Ensign Group’s (Nasdaq: ENSG) strong quarterly earnings were fueled by solid operational performance at transitioned facilities. Encouraged by recent acquisition success, executives said they plan to expand into new states while prioritizing growth in existing markets. “We’re particularly impressed with these results given that we’ve added 53 new operations across several markets in our recently […]
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. […]
Staffing shortages and increased acuity of patients are playing a big role in referral placement, along with preferences and prerequisites of referral sources. This is causing nursing homes and hospitals in high-demand areas to get creative with in-house offerings and hospital partnerships, as they are still experiencing bottlenecks in the referral process. At the same […]
Multiple states have been working toward a transition to managed Medicaid from the traditional state-run program, but there have been concerns about reimbursement timing and insufficient payment amounts due to the change. And that’s just the first layer of challenges. Payment portals unique to each managed Medicaid contractor is another hurdle to overcome, in addition […]
The nursing home sector is on a positive trajectory, and real estate investment trusts (REITs) at the forefront of investments say that stability is favoring greater deal activity in the sector. Despite challenges in staffing, rising operational expenses, and increasing regulatory burdens, particularly in certain states, executives from National Healthcare Investors (NYSE: NHI) and CareTrust […]
The number of states challenging the federal minimum staffing mandate has now grown to 21 states, after 20 states filed a joint lawsuit. As of Tuesday, Iowa’s attorney general was the latest to sue the Biden-Harris administration, challenging the nursing home federal minimum staffing mandate along with Kansas, Virginia, South Carolina, and other mostly Republican-led […]
Nursing homes looking to best utilize QAPI, or the quality assurance and performance improvement program, should think beyond the obvious clinical compliance and care benefits to residents. QAPI is usually seen as a way to reduce falls or tighten up medication management, but operators can do a lot more with the data besides using it […]
Vice President Kamala Harris shared a new proposal on Tuesday to require Medicare to cover the costs associated with in-home long-term care, potentially allowing seniors and individuals with disabilities to receive care in their homes rather than in skilled nursing facilities. The proposal could have broad appeal for middle-income Americans who don’t qualify for Medicaid. […]
For some nursing homes, quality assurance and performance improvement (QAPI) meetings serve merely as a checkbox for requirements, but they haven’t driven changes to improve care quality outcomes. On the flip side, however, other nursing homes are effectively using QAPI meetings to push for success in quality of care. Executives at these facilities emphasize that […]
Nursing homes and hospitals are developing closer ties and improving communication, and with this trend, admissions into nursing homes are expected to increase as rehospitalizations and excessive lengths of stay are also seen as declining. With rising acuity and staffing shortages of recent years, nursing homes have often been reluctant in admitting challenging cases that […]
The Centers for Medicare & Medicaid Services (CMS) released a draft Minimum Data Set (MDS) on Tuesday, and while the changes are minimal, clinical and reimbursement experts noted that they could lead to reduced control over certain quality reporting measures. However, the earlier-than-anticipated release also suggests that the federal agency aims to give operators a […]
For its Quality Reporting Program, the Centers for Medicare & Medicaid Services (CMS) is exploring the possibility of expanding nursing home data collection and submission to all residents, regardless of payer type. Officials heard feedback on the challenges and benefits of such a move during a listening session held on Tuesday. If the federal agency […]
As states in Hurricane Helene’s path grapple with its devastating effects days after it made landfall in Florida Thursday evening, nursing home operators are dealing with significant repair and maintenance challenges that could last a while – particularly in states like North Carolina. Damage to transportation, power and utilities could make recovery in some states […]
In weathering the rise of managed care penetration – which has often meant lost profits – nursing homes are turning to centralized processes for handling claims, beefing up teams to handle additional documentation requests (ADRs), and closely tracking contract renewals. Rates for managed care plans like Medicare Advantage are often lower than traditional fee-for-service Medicare […]
As Florida prepares for yet another hurricane, it serves as a reminder that nursing homes in the area, as well as in other regions prone to extreme weather events, face rising risks and must maintain continued vigilance in following and developing rigorous emergency preparedness plans. Research highlights that older adults are particularly vulnerable during climate-related […]
The U.S. Supreme Court’s June decision regarding civil monetary penalties (CMPs), which allows defendants the right to present their case to a federal jury when a federal agency is seeking financial penalties, may seem like a win for nursing homes at first glance. However, many providers are unlikely to pursue this path. The CMP decision […]
Growth strategies for nursing homes can vary greatly, depending on nonprofit versus for-profit status and especially the geographic market in which an operator is currently operating. But growth and innovation – no matter the sector or region – require risk and a lot of vision to properly execute. Providers will have to reimagine a grander […]
Coming off of his first year as CEO of American Senior Communities Steve Van Camp is busy planning an Institutional Special Needs Plan (I-SNP) joint venture with five other providers in Indiana, while also devoting time and resources to meeting quality measures and outcomes among ASC facilities. Important considerations to forge ahead with these efforts […]
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