Nursing home fines declined even as the number of deficiencies increased, according to a new report released last week by the Long Term Care Community Coalition (LTCCC), a New York-based nonprofit. LTCCC’s report, which analyzes deficiencies and fines on a per-resident basis rather than solely per facility to assess the impact on nursing home residents, found […]
Category: Compliance
AI and predictive analytic tools can help operators improve clinical care, reduce staff workloads, and identify future health issues earlier. But operators must support staff without adding complexity to their operations to make them work. Tech partners and in-house platforms can help nursing home operators avoid unapproved technologies that could expose a facility to HIPAA […]
A wave of nursing home acquisitions by out-of-state chains has coincided with declining care quality in Massachusetts. The state’s post-pandemic nursing home market has allowed aggressive new owners like RegalCare to acquire facilities, reduce costs and redirect substantial sums to affiliated businesses while star ratings declined, according to the Boston Globe’s Spotlight nursing home investigation. […]
The latest update to the Minimum Data Set addresses a major concern for providers facing state case-mid audits and medical reviews, which often demand additional or conflicting documentation. But these updates by the Centers for Medicare and Medicaid Services (CMS) to the MDS 3.0 Resident Assessment Instrument (RAI) manual, which are due to be implemented […]
The number of licensed nursing home beds and facilities has steadily declined in New York, reflecting a broader trend across the country. There have been 24 nursing home closures in the state since 2020, or a loss of more than 3,000 licensed beds, according to a report in the New York Times. As for operators […]
American Healthcare REIT (NYSE: AHR) sees regional nursing home operator Trilogy Health Services as a gold standard for operational lessons to apply across its portfolio and across care settings, and an “operational laboratory” to test out best practices. That’s according to AHR Chairman and CEO Jeff Hanson, who spoke at the Bank of America Securities […]
A lack of consistency in how the Centers for Medicare and Medicaid Services (CMS) reimburses programs serving special needs plan (SNP) populations is getting in the way of improving outcomes and reducing hospitalizations, according to providers, payers and consultants in the nursing home sector. Today’s institutional beneficiary is usually eligible for models with similar clinical […]
Nursing home surveys in New Jersey have fallen behind state and federal regulatory requirements, with inspections frequently delayed. State officials say the delays are due to Covid backlogs, hiring freezes and loss of staff. Federal policy requires each of the state’s 350 nursing homes to be inspected at least every 15 months, while statewide average […]
Nursing homes have only reached the tip of the iceberg when it comes to mental health challenges in the sector, with such challenges affecting quality metrics (QMs) and reimbursement amid renewed monitoring of antipsychotics use in facilities. Operators must start preparing now for behavioral health needs in residents, equipping themselves to handle multiple patient populations. […]
While the Centers for Medicare and Medicaid Services’ (CMS) bid to make resident satisfaction a mandatory part of federal regulation was shelved, a pilot program across skilled nursing facilities is demonstrating the power of resident councils to improve both care quality and the nursing home industry’s tarnished reputation. An 18-month resident council pilot program in […]
With greater scrutiny of case-mix growth and coding, nursing homes should be strengthening documentation. Operators should also prepare now for expanded MDS reporting requirements beginning in 2029, reimbursement experts said. To be sure, the Centers for Medicare and Medicaid Services (CMS) is not implementing a case-mix adjustment in the FY 2027 final rule, but the rule’s language makes clear […]
Nursing homes would be wise to establish protocols – and comment on a certain proposed rule – to safeguard themselves from complications stemming from fraud, waste and abuse initiatives underway as part of a broader focus on Medicare and Medicaid program integrity. That’s because the Trump administration has made this a government-wide priority, and one of the first glimpses […]
Nursing home validation audits so far show MDS coding gaps tied to insufficient or missing documentation, often because of inadequate record-retention practices. And while penalties currently focus mainly on submission timelines, federal agencies could use the findings to inform future regulations related to quality reporting, experts said. MDS accuracy and documentation are a growing area of scrutiny […]
Nursing homes may be impacted by a health insurer’s decision to cut benefits for 3,500 low-income seniors in California, with the latest extensions for the program going through Dec. 31. Health Net has announced a cut to assisted living benefits in the state, and leaders in the post-acute sector believe this may lead to resident […]
In the upcoming era of risk-based surveys, consistency in storing and accessing patient data across facilities, especially following mergers and acquisitions, is ever more important. Providers will have to reconcile with some things remaining the same, however, including surveyor subjectivity. Even as the change to the risk-based survey process has been lauded by the sector […]
Minimum Data Set (MDS) submissions are about to become a lot more complicated for skilled nursing facilities (SNFs), as the Centers for Medicare & Medicaid Services (CMS) places greater emphasis on the accuracy and timeliness of quality reporting while tightening the MDS reporting window in its final payment rule. Under the FY 2027 SNF Final […]
A shortage of guardians, or those empowered to make medical decisions on behalf of incapacitated patients, is contributing to a hospital bottleneck in Massachusetts, according to a report published by the Massachusetts Department of Public Health (DPH) and Eastern Research Group, in collaboration with the Bureau of Health Safety and Quality. The DPH estimates there […]
As part of the federal government’s new risk-based survey model, nursing homes will be marked as “high-performing” using a little gold trophy icon on Care Compare. While the icon could be a powerful marketing tool, sector leaders warn that its use could be problematic on many fronts. First, the gold trophy’s presence could create the […]
The nursing home industry has generally welcomed the risk-based survey approach announced last month by the Centers for Medicare and Medicaid Services (CMS), which rewards high-performing facilities with surveys that take half the time and require fewer surveyors. But the new surveys aren’t simply a Five-star ratings shortcut. CMS created an eligibility test that only […]
Traditional skilled nursing environments remain highly institutional, characterized by visible nurses’ stations, medical equipment and hospital-like layouts. Peter van Kalkeren, COO of Skokie, Presbyterian Living, wants to change that. As Presbyterian Living prepares for measured growth while strengthening its existing operations, the Skokie, Illinois-based organization is updating its buildings to adapt its skilled nursing facilities […]
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