Posts by Alex Spanko:

• In-House Insurance Plans May Boost Skilled Nursing Operators, But Not Without Risk

  Jul 08 2018

  The amount of skilled nursing residents covered by in-house insurance plans remains small, but the growth has been steady in just the last few years — and providers are beginning to stand up and notice. Still, starting an Institutional* Special Needs Plan (I-SNP) isn’t for every operator, and one consultant in the space says savvy Read More

• Skilled Nursing Must-Reads: Lawmaker-Owned Operators, VA Rankings

  Jun 17 2018

  In a week that saw more evidence of occupancy pressures for operators, smart assistants helping employees multitask at a New York skilled nursing facility, and a mixed outlook for the new therapy payment system, here are some stories that you may have missed along the way. Conflicts of Interest Among Lawmakers Who Own Nursing Homes Read More

• MedPAC Again Calls for Skilled Nursing Payment Cuts in Mixed PDPM Review

  Jun 17 2018

  The Medicare Payment Advisory Commission (MedPAC) issued a mostly positive assessment of the new proposed payment rules for skilled nursing facilities, but the organization wants change to come faster than planned. Citing the similarity between the new Patient-Driven Payment Model (PDPM) and the now-shelved Resident Classification System, Version I (RCS-I), MedPAC asserted that the planned Read More

• Skilled Nursing Occupancy Continues Plunge, Drops to 81.6%

  Jun 14 2018

  For the first time in six years, skilled nursing occupancy failed to increase between the fourth and first quarters as the numbers continued their grim march downward. Occupancy fell to 81.6% in the first quarter of 2018, according to the most recent data release from the National Investment Center for Seniors Housing & Care (NIC). Read More

• Alexa, When’s Therapy? Skilled Nursing Operator Pilots Virtual Assistants

  Jun 13 2018

  Most of the talk surrounding the potential for consumer-grade gadgets in long-term care focuses on the lower-acuity world of assisted and independent living, where residents generally have more mobility and autonomy. But one skilled nursing provider says it’s seeing success with its fleet of Amazon Echo devices — both for residents and employees. The New Read More

• QCP Hints at Better Offer in Welltower-ProMedica Deal Wrinkle

  Jun 12 2018

  Quality Care Properties (NYSE: QCP) may have found a more attractive suitor than its current potential buyers. The Bethesda, Md.-based real estate investment trust (REIT) on Tuesday announced that it had received a potentially better takeover offer than the one currently on the table from fellow REIT Welltower Inc. (NYSE: WELL) and non-profit hospital system Read More

• New Skilled Nursing Payment Model Raises Medicare Advantage Questions

  Jun 07 2018

  Providers that have learned to navigate the Medicare Advantage ecosystem will likely have a leg up when approaching the new payment model for skilled nursing facilities, but many questions still remain about how managed care plans will adapt under the coming system. The Patient-Driven Payment Model (PDPM) reflects an ongoing push toward rewarding therapy providers Read More

• DeRosa: Welltower and ProMedica ‘Rescued’ Struggling HCR ManorCare

  Jun 06 2018

  Welltower Inc. (NYSE: WELL) CEO Tom DeRosa on Wednesday offered a spirited defense of his company’s recent skilled nursing mega-deal, saying the transaction will help save HCR ManorCare from its former private equity owners. “These are very good assets — great real estate that’s been run by a very effective management team with one hand Read More

• Azar Touts PDPM But Warns ‘Entrenched Players’ of Challenges Ahead

  Jun 05 2018

  Health and Human Services Secretary Alex Azar on Tuesday trumpeted the new payment model for skilled nursing facilities in a speech before a prominent trade group, positioning the plan as one piece of a larger change in the way the government pays for health care. The new Patient-Driven Payment Model (PDPM) incorporates the dual goals Read More

• Sabra Sells 12 Genesis Facilities, 8 Former CCP Buildings for $174M

  Jun 04 2018

  Sabra Health Care REIT (Nasdaq: SBRA) on Monday announced the sale of 20 total buildings as its so-called “Genesis Exodus” nears completion. The Irvine, Calif.-based real estate investment trust (REIT) closed on the sale of 12 more properties operated by Genesis Healthcare (NYSE: GEN) last Friday, with a total price tag of $134 million. That Read More

• REITs Adopt Novel Approaches to Stay Relevant in Skilled Nursing

  Jun 03 2018

  The shifting skilled nursing landscape has forced the major real estate investment trusts (REITs) to change their game plans — and led some industry-watchers to question whether their time is coming to a close. But there’s still a role REITs can play in the long-term care space, an industry that might actually be more attractive than the far Read More

• 17 State AGs Ask CMS to Bolster Skilled Nursing Oversight

  May 31 2018

  A group of 17 state attorneys general this week asked the Centers for Medicare & Medicaid Services to reconsider decisions they claim reduce federal oversight of nursing homes and put seniors at risk. The officials specifically took issue with CMS’s November 2017 decision to delay enforcement of the new Requirements of Participation (RoPs) for 18 Read More

• Preferred Care Looks to Settle Lawsuits to Speed Up Bankruptcy

  May 30 2018

  Embattled skilled nursing provider Preferred Care has asked a federal bankruptcy judge to approve a settlement regarding allegedly falsified Medicare and Medicaid claims. Settling the pair of federal whistleblower lawsuits, filed in 2016 and 2017, would help accelerate Preferred Care’s Chapter 11 bankruptcy process, the provider argued in a filing submitted last week. Westlaw Practitioner Read More

• Skilled Nursing Providers Need Steady Vision to Survive Value-Based Struggles

  May 29 2018

  While skilled nursing operators have increasingly faced stresses related to the ongoing shift to value-based care — primarily the threat of decreased reimbursements — at least one observer says the industry hasn’t seen anything yet. “You’re just entering the value-based dynamic right now,” Mountasser Kadrie, a health care management consultant, said during a presentation at Read More

• Eight Former Skyline Nursing Homes in PA Sold to New Owners

  May 29 2018

  Temporary oversight of eight former Skyline Healthcare skilled nursing facilities in Pennsylvania has come to an end. The administration of Gov. Tom Wolf last Friday announced that the eight facilities had been sold to new owners, consisting primarily of private investors. “The Wolf administration would like to thank the employees, contractors, and others who have Read More

• 14-SNF Portfolio Sells for $60M; JV Buys County Nursing Home for $11M

  May 28 2018

  County Nursing Home Sells for $11M Local lawmakers last week approved the sale of the Champaign County Nursing Home in Urbana, Ill. to a joint venture between Extended Care Clinical and Altitude Health Services. The sale price was $11 million, according to local news station WCIA, and the transaction is scheduled for completion by the Read More

• What Skilled Nursing Providers Can Learn from Baseball’s Data Revolution

  May 25 2018

  At a recent industry conference, I watched a pair of presenters show some fairly eye-opening statistics about workforce retention. The studies they cited weren’t health care-specific, but they did demonstrate that conventional wisdom about hiring — specifically, that years of experience and education correlate with strong job performance and retention — is wrong. In fact, they Read More

• Skilled Nursing Presence in CCRCs Remains Steady, But Drop Coming

  May 24 2018

  The median number of skilled nursing units in continuing care retirement communities (CCRCs) has remained steady over the last five years, but a decline is coming as developers continue cut SNFs out of the equation. Among the nearly 2,000 CCRCs across the United States, there are a median of 72 skilled nursing units per site, Read More

• Background Check Law for Nursing Home Owners Creates Questions

  May 23 2018

  The state of Georgia this month implemented a new background check law for nursing home owners, who will now be subject to the same requirements as frontline caregivers and other employees who interact with residents. But the threshold for who qualifies as an owner remains unclear. Employees, owners, and administrators will be required to undergo fingerprint Read More

• Skilled Nursing Operators Face Down ‘Unsustainable’ $2 Billion Cut

  Feb 11 2018

  Now that the Senate’s compromise spending plan has become law, skilled nursing providers must figure out how to make do with fewer Medicare dollars over the next 10 years. The decline comes from a freeze in the Medicare market basket rate, which the new budget has set at 2.4% in fiscal 2019. The industry had Read More

• Volatile Market, Rising Interest Rates Add to Skilled Nursing Pressures

  Feb 06 2018

  Just when it seemed like the skilled nursing industry had enough potential issues on its plate for 2018 — potential cuts to Medicaid and Medicare, ongoing reimbursement pressures, and staffing woes — the historically healthy stock market took a major tumble. Sabra Health Care REIT (NASDAQ: SBRA), Ventas Inc. (NYSE: VTR), and other health care Read More

• Using Community Colleges to Fight the Nursing Shortage

  Feb 05 2018

  A shortage of well-qualified nurses and other frontline staff remains one of the major headaches for nursing home operators and investors around the country. Earlier this month, one state came up with a solution that’s getting bipartisan support: allowing community colleges to offer bachelor’s of science in nursing degrees (BSN). “There’s such a severe shortage Read More

• Even With SNF Exit, Kindred Cautious on Future of Long-Term Care

  Feb 05 2018

  Kindred Healthcare, Inc. (NYSE: KND) elected to exit the skilled nursing space last year due to industry headwinds, but the provider is still cautioning that the wind might not necessarily be at its back going forward. In a Monday presentation to investors, the Louisville, Ky.-based company cited low reimbursements, labor cost pressures, and the potential Read More

• 60 Nursing Homes Change Operators in Multi-State Deal

  Feb 04 2018

  More than 60 skilled nursing facilities across six states have new operators after a major real estate investment trust (REIT) decided to make a change. The portfolio stretches across six states in the Midwest and Pacific Northwest, with a total of 5,500 beds, according to Cascade Capital Group, which facilitated the deal. The identity of Read More

• Skilled Nursing Must-Reads: Immigration Worries, Fire in Japan

  Feb 04 2018

  As we enter another week, take a minute to catch up with some of the biggest skilled nursing stories from around the internet and the world. Immigration pressures  The New York Times explored the effects of the Trump administration’s immigration policies on the long-term care industry, in particular shining a light on the so-called “gray Read More

• Why Getting an Extra CMS Star Can Boost a SNF’s Census

  Feb 01 2018

  Consumers are using the Five-Star Quality Rating System to make decisions about skilled nursing care — and there could be a major financial incentive for providers to earn that extra star. Adding a single star to a skilled nursing facility’s rating from the Centers for Medicare & Medicaid Services (CMS) boosts admissions in many cases, Read More

• ManorCare Seeks Dismissal of QCP Receivership Case

  Jan 30 2018

  After months of extensions, HCR ManorCare has finally responded to a receivership claim from its landlord — and the provider seeks to have the case dismissed. Quality Care Properties, Inc. (NYSE: QCP) announced early Tuesday that tenant ManorCare had filed a motion to dismiss “certain claims in the receivership complaint,” according to a filing with Read More

• Could Trump’s Religious Objection Guidance Create SNF Turmoil?

  Jan 25 2018

  On first glance, the Department of Health and Human Services’ new guidance on personal religious beliefs might not appear to affect the long-term care industry. Years from now, however, it could play an integral role in the way SNFs operate and staff facilities. When the government rolled out its two-pronged approach last week — establishing Read More

• Azar, Open to Medicaid Caps, Confirmed as HHS Secretary

  Jan 24 2018

  After a combative confirmation process, the United States Senate has confirmed Alex Azar as the second Department of Health and Human Services secretary in the Trump administration. Azar, a former pharmaceutical executive with Eli Lilly & Co., received a 55-43 vote of support from the U.S. Senate, with six Democrats defecting from the pack to Read More

• Immigration Battle Could Squeeze Nursing Home Finances

  Jan 23 2018

  The long-term care industry dodged a bullet this week with a short government shutdown, but the fate of a federal budget still hinges on Congress reaching consensus over immigration — another issue that could have an outsized impact on the skilled nursing space. Should Congressional Republicans attempt to clamp down on legal immigration and the so-called Read More

• How OpenTable Inspired One Skilled Nursing Software Provider

  Jan 22 2018

  Skilled nursing operators are facing increased incentives to collaborate with providers across the care continuum, and electronic health record (EHR) software is often identified as a potential solution. But such a strategy can only work if every provider in a given chain of care uses the same software, which can create barriers both for SNFs Read More

• Nursing Home Resurrects Communist East Germany to Battle Dementia

  Jan 22 2018

  Creating a comfortable, familiar atmosphere for residents with dementia and other memory issues remains an ongoing challenge for many skilled nursing providers — but for one operator in Germany, the task required skills more typically associated with museum curators than health providers. The AlexA Residence for Senior Citizens in Dresden collected artifacts from the German Read More

• What SNFs Can Expect During a Government Shutdown

  Jan 21 2018

  Though the federal government officially shut down early Saturday morning, skilled nursing and other long-term care operators have little reason to worry about reimbursements — at least for the time being. Medicare and Veterans Affairs-related reimbursements must continue even if the government suspends discretionary spending, as these programs are mandatory. In addition, because state governments Read More

• Trade Group Pulls Opposition to Skilled Nursing Generator Rule

  Jan 17 2018

  Citing a collaborative revision process with the state government, a major long-term care (LTC) industry trade group has withdrawn its opposition to a Florida rule that would require the use of backup generators in skilled nursing facilities. LeadingAge Florida formally rescinded its objection to the Agency for Health Care Administration (AHCA)’s proposed rule last week, Read More

• Skilled Nursing Providers Sue Illinois Over Medicaid Rates

  Jan 15 2018

  A group of five nursing home providers sued the state of Illinois late last week in federal court, claiming that low Medicaid reimbursement rates in the Land of Lincoln could force them to shut down. The companies specifically accuse Felicia F. Norwood, director of the Illinois Department of Healthcare and Family Services, of violating federal Read More

• Federal Judge Tosses $350M False Claims Act Penalty Against Provider

  Jan 15 2018

  A federal judge last week threw out a $350 million False Claims Act judgment against a Florida nursing home provider, writing that its occasionally inaccurate record-keeping didn’t amount to deliberate fraud. In a fiery ruling, U.S. District Judge Steven D. Merryday wrote that the claims brought by a whistleblower against Salus Rehabilitation, LLC — namely Read More

• Holiday Weekend Must-Reads: Genesis Outlook, IL Governor’s SNF Stay

  Jan 12 2018

  You’ve made it to the end of the week before a long holiday weekend, but before you go, take a look at some of the top stories from the nursing home world that didn’t make it to Skilled Nursing News. But first, a quick reminder that SNN’s headquarters in Chicago will be closed on Monday, Read More

• SNFs’ Place in New Bundled Payment Model Unclear

  Jan 10 2018

  The skilled nursing industry is still sorting out how it will participate in a newly announced bundled payment model rolled out by the Centers for Medicare & Medicaid Services on Tuesday. Early analysis of the text from CMS seems to exclude skilled nursing facilities, home health agencies and other post-acute care providers from applying for Read More

• Why Paid Family Leave Laws Could Hurt SNF Census

  Jan 10 2018

  Research shows that statewide paid family leave laws have a slew of benefits for both employees and employers across industries, from higher worker morale to health improvements among children. But for skilled nursing operators, this type of legislation could have an unintended negative consequence: a decline in census. The implementation of generous paid family leave (PFL) Read More

• HHS Nominee: ‘Devil’s in the Details’ of Medicaid Block Grants

  Jan 09 2018

  President Trump’s pick to lead the Department of Health and Human Services on Tuesday again expressed some support for the idea of converting Medicaid to a block-grant program, though he cautioned that any solution is still far in the future. Testifying before the Senate Finance Committee, Alex Azar said he can “find a lot of Read More

• New York Attorney General Requires Operator to Open Two SNFs in Settlement

  Jan 08 2018

  A nursing home owner and operator in New York City will be required to open two new facilities as part of a settlement announced late last week. New York State attorney general Eric Schneiderman also slapped the Brooklyn-based Allure Group with $2 million in fines stemming from the company’s acquisition and subsequent sale of two Read More

• Skilled Nursing M&A Crystal Ball 2018: Top Players’ Predictions

  Jan 03 2018

  After a 2017 that saw a change in presidential administrations, continuing occupancy pressures, declarations that the industry is in a historic downward spiral, and the most sweeping tax overhaul in a generation, players in the skilled nursing mergers-and-acquisitions world might be wondering if 2018 could possibly bring even more turmoil. Earlier this week, Skilled Nursing Read More

• Sabra Completes Sale of 20 Genesis SNFs for $103M

  Jan 02 2018

  Sabra Health Care REIT, Inc. (Nasdaq: SBRA) kicked off the new year by announcing the sale of 20 skilled nursing facilities operated by Genesis Healthcare, Inc. (NYSE: GEN). The deal, which netted Sabra $103.3 million, covers facilities across Kentucky, Ohio, and Indiana, the Irvine, Calif.-based real estate investment trust (REIT) announced. The buyers were not Read More

• Top Skilled Nursing Trends of 2018

  Jan 01 2018

  Now that we’ve broken down the top 10 stories of the last year, it’s time for us to dive into our predictions for the top skilled nursing trends of the coming 12 months. Some key headwinds, such as questions over Medicaid reimbursements, declining occupancy, and new regulations — including the final round of the requirements Read More

• New Year’s Catch-Up: ManorCare’s Rent Cut, Regulatory Rollbacks

  Jan 01 2018

  In case you’ve been blissfully away from your e-mail since before Christmas, here’s a quick rundown of the skilled nursing headlines you missed. QCP Cuts ManorCare a Break Quality Care Properties, Inc. (NYSE: QCP) gave its troubled tenant HCR ManorCare a generous Boxing Day present, announcing a one-year rent cut in a December 26 filing Read More

• Programming Note: Holiday Schedule at SNN

  Dec 21 2017

  As we enter the final weekend before Christmas, we’d like to extend a hearty happy holidays from the entire Skilled Nursing News team. In observance of Christmas and New Year’s Day, SNN’s headquarters in Chicago will be closed from Monday, December 25 to Monday, January 1. Our normal posting schedule will resume on Tuesday, January Read More

• Partial Win for REITs, Non-Profit Operators in Final GOP Tax Plan

  Dec 20 2017

  Congressional Republicans on Wednesday passed their long-planned tax reform package, and while President Trump has classified the deal as a Christmas gift to American taxpayers, the effects for skilled nursing operators and investors remains less than clear-cut. For instance, non-profit developers of continuing care retirement communities (CCRCs) received mixed holiday blessings: The compromise tax bill saving Read More

• Sabra CEO Matros Talks Leadership, Skilled Nursing and Tattoos

  Dec 18 2017

  Sabra Health Care REIT (Nasdaq: SBRA) turned in a busy 2017, completing a major merger with Care Capital Properties, snapping up an additional 24 SNFs, and announcing a long-term plan to completely dump its troubled Genesis assets (NYSE: GEN). At the helm through the process has been Rick Matros, known for his outspoken takes on the Read More

• Humana, Private Equity Firms Could Soon Acquire Kindred

  Dec 17 2017

  Near the end of a year that has already seen Kindred Healthcare, Inc. (NYSE: KND) exit the skilled nursing industry, the health care giant is still making headlines. Insurance provider Humana, Inc. (NYSE: HUM) is reportedly closing in on a deal to buy Kindred in conjunction with a pair of private equity firms, according to Read More

• Top 10 Skilled Nursing Stories of 2017

  Dec 17 2017

  The skilled nursing industry faces an existential crisis over its future, and 2017 was a year filled with threats — financial and regulatory woes at top providers, plummeting occupancy, and continued reimbursement pressures. But it was also a year that saw promising research illustrating the utility of SNF care and successes in new payment models, Read More

• SNF Operator Inks Rehab Partnership to Drive ACO Success

  Dec 13 2017

  Some skilled nursing providers have been wary of accountable care organizations (ACOs), payment and care delivery models that some fear will push more and more potential residents into home health care to save money. But one East Coast operator has found success under the ACO model, and entered into a partnership with a third-party rehabilitation Read More

• CMS Still Looking for SNF Input on Sweeping New Data Rules

  Dec 12 2017

  The Centers for Medicare & Medicaid Services (CMS) is in the midst of a multi-year process to develop new data collection requirements — and the agency still needs skilled nursing facilities in multiple areas around the country to weigh in. CMS and the RAND Corporation last month kicked off the second phase of a program Read More

• Skilled Nursing Beds at Non-Profit Operators Holding Steady Despite Headwinds

  Dec 12 2017

  After more than a decade of declines, the proportion of skilled nursing beds at major non-profit senior living operators has held steady in recent years, even as companies in the space have dealt with reimbursement and staffing strains. Nursing care beds accounted for 32.2% of all units among the top 150 non-profit senior housing providers Read More

• Senior Care Group Bankruptcy Expands to Four More Properties

  Dec 11 2017

  Four more facilities owned by Senior Care Group filed for Chapter 11 bankruptcy protection last week, bringing the total up to 10. The Tampa, Fla.-based non-profit — which owns 13 skilled nursing, home health care, and rehab providers across the Southeast — initially entered Chapter 11 back in July, along with six of its facilities Read More

• Observation Stays Save Money for Private Insurers, Patients

  Dec 10 2017

  Observation stays at hospitals have been controversial in the long-term care world for their role in Medicare reimbursements, but a new study shows that they could save money on the private-pay side — a trend that could have consequences for both types of insurance models. Between 2009 and 2013, non-elderly patients affiliated with three major Read More

• For SNF Quality, It’s All About Location, Location, Location

  Dec 07 2017

  For nursing home operators, quality depends on multiple factors — including staffing, reimbursement figures and compliance with government regulations. But for potential residents, their neighborhoods may play an outsized role in the type and quality of care they receive. Skilled nursing facilities in areas with higher concentrations of minority residents and people living in poverty generally Read More

• Program Helps Curb Costly SNF Infections, But Improvements Still Needed

  Dec 06 2017

  A collaborative program has shown promise in reducing a common type of costly infection in nursing homes, though researchers note that some structural barriers to success remain. An initiative from the Agency for Healthcare Research and Quality (AHRQ) to reduce catheter-associated urinary tract infections (CAUTI) received high marks from participants across the country, according to Read More

• Skilled Nursing Spending Growth Slowed in 2016

  Dec 06 2017

  Overall spending on skilled nursing care slowed in 2016, according to the most recent report from the Centers for Medicare & Medicaid Services (CMS). In all, payers spent $162.7 billion on care at nursing homes and continuing care retirement communities (CCRCs), an increase of 2.9% from 2015. That’s slower than the 3.7% growth between 2014 Read More

• Post-Acute Crunch at Non-Profit CCRCs Predicted for 2018

  Dec 06 2017

  Post-acute concerns could be a thorn in the side of non-profit continuing care retirement community (CCRC) operators next year. Citing industry-wide declines in census, admissions, and revenues amid changing payment models, Fitch Ratings, Inc. identified skilled rehabilitation care as a main concern for non-profit CCRCs in an otherwise sunny report about the state of the industry issued Read More

• Major CCRC Finance Provider Mobilizes Against Tax Bill Threat

  Dec 05 2017

  Industry groups and senior housing financing players are hoping a last-minute advocacy push can convince Congress to save a key funding mechanism for non-profit operators — but there are few guarantees as the Republican-backed tax bill goes to reconciliation. The House version of the GOP’s sweeping rewrite of the U.S. tax code includes the elimination Read More

• Care Coordination in ACOs Might Not Actually Drive Savings

  Dec 05 2017

  Accountable care organizations (ACOs) are built on a basic premise: By working together, providers across the health care continuum can save Medicare money and boost quality. But the largest share of the savings may simply come from shifting patients out of skilled nursing and home health settings, a new study suggests — and not on Read More

• SNFs Could Emerge as ‘Net Losers’ Under GOP Tax Plan

  Dec 04 2017

  Senate Republicans passed their version of comprehensive tax reform in the early hours of Saturday morning, and while lawmakers in both houses still need to weigh in on a compromise bill, fears about the legislation’s impact are coursing through the long-term care industry. Skilled nursing operators could be the “net losers” under the GOP-led tax Read More

• QCP Extends ManorCare Receivership Deadline into 2018

  Dec 04 2017

  Troubled nursing home operator HCR ManorCare got an early Christmas present from its primary landlord Monday morning: another month and a half to respond to a receivership claim. Quality Care Properties, Inc. (NYSE: QCP) pushed back ManorCare’s deadline to January 15, the fourth such extension since the real estate investment trust (REIT) initially filed a Read More

• Opinion: Nursing Homes Need to View Regulators as Partners — Or Perish

  Dec 03 2017

  My job involves combing through Google Alerts in search of the latest filings and nuggets of news about the skilled nursing industry. Most are false positives — especially during the autumn, when my alert for “SNF” returns more information about the coming week’s Sunday Night Football matchup than skilled nursing facilities. But ever since I Read More

• Genesis HealthCare Faces Stock Delisting Warning Amid Financial Pressures

  Nov 30 2017

  Genesis HealthCare (NYSE: GEN) this week received a delisting warning from the New York Stock Exchange, giving the skilled nursing provider six months to see improvements in its stock price. The Kennett Square, Pa.-based company’s stock averaged less than $1 per share over a recent 30-day trading period, a violation of the NYSE’s continued listing Read More

• Warren Presses HHS Pick Over Anti-Psychotic Drugs in Nursing Homes

  Nov 29 2017

  President Trump’s pick to lead the Department of Health and Human Services faced pointed questions Wednesday about his former employer’s history with marketing anti-psychotic drugs to nursing home operators. Alex Azar, most recently a top executive at pharmaceutical giant Eli Lilly and Company (NYSE: LLY), pushed back against criticism of his former company’s history with Read More

• Skilled Nursing Bulletins: Fire Safety Scrutiny, Anti-Psychs in Kansas

  Nov 28 2017

  Fires Bring New Scrutiny to SNF Safety In a year that has already brought significant national attention to the way nursing homes handle natural disasters, concerns about fire risk are springing up across the country in the wake of a Pennsylvania fire that killed four long-term care residents. That blaze, at the Barclay Friends Senior Read More

• CMS Delays Enforcement of Smoking Rules, Other Phase 2 Requirements

  Nov 28 2017

  Skilled nursing operators can breathe a little easier as the second phase of the new Requirements for Participation takes effect this week: The Centers for Medicare & Medicaid Services (CMS) has delayed penalties for several of the new requirements. For the next 18 months, CMS won’t take enforcement action — in the form of civil Read More

• Former Long-Term Care Exec Bets on Cannabis Demand in Canadian SNFs

  Nov 27 2017

  Bruce Dawson-Scully spent years in the long-term care development and operations business in Canada, first in his family business and then as an executive with Sienna Senior Living in Ontario. In 2013, when the country overhauled its medical marijuana laws to allow commercial production and sales for the first time, Dawson-Scully decided to help launch Read More

• Programming Note: Happy Thanksgiving from Skilled Nursing News

  Nov 21 2017

  All of us at Skilled Nursing News hope you have a solid Thanksgiving ahead: No matter how or where you celebrate, we wish you good times with family, friends, and food, along with safe travels to your holiday destinations. We also salute the caregivers, administrators, and other staffers who work through the holiday to keep Read More

• Nursing Home Residents Lack Palliative Care Access, Study Finds

  Nov 20 2017

  Only a very small percentage of nursing home residents who would benefit from palliative care typically receive it, according to a new study released Monday by the Journal of the American Medical Association (JAMA). The researchers, which included representatives from the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, analyzed Read More

• Skilled Nursing Must-Reads: Industry Pressures, 33-SNF Bankruptcy

  Nov 17 2017

  Welcome to Skilled Nursing News’s regular look at the biggest headlines from the week that was, your all-in-one place for the top stories you need to jumpstart your day and discover the things you may have missed. SNN brought you a peek into PointClickCare’s annual customer summit in Orlando, where executives declared that skilled nursing Read More

• Mainstreet Health Investments Makes $425M Acquisition, Announces Name Change

  Nov 17 2017

  Mainstreet Health Investments (TSX: HLP.U) on Friday announced a $425 million acquisition of Care Investment Trust, LLC, giving the Toronto-based real estate investment firm 42 new senior housing and skilled nursing properties. Care Investment Trust had previously been a subsidiary of Tiptree, Inc. (Nasdaq: TIPT), which will become Mainstreet’s largest shareholder upon completion of the Read More

• Almost Family, LHC Merge in $2.4 Billion Deal

  Nov 16 2017

  A little further down the care continuum, two of the largest home health care companies in the nation on Thursday announced a $2.4 billion merger. Louisville, Kentucky-based Almost Family, Inc. (Nasdaq: AFAM) and Lafayette, Louisiana-based LHC Group, Inc. (Nasdaq: LHCG) on revealed that they have agreed to combine in an all-stock merger of equals transaction. Read More

• Skilled Nursing Must-Reads: ManorCare’s Win, Genesis’s Reinvention

  Nov 10 2017

  Earnings season has brought a flurry of news from publicly traded skilled nursing operators and landlords, so in case you missed them the first time around, here’s a quick glance at the biggest stories in the SNF world from the past week — including a major structural shakeup at a leading provider. After a judge Read More

• Genesis Plans Major Restructuring, Blames Historic SNF ‘Down Cycle’

  Nov 09 2017

  Citing a declining census, rising nurse wages, and decreasing reimbursements, Genesis Healthcare (NYSE: GEN) this week announced a major restructuring of its leases with top landlords. The Kennett Square, Pennsylvania-based skilled nursing and post-acute care provider said it reached non-binding agreements with real estate investment trusts (REITs) Welltower, Inc. (NYSE: HCN) and Sabra Health Care Read More

• DOJ Drops False Claims Act Case Against HCR ManorCare

  Nov 09 2017

  The Department of Justice will drop a Medicare fraud case against HCR ManorCare, Inc., according to a court filing obtained by Skilled Nursing News. “The United States has advised Defendants of its intent to move to dismiss this case with prejudice,” the filing reads, indicating that the government will not pursue the matter further. United Read More

• Kindred Posts Solid Revenues Amid Ongoing SNF Sell-Off

  Nov 06 2017

  Kindred Healthcare, Inc. (NYSE: KND) turned in a better-than-expected third quarter, beating analysts’ estimates for revenue and announcing ongoing partnerships with its soon-to-be-sold portfolio of skilled nursing assets. The Louisville, Ky.-based operator has sold 68 of the 89 SNFs involved in its exit from the space, in a deal initially announced back in June, with Read More

• GOP Tax Plan Could Take Toll on SNF Residents, Operators

  Nov 05 2017

  As Congressional Republicans attempt to pass their new tax plan before the holiday recess in December, one major group in the long-term care industry says the legislation would harm residents and providers. LeadingAge — a trade group that represents non-profit nursing homes and other elder-care providers — spoke out against H.R. 1, claiming that House Read More

• Skilled Nursing Must-Reads: Omega’s Strategy Shift, Recruiting DONs

  Nov 03 2017

  We’re knee-deep in earnings season here at Skilled Nursing News, and at least one major real estate investment trust (REIT) used the reporting period to signal a sea change in its strategy going forward. In case you didn’t catch them the first time around, here are the headlines you need to get up to speed Read More

• QCP Pushes ManorCare Deadline Back to December

  Nov 02 2017

  Quality Care Properties, Inc. (NYSE: QCP) on Thursday granted yet another reprieve to its troubled tenant, HCR ManorCare. The Toledo, Ohio-based skilled nursing provider now has until December 1 to respond to a receivership claim that QCP originally filed in August. It’s the third such delay that the real estate investment trust (REIT) has granted Read More

• Advance Care Planning Study Seeks to Help SNFs Help Themselves

  Nov 01 2017

  Academic studies abound in nursing homes, but once the grant money runs out and the researchers pack up their notebooks, the positive effects on localized care can disappear as well. That’s why a team from Indiana University—Purdue University Indianapolis (IUPUI) elected to develop a study on the effects of advance care planning that seeks to Read More

• Why Proposed Federal Disaster Regulations Could be Good for Skilled Nursing

  Oct 26 2017

  Earlier this week, a U.S. representative announced a plan that would bring a Florida-specific emergency preparedness rule to all 50 states. And while providers in the state had expressed concerns over the regulations, national organizations say the rule could prove to be a boon for operators and residents alike. Under Rep. Debbie Wasserman Schultz’s proposed Read More

• Fla. Representative Plans Federal Nursing Home Generator Bill

  Oct 23 2017

  Rep. Debbie Wasserman Schultz on Monday became the latest lawmaker to tackle emergency preparedness in skilled nursing facilities, announcing plans to introduce federal generator legislation. Wasserman Schultz, a Democrat who represents Florida’s 23rd Congressional district, rolled out the plan in a news conference that also featured family members of residents from the Rehabilitation Center at Read More

• Skilled Nursing Facilities Cut Hospitalizations in CMS Initiative

  Oct 20 2017

  A multi-year initiative from the Centers for Medicare & Medicaid Services (CMS) to lower hospitalizations in long-term care has its first set of finalized results, with data showing that the plan is working so far. CMS on Friday announced that all seven participating sites saw declines in hospitalizations. Six of the seven had statistically significant drops in Read More

• Skilled Nursing Must-Reads: ManorCare’s Reprieve, Generator Battle

  Oct 20 2017

  Between the American Health Care Association’s annual conference and expo in Las Vegas and another update in the ongoing drama between a major provider and its landlord, it’s been a busy week in the world of skilled nursing. Check out our weekly roundup of must-reads to get you caught up: QCP Extends ManorCare Deadline Quality Read More

• What SNF and Hospital Workers Really Think About the Discharge Process

  Oct 19 2017

  The transition between hospital to skilled nursing facility presents a key opportunity to reduce rehospitalization risk, improve outcomes and save money — but a new study finds that players on both sides often aren’t on the same page. The research team, led by Sarwat Chaudhry of the Yale Center for Healthcare Innovation, Redesign, and Learning Read More

• Arbitration Battle in SNFs Isn’t Just for Residents

  Oct 19 2017

  Arbitration agreements between skilled nursing operators and residents have become a key battleground in the long-term care space, as the Centers for Medicare & Medicaid Services (CMS) seeks to roll back an Obama-era regulation that would have banned them. But the fight over arbitration clauses — which prevent parties from seeking legal remedies from disputes Read More

• How SNF Executives Can Lobby Lawmakers Without Leaving the Building

  Oct 18 2017

  Fresh off a battle that nearly saw wholesale changes to the Medicaid program, skilled nursing lobbyists say the work isn’t over — and that operators on the front lines can often be the most effective voices in reaching Washington. One of the primary reasons that Congress came so close to gutting Medicaid as part of Read More

• Despite Obamacare Repeal Failures, SNFs Shouldn’t Think Medicaid is Safe

  Oct 17 2017

  Congressional Republicans may have failed at several attempts to repeal the Affordable Care Act and enact deep cuts to the Medicaid program, but at least one expert says long-term care providers shouldn’t breathe a sigh of relief just yet. “I don’t think the states feel like Medicaid is safe right now, and I don’t think Read More

• SNFs Break Down Barriers Between Care Partners to Cut Rehospitalizations

  Oct 16 2017

  Under the new regulatory landscape, avoiding rehospitalizations is king — not just for the skilled nursing facility, but for the hospital and any home health providers that may provide care after discharge. But too often, SNFs focus on care within the facility only, and don’t take steps to manage the entire process from hospital to Read More

• Skilled Nursing Transactions: $12.7M SNF Sale in Georgia

  Oct 15 2017

  Blueprint Arranges Sale of Two GA SNFs Blueprint Healthcare Real Estate Advisors helped arrange the sale of two Georgia skilled nursing and long-term care facilities on behalf of a publicly traded real estate investment trust (REIT). The two facilities — the 100-bed Etowah Landing in Rome, Ga. and the 210-bed River Towne Center in Columbus, Read More

• Why SNF Investment Risk Exists in the Eye of the Beholder

  Oct 15 2017

  Among large swaths of the real estate investment community, reducing exposure to skilled nursing assets is considered a smart play at the moment. Given the uncertain regulatory landscape and shifting payment models, betting on SNFs may just not seem worth it. But several players in the SNF investment market believe that the asset class isn’t necessarily Read More

• Skilled Nursing Must-Reads: The $1 SNF, Occupancy Drops

  Oct 13 2017

  Welcome to Skilled Nursing News’s weekly roundup of the top headlines you need to see to kick-start your morning — from a SNF with a curiously low asking price to more negative trends in occupancy to the long-term effects of a lawsuit over snacks in Pennsylvania. SNN readers flocked to the story of a former Read More

• Amid Fires, California SNFs Face Tough Evacuation Decisions

  Oct 11 2017

  With wildfires threatening multiple communities in Northern California, skilled nursing and other senior living operators are facing a dilemma all too familiar to those who work in the Gulf Coast states: to evacuate or not to evacuate? For some, the choice was clear: In Santa Rosa, Calif., officials at four Oakmont Senior Living communities evacuated 350 residents Read More

• Skilled Nursing Transactions: Former Golden Living Property Could Sell for $1

  Oct 10 2017

  Former Golden Living Building on Block for $1 A Pennsylvania building that once housed a Golden LivingCenter nursing home could sell for as little as $1. That’s the current bid as of Tuesday afternoon in an online auction for the defunct SNF in Cambridge Springs, Pennsylvania. Crawford County authorities currently own the 34,067-square-foot building, which was Read More

• Skilled Nursing Bulletins: Fla. Gov. Wants Constitutional Protections

  Oct 08 2017

  With yet another storm affecting the Gulf Coast — this time Hurricane Nate — the Florida government continues to plan its response to the nursing home deaths in the wake of Hurricane Irma last month. Here are some of the latest updates: Gov. Rick Scott has called for an amendment to the state’s constitution that Read More

• Skilled Nursing Must-Reads: Kindred’s Long Goodbye, Custodial Care Endangered

  Oct 06 2017

  It’s been a busy few weeks in the world of skilled nursing, from a flurry of mergers-and-acquisitions news to a major industry executive’s bold prediction about the future of custodial care. In case you missed them the first time around, here’s a quick recap of the biggest stories you need to read to catch up. Read More

• Quality, Scope of Medicare Advantage Plans Varies Widely

  Oct 05 2017

  As Medicare Advantage becomes increasingly common in the skilled nursing space, consumers may still have trouble determining whether a plan works best for them — or even provides quality coverage with access to a wide variety of physicians and SNF care. And even if a potential MA enrollee finds a plan that appears to cover Read More

• House Democrats Ask CMS to Uphold Arbitration Ban

  Oct 04 2017

  House Democrats on Wednesday called on Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to change her mind on reinstating the use of arbitration clauses in skilled nursing contracts. Referencing the recent problems at nursing homes in the aftermaths of Hurricanes Harvey and Irma, 46 Democratic representatives wrote a letter to Verma asking Read More

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