CMS Value-Based Purchasing Proposals Draw Nursing Home Pushback, But ‘Stability is Welcome’

The Centers for Medicare & Medicaid Services’ (CMS) recently proposed Value-Based Purchasing Program updates include staffing provisions that are being met with provider concern, although other updates should be well received once the dust settles. Among recommended changes, CMS is proposing allowing SNFs to review and correct Payroll-Based Journal (PBJ) data beginning with the fiscal […]

Additional Fines, On Top of Doubled Maximum Penalties, Part of New State Law

Government leaders are cracking down on long-term care providers in Arizona, expanding health officials’ authority to monitor and fine operators in nursing homes, as well as assisted living and memory care. Legislation was signed into law on Monday, originally designed to establish minimum training standards for staff working with memory care residents, according to a […]

‘Further Squeezed’: Medicare Advantage Reimbursement Cuts Could Dig into Nursing Home Payments

Medicare Advantage plans might lower their payments to nursing homes in 2025, to absorb the federal government’s benchmark rate cut to insurers. Nursing home advocacy groups are worried that this move by the Centers for Medicare & Medicaid Services (CMS) to cut Medicare Advantage rates may be passed on to nursing home providers. The Medicare […]

‘Gobbled Up’: CMS Medicare Increase for Nursing Homes Fails to Price in Dire Economic Environment, Costly Regulation

The federal government’s proposed Medicare payment increase for 2025 is not sitting well with the nursing home sector, with financial experts and operators raising concerns that the bump fails to compensate for inflation-induced operating costs – and a staffing proposal anticipated to cost in the billions each year. For some experts, the Centers for Medicare […]

Policy Moves That Are Yielding State Winners on Nursing Home Staffing Front

North Dakota has some of the highest staffing levels in the country – no small feat considering the many pockets of rural communities. The state has achieved this because of a very supportive legislative body that recognizes the value of long-term care services, including skilled nursing, operators and associations say. Garth Rydland, president and CEO […]

OIG: High Facility-Backed Discharges of Mentally Ill Residents From Nursing Homes ‘Raises Questions’ 

A majority of discharges of mentally ill patients from nursing homes are initiated by facilities due to dangerous behaviors, and perhaps many of these patients should never have been admitted in the first place given “the challenges” at nursing homes, according to the Office of Inspector General (OIG). OIG’s review issued Wednesday suggests that of […]

Nursing Homes Misclassified as CCRCs, Causing $88M in Lost Assessment Revenue for Kansas

Some nursing homes in Kansas have been misclassified as continuing care retirement communities (CCRCs), resulting in the state losing close to $88 million in assessment revenue. That’s according to a performance audit conducted by the Kansas Medicaid Inspector General’s (MIG) office, which found that 68% of CCRC certifications between July 2020 and Aug. 31, 2023 […]

Superbug Infection Protocol Shown to Reduce Hospitalization, Deaths Among Nursing Home Residents

Infection-related hospitalizations and deaths among nursing home residents decreased as a result of a coordinated intervention adopted by facilities, along with hospitals and long-term acute care hospitals (LTCHs). The intervention, called SHIELD-OC, was centered around reducing superbugs, or multidrug-resistant organisms (MDROs), and involved 35 health care facilities in Orange County, Calif., according to a study […]

[UPDATED] CMS Proposes 4.1% Increase to Medicare Payments, While Expanding Monetary Penalties

The Centers for Medicare & Medicaid Services (CMS) issued its proposed rule that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System for fiscal year 2025. CMS also proposed to expand the penalties that can be imposed through regulatory revision to allow for more per instance […]

‘The Audits Are Here’: Ways Nursing Homes Can Ease Regulatory Pressures After MDS Changes

As nursing homes are still in the process of updating their procedures to align with October 2023’s MDS requirements, avoiding compliance and payment problems involves having accurate data, and it all begins with its collection. Data collection has become a tough exercise in the midst of staffing challenges, and many facilities have yet to update […]

Nursing Home Use of Ancillary Businesses Spur State Action on Financial Transparency – With Forensic Audits

As financial transparency continues to be one of the top nursing home reform initiatives of state and federal officials, Connecticut Governor Ned Lamont has taken this push one step further with the potential use of forensic audits. Gov. Lamont introduced a bill to authorize the use of forensic audits when the state Department of Social […]

OIG Says Nursing Homes Among Top 6 Provider Types Tied to Medicaid Patient Neglect, Abuse Convictions

Nursing facilities were among six provider types with the most patient abuse and neglect convictions tied to Medicaid than other provider types in 2023, as a whopping 841 criminal and civil patient and abuse complaints related to the sector – topping all other categories – are still open to investigation. There are 238 open nursing […]

Abruptly Closed St. Louis Nursing Home Issued More Fines for Safety, Admin Violations

The largest nursing home in St. Louis, which was shuttered abruptly in December, is now facing more fines linked to safety and administration requirement violations when moving residents out. The Centers for Medicare & Medicaid Services (CMS) is fining Northview Village directors Makhlouf and Lorraine Suissa and Eric Rothner more than $18,000 per day, totaling […]

More Than Two-Thirds of Nursing Homes Fear Closures as Almost All Cite Challenges Recruiting Staff

Despite ongoing investments from operators, the nursing home industry is struggling to rebuild its workforce and recover from the pandemic. Meanwhile, operators are concerned that the federal minimum staffing proposal, once finalized, will make operational challenges worse even as nursing homes limit admissions and are concerned about closures. Such findings were outlined in the American […]

How CMS Can Improve Visibility on Nursing Home REIT, Private Equity Ownership

Even as the Biden administration strives to crack down on confusing ownership structures in the nursing home industry, it appears there are gaps in federal data collection and limited visibility into ownership. Only one-third of private equity (PE) and fewer than one-fifth of real estate investment trust (REIT) investments in the nursing home space are […]

Thousands of Nursing Home Leaders Pen Letter to Congress, Again Urging Rejection of Federal Staffing Proposal

More than 1,000 nursing home leaders, along with associations like LeadingAge and the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), sent a joint letter to House Ways and Means Committee leaders to reject the federal minimum staffing proposal. The letter, spearheaded by AHCA/NCAL, was sent late Thursday and signed by state […]