The new direction of the Centers for Medicare and Medicaid Services (CMS) renews focus on harmonizing payments across care settings – a shift that could impact nursing home profits – even as the federal agency’s commitment to advancing value-based care (VBC) remains strong. In a meeting held by the Center for Medicare and Medicaid Innovation […]
A nursing home regulatory model focused on real-time collaboration between state, federal and provider leaders is crucial, considering existing outdated and punitive regulatory practices seen in some states. In Texas, for example, there’s a disproportionate issuance of immediate jeopardy (IJ) citations and associated financial penalties, which discourage investment in the industry while demoralizing staff, Focused […]
High-level citations could be on the rise since new requirements for transfers and discharges went into effect on April 28. Immediate jeopardy (IJ) citations, for instance, that are dreaded by nursing home operators and are often the result of the many benign and avoidable ways facility staff can misunderstand the citation, can increase with the […]
Cost-cutting measures in nursing homes, particularly food budgets, have been a concerning underlying issue in the industry, with more than a quarter of facilities in the country spending under $10 per day on food per resident. An investigative report by NJ Advance Media, in collaboration with Rutgers University and data experts at SNFdata Resources of […]
While the demand for nursing home MDS coordinators has always been higher than their availability, some organizations are beginning to see fruits from concerted efforts to stabilize this specialized role. MDS coordinators ensure accuracy of minimum data set (MDS), which in turn is evaluated by surveyors. With brand new survey changes going into effect Monday […]
The Department of Veterans Affairs (VA) has yet to address a recommendation made by the U.S. Government Accountability Office (GAO) to identify additional enforcement actions for VA nursing homes, and to ensure such facilities comply with quality standards. The recommendation was made as part of a November 2022 report to help the VA oversee these […]
Changes to nursing home survey protocols — set to take effect April 28 — are putting a sharper focus on resident rights, documentation practices, and medication oversight. The revisions demand airtight documentation, particularly around discharge, behavioral health interventions and psychotropic drug use. Of the ten area changes due to take place, providers should pay the […]
The Centers for Medicare and Medicaid Services (CMS) is once again delaying the deadline to file revalidation paperwork, moving it from May 1 to August 1. It’s a welcome relief for operators given that a vast majority of nursing homes haven’t completed the burdensome paperwork. Martin Allen, senior vice president of reimbursement policy at the […]
The Trump Administration is preparing a plan to eliminate federal regulations swiftly and permanently, which could include removal of the nursing home staffing mandate. According to the New York Times, officials at several federal agencies are being instructed to bypass the traditional repeal process, one that often takes years. President Donald Trump has requested officials […]
With termination notices ramping up for nursing homes on the Special Focus Facilities (SFF) list, operators and legal counsel close to the matter say the time is ripe for an overhaul of the program. For starters, the independent dispute resolution (IDR) process needs to be revised, and a more timely appeals process should be essential. […]
Abrupt termination notices related to Medicaid and Medicare certification for nursing homes on the Special Focus Facilities (SFF) list have picked up dramatically as of late February, often occurring without warning or giving facilities the chance to demonstrate improvement. As a result of these abrupt terminations, nursing homes on the list have closed, including 143-bed […]
The Centers for Medicare and Medicaid Services (CMS) released a proposed rule on Friday outlining Medicare payment policy and rate updates for skilled nursing facilities under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year 2026, as part of its annual update requirements. For fiscal 2026, CMS plans to increase SNF PPS […]
The Centers for Medicare & Medicaid Services (CMS) issued a final rule Friday to modernize and improve several Medicare programs, including Medicare Advantage (MA), but it does not include new restrictions on MA plans’ use of artificial intelligence. The rule for contract year 2026, effective June 3, introduces changes to prescription drug coverage, the Medicare […]
Nursing home surveys – already an area of trouble given chronic underfunding – are set to fall into deeper turmoil amid massive workforce cuts and restructuring planned at the Department of Health and Human Services (HHS). Chiquita Brooks-LaSure, former chief of the Centers for Medicare and Medicaid Services (CMS), expressed skepticism that the Trump administration’s […]
The Department of Health and Human Services (HHS) restructuring plans announced Thursday could impact several departments serving the nursing home sector, leaving operators on edge. The department plans to cut around 10,000 full-time employees, including 300 at the Centers for Medicare and Medicaid Services (CMS), in the latest round of cuts. Combined with HHS’ previous […]
With many of the upcoming nursing home survey changes being tied to care transitions to home, hospitals or other settings, operators say the link between clinical teams and these transitions is more important than ever. However, even though worker shortages have complicated transitions, operators haven’t given up on finding workarounds. So, how do operators square […]
Razor thin margins have been a hallmark of operators in the nursing home industry for some time, but lackluster Medicaid rates and the possibility of Congressional cuts to Medicaid may push some over the edge. The spectre of closures, and in turn access issues for residents and their family members, has been haunting the industry […]
Dr. Mehmet Oz vowed to reduce the bureaucratic footprint of the Centers for Medicare & Medicaid Services (CMS) if confirmed to lead the federal agency. He also acknowledged problems with Medicare Advantage plans and criticized the preauthorization process and overbilling by insurers. During his appearance before the Senate Committee on Finance Friday, Oz seemed to […]
The Medicare Payment Advisory Commission (MedPAC) has recommended that Congress reduce nursing home Medicare base payment rates by 3% for 2026. The Commission tempered their cut, they said, acknowledging uncertainty around the impact of the new nurse staffing requirements on costs to the sector next year. While many in the sector expect the mandate to […]
During a House subcommittee hearing on post-acute care held on Tuesday, Medicare Advantage plans were the target of bipartisan criticism as lawmakers sought solutions to curb the declining access to and affordability of nursing home care, as well as other long-term care, amid staffing shortfalls and proposed Medicaid cuts. Improper denials and delays by Medicare […]
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