Posts by Alex Spanko:

  • Study Finds Quality Gains in Skilled Nursing Facilities Come at a Price

    Sep 24 2018

    The federal government has taken major steps over the last decade to reduce spending while also improving resident care, but a recent study finds that achieving the goal might not be so easy. A team of researchers led by Kathleen Carey of the Boston University School of Public Health found that quality gains at Veterans Read More

  • Savings Success in ACOs Takes Time, and Risk Might Not Matter

    Sep 23 2018

    Accountable care organizations (ACOs) need time to work out their growing pains before producing savings for the government, according to a new study from a top health care consulting firm — and a major assumption about risk might not actually be true. ACOs active for four years or longer accounted for just about all of Read More

  • South Florida Shuffle: Welltower Sells Building for $15.4M, Two-SNF Portfolio Nets $24 Million

    Sep 23 2018

    Welltower Offloads Broward County SNF for $15.4M Welltower Inc. (NYSE: WELL) recently sold the Heartland of Tamarac skilled nursing facility for $15.4 million, the South Florida Business Journal reported. The real estate investment trust offloaded the building to 5901 Tamarac LLC, a company associated with Millennium Management of Miami, according to the publication. The facility Read More

  • White Oak’s $33M Skilled Nursing Refinance; State Takeover in Kansas

    Sep 20 2018

    White Oak Lands $33M Refinance for Granite Group White Oak Healthcare Finance this week announced the funding of a $33.2 million senior credit facility for Granite Investment Group; in turn, Granite used the funds to refinance a four-building skilled nursing portfolio in Texas. A subsidiary of White Oak Global Advisors, the health care finance firm Read More

  • New York Official Calls for Tougher Skilled Nursing Facility Inspections

    Sep 20 2018

    A top official accused the New York State Department of Health of performing insufficient inspections of nursing home equipment, recommending more in-depth surveys in the future. Health officials only look at very small samples of medical and generator equipment when performing inspections, according to a report issued this week by the office of New York comptroller Read More

  • Skilled Nursing’s Future Rests on ‘Marriage’ Between Financial, Medical Data

    Sep 19 2018

    It may be slightly early to make a definitive declaration, but the rise of data could be the single most prominent trend in skilled nursing for 2018. From new payment models to preferred provider networks to consumer outreach, the importance of data has been a recurring theme at conferences and on earnings calls for the Read More

  • Assisted Living Construction Has Negative Impact on Skilled Nursing Facilities’ Finances

    Sep 18 2018

    Assisted living facilities have increasingly represented a viable alternative to skilled nursing for many older consumers, and a recent study found that the rise of lower-acuity senior housing has a direct impact on SNFs’ profit margins. The addition of every 10 assisted living beds — per 1,000 residents over the age of 65 in a Read More

  • When Hospitals Build Skilled Nursing Networks, How Narrow is Too Narrow?

    Sep 17 2018

    Skilled nursing providers have faced pressure to break into area hospitals’ top-tier referral groups — the increasingly select few deemed fit to manage acute care operators’ patient populations across the continuum. But when SNFs size up their competitors in their marketplaces, are they facing off for a slot in a hospital’s top five, or top Read More

  • Sabra, LTC: Skilled Nursing Market Has Hit ‘Trough,’ Slow Occupancy Growth Ahead

    Sep 16 2018

    Multiple players across the skilled nursing industry have offered predictions as to when slumping occupancy figures will bottom out, and two prominent voices earlier this month declared that the bottom may be upon us. “I think we’re probably at around the trough,” Sabra Health Care REIT (Nasdaq: SBRA) chief investment officer Talya Nevo-Hacohen said during Read More

  • CMS Waives Certain Skilled Nursing Rules in Wake of Hurricane Florence

    Sep 14 2018

    Hurricane Florence prompted skilled nursing evacuations throughout the Eastern seaboard, and the Centers for Medicare & Medicaid Services (CMS) this week issued a series of emergency orders to alleviate the pressure on operators and beneficiaries as they weather the storm. Administrator Seema Verma formally waived the three-day hospital stay requirement for Medicare skilled nursing coverage Read More

  • Centers Pays $1.6M Over Alleged Managed Medicaid Fraud in New York

    Sep 13 2018

    An affiliate of skilled nursing provider Centers Health Care paid a $1.65 million settlement to the New York State and federal governments over allegations that its managed Medicaid plan falsely billed for services. The Centers Plan for Healthy Living LLC submitted monthly state Medicaid claims of up to $4,300 per member for services that it Read More

  • Skilled Nursing Occupancy Falls to New Low in Second Quarter

    Sep 12 2018

    The skilled nursing industry set another record low in occupancy during the second quarter of 2018. Skilled nursing facilities were 81.7% full during the quarter, according to the most recent set of data from the National Investment Center for Seniors Housing & Care (NIC), down 79 basis points from the first quarter and 137 basis Read More

  • SNN Interview: Congressman Wants to Find Balance Between Regulations, Operator Autonomy

    Sep 11 2018

    Last week, two leaders of the powerful House Ways and Means Committee — chairman Kevin Brady and health subcommittee chairman Peter Roskam — called on the Centers for Medicare & Medicaid Services (CMS) to slash red tape for skilled nursing and other long-term care providers. “There is a real opportunity to get red tape out Read More

  • CareTrust Grows in Silicon Valley; SLIB Arranges Three Skilled Nursing Deals

    Sep 10 2018

    CareTrust Picks Up Former Non-Profit CareTrust REIT (Nasdaq: CTRE) last week announced the purchase of the Villas at Saratoga, a senior living community with 85 skilled nursing beds and 37 assisted living units in Saratoga, Calif. — a city to the southwest of San Jose. CareTrust will invest about $19 million in the property, including Read More

  • Skilled Nursing Continues to Drag on CCRCs’ Future

    Sep 09 2018

    A major financial ratings service released an overall stable outlook for the continuing care retirement community (CCRC) market over the coming year, but expressed nagging doubts about the effects of skilled nursing on the industry’s overall health. For the sixth consecutive year, Fitch Ratings issued a “stable” credit rating projection for the CCRC sector, which Read More

  • Federal Lawmakers Grill CMS, HHS Over Nursing Home Safety

    Sep 06 2018

    Representatives from the federal agencies that oversee skilled nursing agencies faced pointed questions from lawmakers on Capitol Hill on Thursday morning, with many expressing frustration with recurring resident safety issues. “We do this over and over again, but yet one-third of Medicare residents have experienced harm,” Rep. Diana DeGette, a Colorado Democrat, said during a Read More

  • Congressmen Ask CMS to Ease Red Tape for Skilled Nursing Facilities

    Sep 05 2018

    Two leaders of the powerful House Ways and Means Committee this week asked the Centers for Medicare & Medicaid Services (CMS) to ease regulatory burdens on skilled nursing facilities. In multiple letters to CMS administrator Seema Verma, Rep. Kevin Brady and Rep. Peter Roskam called for reduced compliance burdens for post-acute care providers, hospitals, and Read More

  • 15% of Skilled Nursing Assistants Live in Poverty Amid Stagnant Wages

    Sep 04 2018

    Skilled nursing and seniors housing executives have blamed wage pressures in part for their struggles in recent years, but a new analysis finds that nursing assistants haven’t seen their wages increase in a decade. The median nursing assistant brought in $12.78 per hour in 2007, compared to an inflation-adjusted $12.84 a full 10 years later, Read More

  • Has the Skilled Nursing Industry Finally Hit Bottom?

    Sep 03 2018

    As summer ends, it’s tempting to start looking ahead to what 2019 will hold for the skilled nursing industry. While the widely praised new payment model will likely grab the most attention, next year could also signal an upward climb out of an industry valley, or more troubled times ahead — depending on who you Read More

  • Replacing Long-Term Care Hospitals with Skilled Nursing Could Save Medicare $4.6B

    Sep 03 2018

    New research takes aim at the long-term care hospital (LTCH), suggesting that the federal government could save billions if it paid those providers the same way as skilled nursing facilities — or just replaced them with SNFs altogether. “We find that most LTCH patients would have counterfactually received care at skilled nursing facilities … and Read More

  • Eduro Healthcare Eyes Skilled Nursing Expansion with CareTrust

    Aug 30 2018

    As the skilled nursing industry moves away from large national operators, smaller regional providers are stepping up to fill the void — often in markets that fly under the radar of other investors. One of those players in recent years has been Eduro Healthcare, a Salt Lake City-based operator that launched in 2008 with a Read More

  • OIG to Investigate CMS Oversight of Skilled Nursing Staffing Measures

    Aug 30 2018

    In the wake of controversy over nationwide skilled nursing staffing levels, the health care industry’s top government watchdog has stepped in to investigate. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) announced that it will launch a probe into the way skilled nursing facilities maintain their staffing records — Read More

  • Sanford, Fresh Off Good Samaritan Merger, Eyes $1B Chicago Health System

    Aug 29 2018

    Non-profit hospital system Sanford Health is on track to complete a merger with a skilled nursing provider by fall, and a recent report hints that the operator isn’t done expanding. The Sioux Falls, S.D.-based Sanford could soon announce a merger with a $1 billion health system based in Chicago, CEO Kelby Krabbenhoft teased to SiouxFalls.Business. Read More

  • Study Confirms the Metrics Hospitals Want from Preferred Skilled Nursing Partners

    Aug 28 2018

    As hospitals’ preferred discharge networks narrow, high-level thinkers and consultants in the skilled nursing space have long preached the importance of certain key metrics: shorter lengths of stay, lower readmissions, and less overall Medicare spend. Now a new study shows those concerns are grounded in reality. In the years leading up to the creation of Read More

  • OIG Wants to Revise Anti-Kickback Rules to Ease Care Coordination

    Aug 28 2018

    As the federal government increasingly emphasizes care coordination among players across the health care continuum, the industry’s top watchdog signaled that it could soon overhaul its anti-kickback regulations to help providers avoid pitfalls. The Department of Health and Human Services’ Office of the Inspector General (OIG) this week published a call to providers, asking for Read More

  • Arkansas Vets Home Gets $1.8M Boost; New Beds Gain Approval in Florida

    Aug 27 2018

    Arkansas Veterans Home Receives $1.8M Subsidy After operating at a deficit for more than a year and a half, an Arkansas skilled nursing facility for veterans finally received a $1.8 million boost. Legislators last week approved a call from the governor to send the funds to the Arkansas State Veterans Home in North Little Rock, Read More

  • ProMedica Lays Off 100, Cuts 60 More Jobs One Month After ManorCare Acquisition

    Aug 24 2018

    Less than a month after completing its acquisition of skilled nursing giant HCR ManorCare, ProMedica Health System this week laid off 100 employees and cut 60 unfilled positions. The Toledo Blade first reported the news. The majority of the layoffs consisted of employees “in leadership roles and corporate functions,” according to a statement provided to Read More

  • Editor’s Take: Multiple CEOs (Probably) Can’t Be Wrong on PDPM

    Aug 22 2018

    When covering any industry that operates under heavy government scrutiny, hearing one CEO praise a new set of regulations is a surprise. Hearing near-unanimous support is frankly shocking. But that’s where the skilled nursing industry finds itself with the Patient-Driven Payment Model, the latest overhaul of the way SNFs receive reimbursements from Medicare. On its Read More

  • Providers Struggle to Add New Tech as Payment Models Can’t Keep Up

    Aug 22 2018

    Go to any skilled nursing or senior living conference, and you’ll be greeted with a wide array of exciting new technologies with the potential for making residents’ and workers’ lives better. On the flashier end, there’s full-size exoskeletons that can help seniors walk again, or virtual-reality games that help users re-learn how to swallow and Read More

  • Inside the Key Metrics Skilled Nursing Buyers Should Track Before Investing

    Aug 20 2018

    Big-picture concerns about the skilled nursing industry haven’t slowed down transaction volume in the space, with nursing homes accounting for 55% of all deals in a second quarter that saw $6.3 billion in senior housing and care investments. The major real estate investment trusts (REITs) certainly played a role in that strong quarter, with multiple Read More

  • China Beckons to US Skilled Nursing, Long-Term Care Operators

    Aug 19 2018

    Amid difficult trends at home, a handful of U.S. long-term care operators have looked to Asia as their next potential frontier – and while their strategies differ, they all believe in the region’s potential. “We really like the demographic trends for senior living in Asia,” Nate McLemore, managing director for international health care at developer Read More

  • PDPM Success Rests on Taking Credit for Existing Skilled Nursing Services

    Aug 16 2018

    As skilled nursing operators scramble to adapt to a new Medicare reimbursement model ahead of its implementation next fall, the secret to success could lie in taking credit for the services most SNFs already provide. At Zimmet Healthcare Services Group’s annual conference in Atlantic City, N.J. last week, multiple speakers emphasized the importance of identifying Read More

  • OIG Targets Hospice Services in Skilled Nursing Facilities, Recommends Cuts

    Aug 16 2018

    When the Department of Health and Human Services’ (HHS) top watchdog arm issued an overall warning about the state of hospice care earlier this summer, skilled nursing facilities were specifically singled out as areas for improvement. The HHS Office of the Inspector General (OIG) accused hospices of using residents in nursing homes to artificially inflate Read More

  • Turnaround Properties Draw Interest in Midwest; $4.7M Skilled Nursing Sale in NC

    Aug 16 2018

    Blueprint Turns Two in Ohio, Wisconsin Blueprint Healthcare Real Estate Advisors recently announced a pair of deals in the Midwest on behalf of major publicly traded real estate investment trusts (REITs). The 96-bed Pine Valley Care Center in Richfield, Ohio has a new owner-operator, according to the Chicago-based brokerage. Once a recipient of the coveted Read More

  • S&P Downgrades ProMedica in Wake of ManorCare-Welltower Deal

    Aug 15 2018

    After warning last month that a credit downgrade was likely, Standard & Poor’s this week lowered its long-term credit rating for non-profit health care provider ProMedica by multiple levels. The Toledo, Ohio-based hospital and skilled nursing chain now sits at BBB, down from the A+ rating ProMedica had maintained ahead of its blockbuster deal to Read More

  • Record-Setting $1 Billion Skilled Nursing Fraud Case Hits Snag

    Aug 15 2018

    The case against a former Miami-area skilled nursing operator accused of pulling off the largest Medicare fraud on record hit a snag this week as a judge tossed crucial pieces of evidence. Defense lawyers for Philip Esformes scored a major victory when a judge found that federal investigators improperly seized evidence that was protected under Read More

  • HHC’s $157M Run of Skilled Nursing Loans; Alumni-Run CCRC Changes Hands in Texas

    Aug 14 2018

    HHC Lands $157M in Loans Since June Housing and Healthcare Finance this week announced a group of eight loans closed over the past two months, totaling $157 million for multiple skilled nursing facilities around the country. The Bethesda, Md.-based lender’s recent roster includes a $100 million bridge loan for an eight-facility portfolio in Pennsylvania, a Read More

  • Looking Locally at Skilled Nursing Industry Could Show Brighter Future

    Aug 13 2018

    If there’s been one recurring theme in the skilled nursing industry over the last few years, it’s distress, with dropping national occupancy stats and new payment models changing the way providers deliver post-acute care. But one leading industry voice says it isn’t productive to ask about the future of the skilled space as a national, Read More

  • Skilled Nursing Stuck in Awkward Middle Between Old and New Payment Models

    Aug 12 2018

    Narrowing networks of referral providers have been a top concern for skilled nursing facilities over the last two years, with industry leaders preaching the importance of improving certain metrics in order to impress hospitals and home health agencies. Under models such as Bundled Payments for Care Improvement (BPCI) and other shared-savings plans, the thinking goes, Read More

  • Skilled Nursing Industry Must Respond Quickly to Survive Under PDPM

    Aug 08 2018

    With a little over a year to go before the skilled nursing industry must adapt to a new payment model, smart providers are poised to take advantage — and one expert says it’s time to begin preparing now in order to achieve the most benefits. “SNF operators are optimistic, and I think you should be,” Read More

  • Omega Joins CareTrust in Predicting Post-PDPM Wave of Skilled Nursing Sales

    Aug 06 2018

    Leaders at two major real estate investment trusts (REITs) focused on health care assets have predicted a coming wave of mergers-and-acquisitions volume as smaller providers refuse to adapt to new skilled nursing payment rules. As mom-and-pop operators begin to unpack the changes associated with the Patient-Driven Payment Model (PDPM) — the new set of therapy Read More

  • AHCA Chief Blasts ‘Offensive’ Skilled Nursing Commentary from CMS

    Aug 05 2018

    The Centers for Medicare & Medicaid Services (CMS) explicitly pointed to the potential for therapy fraud under its old rules while rolling out its updated payment structure for nursing homes — and the head of a leading trade group says that’s a slap in the face to the industry. Mark Parkinson, president and CEO of Read More

  • Ensign Group Touts ‘Enormous Organic Growth’ Potential for Skilled Nursing Properties

    Aug 05 2018

    The Ensign Group (Nasdaq: ENSG) turned in yet another upbeat quarterly earnings call last week, emphasizing its improved turnaround strategies for underperforming skilled nursing facilities and its strong partnership with landlord CareTrust REIT (Nasdaq: CTRE). CEO Christopher Christensen touted Ensign’s progress on bolstering operations at buildings the Mission Viejo, Calif.-based operator took over in 2017 Read More

  • Uncertainty Surrounds New ‘Arbitrary’ Skilled Nursing Payment Rules

    Aug 01 2018

    Early reactions to the finalized skilled nursing payment rules from the Centers for Medicare & Medicaid Services (CMS) are in, with one leading provider group issuing a stark warning about the days ahead. “While the skilled nursing profession welcomes a new payment model, we are concerned with the language in this rule about the Patient-Driven Read More

  • Skilled Nursing Construction Costs Continue to Rise as Tariffs Loom

    Aug 01 2018

    A tight labor market has continued to drive up construction costs for skilled nursing facilities — and that’s before accounting for the potential effects of disruptive new tariffs from the Trump administration. The cost to build a “high-level” SNF rose from $317 per square foot last winter to $326 this summer, according to the most Read More

  • S&P Warns of ProMedica Downgrade in Wake of ManorCare Acquisition

    Jul 31 2018

    Standard & Poor’s last week warned that ProMedica Health System’s acquisition of struggling skilled nursing chain HCR ManorCare may lead to a credit downgrade by the end of the summer. While asserting that the non-profit chain still has an A+ rating for its long-term debt, S&P expressed concerns about the way ProMedica funded the transaction, Read More

  • CMS Finalizes New Skilled Nursing Payment Rules, Predicts $820M Funding Boost

    Jul 31 2018

    The Centers for Medicare & Medicaid Services (CMS) on Tuesday finalized its skilled nursing payment updates for fiscal 2019, formally enshrining the Patient-Driven Payment Model (PDPM) and other changes in a final rule. Under the finalized proposal, the PDPM — which will see therapy payments based increasingly on the complexity of patients’ clinical needs, and Read More

  • CMS Hits 1,400 Nursing Homes with One-Star Reviews Over Staffing Concerns

    Jul 30 2018

    Less than a month after a New York Times story revealed concerns about insufficient nursing home staffing levels, the Centers for Medicare & Medicaid Services (CMS) handed out nearly 1,400 one-star reviews. Last week, when CMS updated its Five-Star Quality Rating System for nursing homes, 1,387 facilities received one-star ratings for staffing coverage, according to Read More

  • Welltower Attracting Interest from Hospital Systems for New Skilled Nursing Partnerships

    Jul 27 2018

    The ink isn’t quite dry on Welltower Inc.’s (NYSE: WELL) major skilled nursing play, but the real estate investment trust (REIT) is already attracting interest from hospital systems that want to join in its new post-acute care plans. That’s at least according to CEO Tom DeRosa, who hinted on his company’s Friday morning quarterly earnings Read More

  • Welltower, ProMedica Close on $4.4B QCP-ManorCare Deal

    Jul 26 2018

    Just one day after shareholders approved Welltower Inc.’s (NYSE: WELL) acquisition of Quality Care Properties (NYSE: QCP), the rest of the megadeal dominoes fell late Thursday. The Toledo, Ohio-based real estate investment trust (REIT) announced that it had closed on its joint-venture purchase of QCP’s real estate with non-profit hospital system ProMedica. In the same Read More

  • Sabra Takes Proactive Approach to Skilled Nursing Data with PointRight Partnership

    Jul 26 2018

    Sabra Health Care REIT (Nasdaq: SBRA) last week announced a strategic partnership with health care data analytics firm PointRight, in a move the companies are describing as a more proactive approach to monitoring individual skilled nursing facility performance. Under the agreement, tenants of Sabra-owned nursing homes will be able to use PointRight’s data software for Read More

  • Orianna Strikes Back at Omega Over Terminated Restructuring Deal

    Jul 25 2018

    Orianna Health Systems fired back at landlord Omega Healthcare Investors (NYSE: OHI), claiming that the real estate investment trust’s (REIT) decision to terminate a restructuring deal will prove detrimental to both parties. “Orianna is disappointed by Omega’s actions, which we believe will only cause delay in finalizing Orianna’s reorganization and impair the recovery ultimately realized Read More

  • QCP Shareholders OK Merger Deal with Welltower in Latest ProMedica-ManorCare Milestone

    Jul 25 2018

    Shareholders of Quality Care Properties (NYSE: QCP) on Wednesday voted to approve the company’s acquisition by fellow real estate investment trust Welltower Inc. (NYSE: WELL), marking the latest milestone in a mega-deal that will shake up the skilled nursing industry. The Bethesda, Md.-based QCP’s investors will receive $20.75 per share as part of the deal. Read More

  • Operators, Telehealth Providers See Skilled Nursing Promise in New CMS Proposal

    Jul 24 2018

    While they don’t represent broad-based coverage for skilled nursing facilities, new proposed telehealth guidelines from the Centers for Medicare & Medicaid Services (CMS) have drawn praise from providers and groups that see the news as a sign of even wider coverage on the horizon. Under the proposed rule issued earlier this month, CMS would expand Read More

  • Omega Pulls Plug on Restructuring Agreement with Struggling Orianna Skilled Nursing Chain

    Jul 23 2018

    Omega Healthcare Investors, Inc. (NYSE: OHI) has pulled out of a proposed restructuring agreement with troubled tenant Orianna Health Systems, citing frustration with the process and a desire to protect its shareholders. The Hunt Valley, Md.-based real estate investment trust (REIT) said Monday that Omega will terminate its participation in the deal effective July 25. Read More

  • DOJ Smacks Skilled Nursing Facilities, Consultants with $10M Settlement for False Billings

    Jul 19 2018

    Nine skilled nursing facilities and a pair of consulting firms will pay the federal government $10 million as part of a deal to settle allegations of false Medicare claims. Southern SNF Management Inc., Rehab Services in Motion dba Dynamic Rehab, and nine related SNFs in Florida and Alabama were accused of providing unnecessary therapy services Read More

  • Sabra Enters into Skilled Nursing Data Partnership with PointRight

    Jul 17 2018

    In a skilled nursing era where success is increasingly defined by the volume and accuracy of data, a major real estate investment trust (REIT) in the space on Tuesday announced a partnership with a leading health care analytics firm. The Irvine, Calif.-based Sabra Health Care REIT (Nasdaq: SBRA) will begin using three data products from Read More

  • QCP Clears Up Investor Objections, Welltower Deal Vote Remains on Track

    Jul 16 2018

    Quality Care Properties (NYSE: QCP) last week announced steps to clear up a pair of lawsuits surrounding its impending acquisition by fellow real estate investment trust (REIT) Welltower Inc. (NYSE: WELL). The two class-action lawsuits — Sanderson v. Quality Care Properties and Kent v. Quality Care Properties — alleged that the REIT violated the Exchange Read More

  • 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

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