A federal judge this week ordered that a long-running lawsuit against the government over Medicare skilled nursing benefits must go to trial, citing the very real risk that residents have been wrongly denied coverage. U.S. District Judge Michael Shea rejected the Department of Health and Human Services’ (HHS) request to dismiss the class action suit, […]
The Evangelical Lutheran Good Samaritan Society has sold a pair of skilled nursing facilities to for-profit industry leader The Ensign Group (Nasdaq: ENSG), Skilled Nursing News has learned, marking the latest in a series of recent dispositions by the non-profit provider. The two properties in Mesa and Peoria, Ariz., branded as Good Shepherd, will be […]
Pressured by already light coffers and razor-thin margins, skilled nursing facilities could see an even wider gulf grow between top and bottom performers under the new Medicare payment model. That’s at least according to Cain Brothers director Taaha Shaikh, who this week wrote a commentary calling the coming Patient-Driven Payment Model (PDPM) “the next great […]
The Centers for Medicare & Medicaid Services (CMS) on Wednesday announced an open challenge to tech providers, dangling $1 million for the algorithms that can best predict potential admissions to skilled nursing and other health facilities. With the Artificial Intelligence Health Outcomes Challenge, CMS hopes to entice tech firms and individuals to compete against each […]
Despite the second straight year of declines in overall recoveries, the Department of Health and Human Services’ (HHS) top watchdog arm took back nearly $50 million in Medicaid reimbursements from nursing homes in fiscal 2018. The HHS Office of the Inspector General (OIG) this week reported a haul of $48.7 million from nursing providers accused […]
The Department of Health and Human Services (HHS) made a splash last month when it claimed that skilled nursing facilities received $84 million in Medicare payments for treatments that didn’t qualify — but now a group of doctors claims that the proposed cures might be worse than the disease. Writing in a blog post for […]
Housing & Healthcare Finance earlier this month pulled off an $81 million refinancing for Cascade Capital Group and its operating affiliate, Legacy Healthcare. The North Bethesda, Md.-based HHC Finance arranged the deal for a six-building portfolio in the greater Chicagoland area, refinancing the buildings through the Department of Housing and Urban Development’s (HUD) 223(f) loan […]
Therapy has taken center stage in the run-up to the new Medicare payment model for skilled nursing facilities, but a growing chorus has begun to frame the change as a return to the primacy of nurses in nursing homes — with a leading provider planning on adding 600 of them to meet the new priorities […]
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 […]
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 […]
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 […]
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 […]
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 […]
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% […]
A company that develops care coordination software similar to Slack has raised $2.5 million in a funding round aimed at expanding its reach to more hospitals and post-acute care facilities. Launched a little over a year ago, Olio aims to break down the barriers between hospitals and their post-acute partners by facilitating easy communication among […]
Skilled nursing operators saw static occupancy between the third and fourth quarters of 2018 — a notable, if moderate, bit of good news for an industry that had seen four straight years of declines. The nation’s nursing homes were approximately 82.4% full during the fourth quarter of last year, according to the most recent set […]
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 […]
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 […]
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 […]
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 […]
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