Nursing home leaders are anticipating big changes to the sector with President Donald Trump’s inauguration drawing closer. The federal staffing mandate is likely to be on the chopping block, as Republicans eye $22 billion in savings if it is delayed or stopped. However, operators must balance this win, among potential others, with the incoming administration’s […]
New reporting requirements related to acute respiratory illnesses for nursing homes will take effect on Jan. 1, according to the Centers for Medicare & Medicaid Services (CMS). Nursing homes must report data related to, but not limited to, the flu, Covid-19 and respiratory syncytial virus (RSV). The rule essentially replaces existing reporting requirements. Questions pertaining […]
A vast majority of nonprofit and government-owned nursing homes across the U.S. complied with federal infection prevention training requirements, according to the results of an audit conducted by the Office of Inspector General (OIG), released Tuesday. Those that failed to comply cited staffing challenges. The OIG’s audit, conducted between April 2024 through October 2024, examined […]
Federal agencies are honing in on ownership transparency and corporate-level compliance, most recently with the Office of Inspector General (OIG) citing concerns about certain practices that allow nursing homes to hide profits. OIG’s latest guidance focuses on the practice of “tunneling,” which refers to the misrepresentation or concealment of profitability in payments to related parties, […]
Surveyors will be evaluating for compliance in new ways, as a result of nursing home survey changes for 2025. While significant, these changes reflect federal initiatives that associations and operators have been seeing for some time now. Nursing home providers are parsing through recent, significant changes to the survey process and trying to grasp the […]
In the latest development related to litigation against the federal nursing home staffing mandate, the U.S. Department of Justice (DOJ) is urging a federal judge to deny the injunctive relief requested by 21 state attorneys general and several providers. The DOJ on Nov. 21 filed a memo with the U.S. District Court for the Northern […]
The Centers for Medicare and Medicaid Services (CMS) is set to implement a series of major revisions to its long-term care survey guidelines, effective February 2025. The changes, which were shared in an advance copy of a 900-page document, focus on a variety of areas, ranging from admission agreements and medication management to infection control […]
President-elect Donald Trump has picked Dr. Mehmet Oz, the renowned celebrity physician, to serve as administrator of the Centers for Medicare & Medicaid Services (CMS). The appointment was announced on Tuesday afternoon. “Our broken Healthcare System harms everyday Americans, and crushes our Country’s budget. Dr. Oz will be a leader in incentivizing Disease Prevention, so […]
Fewer than 20% of evaluated nursing homes made the list of “Best Nursing Homes” in U.S. News & World Report’s 2025 Best Nursing Homes rankings, out of nearly 15,000 facilities in the country. This includes those providing short-term rehabilitation, long-term care, or both. And, nearly half of nursing homes didn’t comply with federal regulation to […]
Uncertainty surrounding the information required for the new nursing home Medicare revalidation process has led to high levels of concern, particularly among for-profit operators, who view it as yet another punitive measure. Following letters from nursing home advocates about the rushed timing of the off-cycle revalidations, the Centers for Medicare & Medicaid Services (CMS) has […]
The long-term financial viability of nursing homes will be seriously challenged as operators face the fallout from the complete wind down of public health emergency (PHE) funds. This is especially true for nonprofit organizations, with many facilities unable to fund existing staffing levels. According to a report published in Health Affairs Covid-19 PHE funds allowed […]
Ahead of Tuesday’s presidential election, the two leading candidates appear to share some common ground regarding overall support for long-term care, including nursing homes, and their commitment to Medicare. However, a deeper look at their positions reveals differences that could, according to some, lead to changes in the nature of the Medicare program over time. […]
In 2025, the nursing home sector can expect several policy updates from the Centers for Medicare and Medicaid Services (CMS), Director Evan Shulman said on Tuesday. He highlighted the agency’s work on risk-based surveys to reduce delays and new consumer guides for which the agency is seeking feedback from nursing homes, among other initiatives. Speaking […]
While prior authorization has a legitimate role in Medicare Advantage coverage, the practice has expanded to the point of negatively affecting care. This aspect of MA needs to be right sized, and likely through legislation, nursing home leaders said. About 90%-plus of physicians, including those serving nursing home patients, have said that one or more […]
The Centers for Medicare & Medicaid Services (CMS) will no longer process optional state assessments (OSAs) after Oct. 1, 2025 for providers in states that are still transitioning to the Patient Driven Payment Model (PDPM). Moving ahead, CMS will not be involved in whether a state will continue to require the completion and submission of […]
On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released plans to update the State Performance Standards System (SPSS) for the 2025 fiscal year. This will involve eliminating two measures from the previous year, introducing a new one, and revamping several others. A new addition to the SPSS, which is the federal agency’s rubric […]
A newly released study casts doubt on whether the shift to Medicare Patient Driven Payment Model (PDPM) succeeded in the goal of curbing so-called “upcoding” practices among nursing homes. Conducted by researchers from the University of Rochester and the University of Texas at Austin, the analysis spans seven years and found patterns of exploitation that […]
The Centers for Medicare & Medicaid Services (CMS) overstepped its authority in finalizing the federal nursing home staffing mandate, which “cannot stand” and should be set aside swiftly by a judge. This is the argument that the American Health Care Association, LeadingAge and other plaintiffs made in a Motion for Summary Judgment filed on Oct. […]
The Centers for Medicare & Medicaid Services (CMS) went over the off-cycle Medicare revalidation process for nursing homes in its latest open door forum on Thursday, its first in several months. About one-third of all providers will receive a letter from their Medicare administrative contractor (MAC) between this month and December requesting completion of the […]
Skilled nursing facilities need reasonable flexibility and additional support to meet the latest federal mandate – an off-cycle revalidation process for Medicare – for which nursing home advocates are seeking an extension. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) sent a letter on Wednesday to the U.S. Department of Health […]
