Ensign Group Completes Five-Year OIG Oversight Agreement

Leading skilled nursing provider The Ensign Group (Nasdaq: ENSG) on Thursday announced that it has successfully completed a five-year Department of Health and Human Services (HHS) oversight period. The Mission Viejo, Calif.-based company initially entered into a corporate integrity agreement (CIA) with the HHS Office of the Inspector General (OIG) back in October 2013; at […]

Doctors, Software, Training: Preparing for ‘Non-Negotiable’ PDPM Coding Pressures

Starting October 1, skilled nursing facility operators will have no choice but to become proficient with a specific type of medical coding that previously had no bearing on reimbursements — and leading industry voices say there are multiple paths to getting there. ICD-10 codes, specific diagnosis identifications long used by hospitals, will play a key […]

PDPM’s Effects Could Stretch Far Beyond Medicare for Skilled Nursing Facilities

On paper, the Patient-Driven Payment Model (PDPM) will only affect one pillar of the payment equation for skilled nursing facilities. But as players start to unpack the coming rule changes, PDPM’s reach begins to extend far beyond Medicare. Medicare Advantage and Medicaid frequently base rate calculations on the existing Medicare structure, a pair of experts […]

Avoiding Million-Dollar Medicaid Eligibility Mistakes in Nursing Facilities

Skilled nursing operators can’t control day-to-day Medicaid rates in their states, but they do have a broad toolbox that can help them avoid eligibility errors and oversights that can cause millions in losses. In an era of constricted Medicaid reimbursements, frontline staff can still play a crucial role in maximizing dollars, sb2 Inc. CEO and […]

HHC Finance Looks to Build on $1B Year of SNF Lending Despite Shutdown Backlog

Housing & Healthcare Finance rode strong demand for bridge financing to a record-setting 2018 for its skilled nursing and assisted living lending practice, and while the government shutdown may lead to a 2019 slowdown, the company’s chief investment officer still sees strong demand ahead. The North Bethesda, Md.-based HHC Finance clocked more than $1 billion […]

MedPAC Again Calls for $2B in SNF Cuts, But Also Urges Caution Amid PDPM Shift

The Medicare Payment Advisory Commission (MedPAC) on Friday again called for up to $2 billion in cuts to skilled nursing reimbursements under Medicare — but with a caveat that the new payment model could cause significant changes for operators moving forward. The nation’s more than 15,000 skilled nursing facilities should not receive a scheduled 2.6% […]

Lawmakers Again Take Aim at ‘Observation Stay’ Rules for Medicare SNF Coverage

A bipartisan coalition of federal lawmakers this week took another stab at clarifying the rules regarding a frequently confusing aspect of skilled nursing coverage under Medicare. Under the terms of the proposed legislation, the Improving Access to Medicare Coverage Act of 2019, so-called “observation stays” would count toward the three days of inpatient acute care […]

Skilled Nursing Facilities Outperform Home Health on Readmission Rates: Study

Despite the increasing preference among payers and hospital partners to discharge residents to home health agencies, brick-and-mortar skilled nursing facilities are superior at reducing hospital readmissions — with one key caveat. After controlling for a variety of factors, residents sent from a hospital to the care of a home health agency had a 5.6-percentage-point higher […]

Hager: Shift from SNFs to Home Has Run Course, Therapy Costs to Drop 10% to 15% Under PDPM

Large-scale efforts to shift post-acute residents from skilled nursing facilities to the home health space have largely “run their course,” Genesis HealthCare (NYSE: GEN) CEO George Hager said Tuesday, while also predicting serious cost savings under the new Medicare payment model. Though industry leaders have long worried about payers’ growing preference for the lower-cost home […]

Invesque CEO White on Why It’s ‘Dangerous’ to Worry About Year-to-Year Changes in SNF Space

As real estate investment firm Invesque Inc. (TSX: IVQ.U) continues its diversification plan after a 2016 separation from skilled nursing operator Mainstreet, its CEO insists that the future for the SNF space remains bright. In fact, Scott White’s Invesque — known as Mainstreet Health Investments until late 2017 — continues to own buildings developed by its […]

Trump Budget Plan Would Cut $845B from Medicare, $241B from Medicaid

The White House on Monday released a budget proposal that would substantially slash Medicare and Medicaid spending over the next decade. In part by adopting a site-neutral payment model for post-acute care under Medicare and converting the Medicaid system to block grants, the federal government would end up gutting more than $1 trillion from the […]

Nurses May Need to Shoulder Documentation Burdens Under PDPM

Once the new Medicare payment model takes effect, frontline nurses may prove vital to securing the proper reimbursements for skilled nursing services. The Patient-Driven Payment Model (PDPM) will place increasing pressure on nursing facilities to justify each resident’s need for Medicare-reimbursed skilled care, Zimmet Healthcare Services Group president Marc Zimmet said during a recent industry […]

Real Time Medical Raises $10M to Expand Skilled Nursing Analytics Platform

The developer of a software platform that has brought substantial hospital readmission cuts to skilled nursing facilities now has a $10 million cash influx to expand its footprint. Real Time Medical Systems raised that haul in a successful funding round involving multiple investors led by SunBridge Capital, Real Time founder and executive chairman Scott Rifkin […]

ProMedica Loses $70M in 2018 After ManorCare Skilled Nursing Acquisition

Non-profit hospital operator ProMedica announced its first set of annual financial data after acquiring skilled nursing giant HCR ManorCare last year, and the early results weren’t positive. The Toledo, Ohio-based firm reported $70 million in losses for fiscal 2018, according to an unaudited financial report for bondholders, despite a major revenue gain from absorbing approximately […]

CMS to Crack Down on Staffing, Separate Short- and Long-Term Stays in SNF Star Rating Overhaul

The Centers for Medicare & Medicaid Services (CMS) on Tuesday announced stricter standards for its consumer-facing nursing home ratings, including a lower threshold for staffing penalties and new separate ratings for short-term and long-term stays. Starting April 24, CMS will automatically hand out one-star staffing ratings to buildings that have four or more days in […]