nursing industry could hypothetically solve its persistent staffing problems with cyborg assistants — a solution that’s already gained Read More

  • Japan’s Elder Care Robot Industry Set to Top $3B by 2035

    Mar 28 2018

    Faced with a demographic situation even more dire than the one in the United States, firms in Japan are leading the way in developing robotic solutions to a caregiver shortage — with an eye on cornering the market in the years to come. The overall worldwide market for robotic assistants used in nursing homes and Read More

  • OIG: More Than 60% of Therapy Claims Don’t Meet Medicare Requirements

    Mar 27 2018

    More than 60% of outpatient therapy claims filed over a six-month period didn’t meet Medicare’s requirements — a figure that has a key government watchdog agency concerned. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) looked at a representative sample of 300 Medicare therapy claims filed in the final Read More

  • Bank of America Upgrades Sabra Outlook Amid Senior Housing Push

    Mar 26 2018

    By at least one analyst’s assessment, Sabra Health Care REIT’s (Nasdaq: SBRA) decision to diversify away from skilled nursing facilities has boosted its fortunes. Bank of America Merrill Lynch upgraded the real estate investment trust’s (REIT) stock from “underperform” to “neutral,” with research analyst Juan C. Sanabria pointing to Sabra’s ongoing divestment from properties operated Read More

  • Florida’s Nursing Home Generator Rule Finally Becomes Law

    Mar 26 2018

    After months of legal wrangling and strong feelings on both sides, the state of Florida has finally enshrined its emergency power rules for skilled nursing facilities into law. Gov. Rick Scott on Monday signed a pair of bills that will require SNFs and assisted living facilities to have generators capable of maintaining a temperature of Read More

  • Skilled Nursing Must-Reads: A Nursing Home for Parolees

    Mar 25 2018

    Start your week with a look at some of the most interesting skilled nursing stories from around the web, including a SNF with a unique clientele in Connecticut. SNF that serves parolees wins case A skilled nursing facility that serves prison parolees in the suburbs of Hartford, Conn. won a court ruling this week against Read More

  • Inside Cleveland Clinic’s Skilled Nursing Strategy

    Mar 22 2018

    The Cleveland Clinic followed a familiar path to boost its care coordination efforts, building partnerships with trusted skilled nursing facilities and relying on its own staff to ensure quality. And the Ohio-based health care provider has the results to prove that the model can work. “What our data has told us, and has been consistent Read More

  • To Win Medicare Advantage, Skilled Nursing Must Speak Insurers’ Language

    Mar 21 2018

    With managed plans gobbling up an increasing share of Medicare enrollees, skilled nursing executives need to gain fluency in the language of insurance providers — or risk being left behind. That was the message from a recent panel discussion at the National Investment Center for Seniors Housing & Care (NIC) Spring Investment Forum in Dallas, Read More

  • Ensign Looks to Apply Skilled Nursing Strategy to Assisted Living, Home Health

    Mar 21 2018

    Major skilled nursing provider The Ensign Group (Nasdaq: ENSG) has its sights set on assisted living and home health expansion, citing the potential for higher stockholder value and less competition for their target properties. The company has applied the strategy that executive vice president Chad Keetch said has brought skilled nursing success: vesting significant power Read More

  • Senators Issue Bipartisan Call to Move Away from Fee-For-Service Medicare

    Mar 20 2018

    A pair of United States senators asked new Health and Human Services Secretary Alex Azar to focus on developing alternative payment models for Medicare — while moving away from traditional fee-for-service (FFS) Medicare. “As the largest purchaser of health care in the United States, the federal government needs to send a strong signal that paying Read More

  • Data, Not Donuts: Building Today’s Skilled Nursing Partnerships

    Mar 19 2018

    In the past, nailing down a partnership with a local hospital or home health agency might have simply been a matter of providing the right free breakfast to the right group of hungry administrators. But in a world with shifting payment models and increasing emphasis on outcomes, skilled nursing providers must step up their game with Read More

  • Skilled Nursing Must-Reads: Mainstreet Troubles, Generator Rule

    Mar 18 2018

    Lost in a flurry of news from the National Investment Centers for Seniors Housing & Care (NIC) Spring Investment Forum and harsh funding recommendations from MedPAC, here are some of the stories we couldn’t cover earlier in the week to help get you ready for the one ahead. Mainstreet hits another snag A week after Read More

  • Genesis Posts $89M Loss in Fourth Quarter, Pledges Sunnier 2018

    Mar 16 2018

    Genesis HealthCare, Inc. (NYSE: GEN) lost $89.2 million in the final quarter of 2017 and $579.0 million over the course of last year — numbers that the company continues to blame on the overall skilled nursing landscape. “As health care reform continues to transform the delivery of health care by changing reimbursements and holding providers Read More

  • Skilled Nursing Operators Fighting for Share of Shrinking Medicare Pool

    Mar 15 2018

    The number of skilled nursing stays among Medicare recipients dropped 15% over the last several years — but not necessarily for the reason many in the industry might believe. Instead of lower-cost options like home health cutting into demand for nursing home services, the post-acute sector in general is seeing declines amid an overall drop in Read More

  • MedPAC: Congress Should Cut Medicare Rates for Skilled Nursing Facilities

    Mar 15 2018

    Citing high Medicare margins and concerns over therapy services, the Medicare Payment Advisory Commission (MedPAC) has asked Congress to cut reimbursement rates for skilled nursing facilities. The non-partisan agency called on Congress to scrap the Medicare market basket rate increases for fiscal years 2019 and 2020 — which would amount to 2% and 2.1%, respectively Read More

  • Health Care Job Openings Exceed Worker Demand by 44% Amid ‘Skills Gap’

    Mar 14 2018

    Skilled nursing executives and managers worried about a persistent workforce shortage now have another number to keep them up at night: 44%. That’s the gulf between open positions and available health care practitioners, the most severe supply-demand mismatch identified in a new study prepared for the U.S. Chamber of Commerce Foundation. The health care workforce Read More

  • Skilled Nursing Occupancy to Keep Falling in 2018

    Mar 14 2018

    Skilled nursing occupancy rates, already sitting at record lows, will continue to plummet in 2018 according to the most recent projections from Marcus & Millichap. The commercial real estate brokerage predicts that skilled nursing occupancy will fall to 85.3%, a dip of 80 basis points and a new low for the decade. “The skilled nursing Read More

  • How In-House Insurance Plans Can Boost Skilled Nursing’s Fortunes

    Mar 13 2018

    In an era of record-low skilled nursing occupancy and rapidly shifting payment models, some operators have found a single solution to both problems: an in-house insurance plan. Skilled nursing providers can create their own institutional special needs plans (I-SNPs), a type of Medicare Advantage program specifically designed to cover beneficiaries who are confined to an institution Read More

  • Finding Hidden Benefits of Scale in the Skilled Nursing Industry

    Mar 12 2018

    The recent bankruptcies of the HCR ManorCare and Orianna skilled nursing chains seemed to validate an industry-wide opinion that the future belongs to the smaller, regional operator. But there are still advantages to scale in the skilled nursing industry — even if they remain under the radar. The Ensign Group (NASDAQ: ENSG) has a nationwide Read More

  • What the Rise of Medicare Advantage Means for Skilled Nursing

    Mar 11 2018

    About 33% of seniors enrolled in the Medicare program have elected to use managed Medicare Advantage plans, and that number is expected to grow — potentially faster than the government thinks. The Congressional Budget Office has predicted growth in MA plans by about 4% per year, but Dan Mendelson, president of Avalere Health, says his Read More

  • Formation Founder: Time for Skilled Nursing to Leave the ‘Kids’ Table’

    Mar 08 2018

    Despite all the doom and gloom in the skilled nursing industry in recent years, at least one major financial player thinks the time is ripe for operators and investors to expand. “We, as an industry, need to be at parity in the health care delivery system,” Formation Capital Founder and Chairman Arnold Whitman said during Read More

  • HHS Secretary Wants Providers to Take Amazon, Yelp’s Lead

    Mar 06 2018

    If Health and Human Services secretary Alex Azar has his way, the health care consumer of the future will select providers the way they currently decide where to eat or which knockoff iPhone charger to buy. “Imagine a day when health care delivery in the United States functions the way other parts of our economy Read More

  • Despite Steep Debt, ManorCare to Pay $100 Million to Former CEO

    Mar 05 2018

    Recently filed bankruptcy documents reveal that HCR ManorCare’s total missed rent to Quality Care Properties, Inc. (NYSE: QCP) topped $445 million — while its former CEO is set for a handsome payday. Paul Ormond, who left the embattled provider in September, could receive a settlement in excess of $100 million, according to a letter from ManorCare Read More

  • ACOs Gain by Shifting Money Away from Skilled Nursing

    Mar 04 2018

    Skilled nursing providers have long been wary of accountable care organizations (ACOs), fearing that the models’ emphasis on cost-sharing might drive dollars away from their buildings. And a new study shows that those concerns might be grounded in reality. For every 1% that a given ACO cut skilled nursing spending, the overall savings rate increased Read More

  • When is the Skilled Nursing Wave Coming? Depends Who You Ask

    Mar 01 2018

    Depending on whose earnings call you happened to catch this season, the predicted surge in demand for skilled nursing services is just around the corner — or it isn’t coming at all. At Omega Healthcare Investors (NYSE: OHI), management enlisted the services of two consulting firms to crunch the numbers on demographic trends over the Read More

  • Genesis Regains NYSE Compliance After Delisting Warning

    Mar 01 2018

    Three months after Genesis Healthcare, Inc. (NYSE: GEN) received a delisting warning from the New York Stock Exchange, the skilled nursing provider is back in the exchange’s good graces. The Kennett Square, Pa.-based company on Thursday announced that it has once again met the NYSE’s continuing listing standard and will shed the “.BC” — for Read More

  • Going to Dallas for NIC? Let’s Meet Up

    Mar 01 2018

    This time next week, the Skilled Nursing News team will be down at the National Investment Center for Seniors Housing & Care (NIC) Spring Investment Forum in Dallas — and we’d like to meet up. We know time is at a premium, but if you have five minutes to spare to share your latest project, Read More

  • Industry Responds to Democrats’ Call for Skilled Nursing Scrutiny

    Feb 28 2018

    In a Valentine’s Day letter to top health officials, a group of influential Senate Democrats asked the Centers for Medicare & Medicaid Services (CMS) to reconsider certain rollbacks of nursing home regulations. In response, a leading industry group on Wednesday wrote back to the senators to clarify and rebut some of their points. “We think Read More

  • CareTrust: Micro-Level Skilled Nursing Gains Outweigh Macro Pains

    Feb 28 2018

    CareTrust REIT (NASDAQ: CTRE) has made moves to divest from a troubled operator, but management still remained upbeat about the potential for skilled nursing success in the year to come. After a positive experience transitioning seven of its 16 properties operated by Pristine Senior Living and Post-Acute Care in Ohio, CareTrust will market the remaining Read More

  • Assuming Risk Key to Medicare Savings Under New Payment Models

    Feb 27 2018

    Accountable care organizations (ACOs) only generate savings for the government if they accept risk, according to an analysis from the Kaiser Family Foundation. ACOs generated net savings of $47 million in 2016, the Menlo Park, Calif.-based non-profit found in an independent analysis of publicly available ACO data and previously unpublished numbers from the Centers for Read More

  • Former Dude Ranch Wins Skilled Nursing Design Award

    Feb 26 2018

    When the developers of The Springs at Hacienda at the River decided that their new skilled nursing project shouldn’t feel institutional, they took a major leap: They picked a design firm that had never built a SNF before. Now, several years later, the team at Watermark Retirement Communities is celebrating a 2017 Senior Housing News Read More

  • Sabra CEO: Signature Deal Likely, Genesis Model ‘Does Not Work’

    Feb 22 2018

    The CEO of Sabra Health Care REIT (Nasdaq: SBRA) on Thursday indicated that a deal to restructure Signature HealthCARE could soon be in the cards. “We have an agreement with the other primary landlords on Signature,” Sabra CEO Rick Matros said on his company’s fourth-quarter earnings call with shareholders and analysts — though he added Read More

  • Per-Bed Skilled Nursing Prices Trickling Downward

    Feb 21 2018

    After a year that saw reports of eye-popping prices for skilled nursing beds, the trend appears to be headed in the opposite direction. The per-bed price for skilled nursing facilities dropped 1% between the third and fourth quarters of 2017, falling to $83,800 according to the most recent data from the National Investment Center for Read More

  • Democrats Ask CMS to Halt Skilled Nursing Regulatory Rollback

    Feb 20 2018

    A group of 12 Democratic U.S. senators slammed the Centers for Medicare & Medicaid Services in a letter sent last week, claiming that its leadership’s decision to ease regulatory restrictions on nursing homes has put seniors in danger. “We write with deep concern over a string of actions by the Centers for Medicare & Medicaid Read More

  • NHC Saved $8.5 Million Under New Tax Plan in 2017

    Feb 20 2018

    National HealthCare Corporation (NYSE American: NHC) turned in a positive 2017 with the help of the recent Republican-led tax overhaul. The Murfreesboro, Tenn.-based skilled nursing provider announced Tuesday that it logged net income of $56.2 million for the year ended December, a boost of 11.2% from NHC’s performance in 2016. Last year’s performance included an Read More

  • Mixed-Age Skilled Nursing Facilities Face Significant Barriers

    Feb 14 2018

    When Skilled Nursing News set out to envision the nursing home of the future, one topic kept coming up over and over again: the intergenerational SNF, a place where people of all ages could recover from surgeries or receive long-term care together. But creating such a diverse facility is easier said than done. “For short-term Read More

  • Spending on Nursing Care to Increase Steadily Through 2026

    Feb 14 2018

    Annual expenditures on skilled nursing care will increase by 3.9% this year and keep rising through 2026, according to a new study from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. This rise in nursing home spending tracks with overall gains in outlays for health care services: Between 2017 and 2026, Read More

  • Operators Bearish on Future of Standalone Skilled Nursing Facilities

    Feb 13 2018

    Just 19% of senior housing operators think the future for standalone skilled nursing facilities looks “good” over the coming three years — while a plurality see a “poor” path ahead. Investment banking and advisory firm Lancaster Pollard on Tuesday released the results of its expansive senior housing and care survey, which collected the opinions of Read More

  • Benefits of Advanced Nursing Degrees Outweigh Staffing Squeeze

    Feb 13 2018

    A landmark law in New York State could present additional challenges for skilled nursing providers, but major industry trade groups say that the potential benefits for residents could outweigh the staffing stress. Late last year, the Empire State passed a sweeping law that will require nurses to obtain Bachelor’s of Science in nursing degrees within Read More

  • Ensign: The Skilled Nursing Business Isn’t As Hard As It Seems

    Feb 09 2018

    The Ensign Group (NASDAQ: ENSG) announced solid earnings for the fourth quarter of 2017 — and took a not-too-subtle shot at some of its competitors. The Mission Viejo, Calif.-based post-acute provider saw a 40.2% increase in revenues related to transitional and skilled nursing care from the fourth quarter of 2016, along with gains in occupancy Read More

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