Diversicare ‘A Very Different Company’ After Kentucky Exit, Touts 7.5% Medicare Rate Boost

Despite a net loss for the quarter, skilled nursing operator Diversicare Healthcare Services (OTCQX: DVCR) touted its performance at the end of 2019, pointing to a 7.5% Medicare rate boost and generally positive performance under the new Patient-Driven Payment Model (PDPM). “With our portfolio changes behind us after the Kentucky exit and the implementation of the new […]

DOJ Forms Nursing Home Task Force, Promises Criminal and Civil Penalties for Owners and Operators

The Department of Justice this week announced the creation of a specialized task force targeting “grossly substandard care” in nursing homes, with both criminal and civil penalties on the table for owners and operators. About 30 individual facilities across nine states are already under investigation, the DOJ revealed in announcing its new National Nursing Home […]

‘I Would Take a SNF Operator With Me in a Dark Alley’: How Nursing Homes Can Prove Worth to a Skeptical Public

Nursing home providers have long suffered from a worse public image than their peers along the senior housing and care continuum, with just the phrase itself conjuring images of a place that few people would ever choose to call home. It’s a problem that leaders with decades of experience in the space acknowledge could become […]

CMS Confirms Some PDPM Claim-Processing Errors, Promises Fix by October

The federal government on Thursday acknowledged some errors in processing Medicare claims under the new payment system for nursing homes, promising to make a full correction by the start of its next fiscal year. The main issue has to do with the sequence of initial claim filings for Patient-Driven Payment Model (PDPM) reimbursements, the Centers […]

Rise of Data Could Bring More False Claims Act Cases, CMS Scrutiny to Skilled Nursing

Attend any conference geared toward long-term and post-acute health care operators, and you’ll hear a common thread: Data is king. In a landscape defined by value-based payment models such as Medicare Advantage plans and accountable care organizations (ACOs), investing in data analytics has become almost a prerequisite for success. If a given operator can prove […]

Verma: CMS’s Nursing Home Oversight Push More ‘Internal’ Amid PDPM Shift

Seema Verma on Tuesday laid out a sweeping plan for data-driven oversight and enforcement across the health care spectrum, and took a similarly broad view of her agency’s regulatory plans when directly asked about potential changes to the new Medicare payment model for nursing homes. Specifically citing the early success of the agency’s recent push […]

I-SNPs vs. ACOs: Balancing the Skilled Nursing Risks, Rewards of Two Hot Payment Models

As the skilled nursing industry struggles to adapt to a new Medicare payment landscape, in-house Medicare Advantage plans have emerged as one of the hottest topics among leaders — while the space’s publicly traded behemoth has thrown its full support behind the separate accountable care organization (ACO) model. There may not be one set answer […]

CMS Proposes Three-Year Extension, Additional Outpatient Coverage for CJR Bundled Payment Model

The federal government on Thursday issued a proposed rule that would extend the Comprehensive Care for Joint Replacement (CJR) bundled-payment model for an additional three years — while also expanding its reach to include outpatient procedures. Initially set to expire on December 31, CJR would remain active through the end of 2023 if the Centers […]

After Record Rosewood Default, HUD Tightens the Screws on Skilled Nursing Financing

Nursing home operators that have relied on government-backed financing for acquisitions and renovations can begin measuring time in two distinct eras: pre-Rosewood and post-Rosewood. The record-setting default on the Rosewood Care Centers portfolio, publicized in the New York Times, has prompted the Department of Housing and Urban Development (HUD) to take a harder line on […]

Nursing Home Operator Guardian Elder Care to Pay $15.5M in False Claims Act Settlement

Guardian Elder Care, a nursing home operator with more than 50 buildings, will pay $15.5 million to resolve federal accusations of medically inappropriate therapy practices, the Department of Justice announced Wednesday. The Brockway, Pa.-based Guardian faced allegations — brought by a pair of former employees — that the company pressured therapists to perform unnecessary services […]

‘CMS Loves That’: Moderate Therapy Shifts, Bureaucratic Reality Could Slow PDPM Changes

Despite steady reports of increasing reimbursements under the new Medicare payment model for nursing homes, at least one industry leader believes that the federal government will be happy with the early returns — and that any changes are fairly far down the road. Skilled nursing operators have not gone overboard with the strategy changes that […]

Buoyed by Series A Funding, Skilled Nursing Telehealth Firm Tapestry Targets Managed Care, Home Health

Fresh off a successful Series A funding round, a telehealth company that built its platform around serving rural skilled nursing facilities sees growth ahead in urban markets — as well in serving other post-acute providers along the continuum. TapestryCare last week announced the completion of a funding round led by the New York City-based Sopris […]

ManorCare Exceeds Expectations, in Talks to Strike Post-Acute Partnerships with Health Systems

Skilled nursing giant HCR ManorCare outperformed projections in its first full year as a tenant of Welltower Inc. (NYSE: WELL), the real estate investment trust (REIT) announced Thursday, and could soon expand its footprint to include partnerships with health systems outside of its current orbit. “[The] ManorCare portfolio did not hit our expectation; it exceeded […]

Verma Strikes Back on MFAR: Worries Over Billions in Medicaid Cuts ‘Alarmist’ and ‘Overblown’

The head of the Centers for Medicare & Medicaid Services (CMS) on Wednesday issued a strong defense of a proposed rule that nursing home advocates claim would place up to $50 billion in Medicaid reimbursements in immediate jeopardy, framing the move as a necessary step toward reducing fraud and waste. The Medicaid Fiscal Accountability Regulation […]