Certain nursing home operators and politically connected investors have profited through financial schemes, chronic understaffing and weakened federal oversight, according to a new Senate Finance Committee minority report released Thursday. Meanwhile, the nursing home industry appears divided over transparency requirements and federal staffing standards. The report alleges that while the Trump administration rewarded some industry […]
The national Civil Monetary Penalty Reinvestment Fund (CMPRF) balance increased to $713.6 million as of Jan. 1, 2026, up $97.6 million, or 15.85%, from $616 million reported a year earlier. This is according to updated state-by-state data published this week by the Centers for Medicare and Medicaid Services (CMS). Ohio recorded the largest increase in […]
Lawmakers are raising concerns about the Centers for Medicare and Medicaid Services’ (CMS) new Risk-Based Survey program for nursing homes, warning in a letter Tuesday that shortened inspections could put thousands of residents at risk. In the letter addressed to CMS Chief Dr. Mehmet Oz, Sens. Elizabeth Warren, D-Mass., and Mazie K. Hirono, D-Hawaii, expressed […]
The top 10 states with the most nursing home citations tied to insufficient staffing so far this year include Iowa, Illinois and California, among others. An analysis of data from the Centers for Medicare and Medicaid Services (CMS) by the Iowa Capital Dispatch shows that staffing violations don’t result in fines or any other financial […]
Sweetwater Care affiliates were blocked from acquiring 11 Next Step Healthcare nursing homes in Massachusetts, according to a ruling by the state Department of Public Health. Affiliates of Carlsbad, California-based Sweetwater were found “unsuitable” to acquire the Massachusetts facilities by state officials.; Sweetwater can appeal the decision but isn’t allowed to obtain a license for […]
As lawmakers aim to overhaul the nation’s long-term care (LTC) system, with proposals addressing nursing home ownership transparency and staffing standards, providers are seeking adjustments while expressing support for many of the proposed changes. Senate Finance Committee Democrats, led by Ranking Member Ron Wyden, who issued a request for information (RFI) on Friday, are seeking […]
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 […]
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 […]
