Closing the Medicaid Gap Is Just the First Step, as Nursing Homes Fight for Predictable Reimbursement

Nursing homes and the state associations that represent them continue to put pressure on legislators to match Medicaid rates with rising costs, and change how often rebasing occurs to give operators a more even playing field. In a lot of cases, Medicaid increases helped lessen the gap between costs and stagnant rates. But, legislators still […]

‘Tougher Every Day’: Nursing Home Operators, CCRCs Weigh in on Future of Skilled Nursing

Operating a skilled nursing facility today is considered a difficult business with regulations and reimbursement woes making the space “tougher every day.” As a result, some operators say they regularly budget a loss for skilled nursing services, and if it weren’t for other lines of business, skilled nursing would be unsustainable. This dire view of […]

Otterbein SeniorLife’s Green House Homes Reshape Skilled Nursing Care in Ohio, Elevating Reimbursement Rates

An operator based in a state mired by lower reimbursement rates found a way to turn the tables by utilizing Green House homes, which are part of a reimagined long-term care housing project that is focused on not only better living quarters, but innovative staffing approaches, lobbying the state legislature, and advising on greater community […]

Repositioning Nursing Homes For Acuity, More Closures, Less Deal Making Expected in 2024

As the skilled nursing industry heads toward a new year with continued labor shortages and reimbursement gaps, service repositioning and closures among operators are expected trends for the space. And although there are signs of positivity in the form of increased Medicaid reimbursement in some states, extensive rural closures are creating “nursing home deserts” and […]

Beating the ‘Sea of Sameness’: Focus on Balance Sheet, Quality, Integration Across Continuum Important for Nursing Homes

A strong balance sheet and strategies for delivering more continuous, integrated care will be key for successful skilled nursing providers. Often, nursing home care is catered to “graduating” patients out of hospitals when in reality, residents constantly return to the hospital system. Those investors currently involved with incubating post-acute organizations say that they are attempting […]

MedPAC Advises Cutting Skilled Nursing Medicare Payment Rate by 3%

The Medicare Payment Advisory Commission (MedPAC) is recommending that for fiscal year 2025, Congress should reduce the 2024 Medicare-based payment rates for skilled nursing facilities (SNFs) by 3%, citing strong margin projections, occupancy growth and access to capital for the sector. “We project the SNF margins in 2024 to remain high even with the downward […]

CMS’ New Transparency Rule Can Help ‘Weed Out a Few Bad Actors’ but Won’t Impact Deals Much, Other Factors at Play

Nursing home ownership changes have largely been embraced by the industry and will have little impact on deal activity, with the new transparency rule from the Centers for Medicare & Medicaid Services (CMS) having very little impact on the sector. Instead, the new rule will force nursing homes to report ownership details during critical junctures […]

Insights on Exposing, Resolving Chronic Underfunding of Nursing Homes

As nursing homes grapple with a tough economic and labor environment – which has forced closures and created access issues – patient and nursing home advocates underscored the emotional toll of care, calling upon the federal and state governments to do more to address new and emerging generational challenges to care. Anne Tumlinson, founder of […]

Dealmaking In Nursing Homes: Bubble Will Burst As States Aim for Budget Neutrality During Medicaid Recalibration

In adjusting to new case-mix systems under the Patient Driven Payment Model (PDPM), the changes to reimbursement rates might be more widespread and large-scale than anticipated, posing financing threats to the nursing home sector because lenders are basing loans on rate projections that are expected to be scaled back. The goal of budget neutrality – […]

How the Removal of MDS Section G Is Affecting Quality Measures, Staffing Calculations, and Five-Star Ratings

Implementing changes to the Minimum Data Sets (MDS) will have large implications for operators beyond quality assessments, and with a possible direct impact on Five Star Ratings in the coming months. The removal of Section G and replacement with section GG is of particular concern to experts on the matter, who called upon nursing homes […]

Nursing Homes Must Advocate for Medicaid Increases, as States Work En Masse to Rebase Rates

The past year or two have seen big wins in terms of increased Medicaid funding for nursing homes – a welcome relief as the sector faces staffing shortages amid a looming minimum staffing proposal, higher inflationary costs and rising acuity of resident needs. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) […]

‘Operating Pressures Are Very Intense’: Ohio Living CEO on Skilled Nursing Strategy and Mega-Trends

Operational pressures continue to shape the landscape of the skilled nursing sector as many organizations with assets across the care continuum are divesting nursing homes in favor of other service lines. Responding to pressures from staffing and low reimbursements, Ohio Living decided to act “proactively” and downsize its skilling nursing segment while growing its services […]

How Medicaid Waivers Have Affected Nursing Home Utilization – And Why the Staffing Proposal May Further This Trend

One of the unintended consequences of the minimum staffing proposal may mean less utilization of nursing homes as residents are shifted to other means of care – a trend spurred by an expanded use of Medicaid waivers. Policymakers may opt for these as a safety net for access issues among seniors, especially in rural settings, […]

Minimizing Risk for Nursing Home Operators Means Fostering Culture, Enabling Robust Compliance

As operators mull problems on staying up to date with new or upcoming rules, legal and compliance executives believe that the federal government’s staffing proposal and focus on healthcare fraud prosecution are among the top challenges facing the sector. Speaking at Skilled Nursing News’ Risk Summit, leaders from Cascadia Healthcare and American Senior Communities, discussed […]

Ignite CEO Focuses on Solutions, Growth Amid ‘Punitive, Vindictive’ Surveys, Managed Care Pressures

From managed care burdens and “punitive, vindictive surveys,” to threats posed by the potential federal staffing mandate and issues stemming from the “radically broken” Five Star rating system, Ignite Medical Resorts CEO Tim Fields is well aware of the many challenges facing skilled nursing providers. But as Ignite celebrates its fifth year as a company […]

‘Where the Ship is Heading’: Theoria Joins ACO REACH to Better Align With Value-Based Care in SNFs

Some physician groups have decided to join the accountable care organization (ACO) REACH programs to better serve high needs groups given that the nursing home sector is gravitating toward value-based care – the trend being especially true if patients are already aligned with an ACO through their primary care provider. Theoria Medical, for one, made […]

Fighting the Market Not a Winning Strategy: United Church Homes CEO on the Future of Managed Care

United Church Homes (UCH) is continuing to make progress on a recently announced value-based care play with health plan provider CareSource, while responding to the ongoing market and regulatory pressures in the nursing home space. In June, UCH — with a portfolio of about 1,600 senior housing and care units, including 600 nursing home units […]

‘Only the Beginning’: Staffing Mandate Assessments May Push Operators to the Brink

Beyond minimum staffing requirements, operators may need to prepare for updated assessment requirements, which leaders say will be a “core” aspect of the mandate, along with the 24-hour registered nurse (RN) requirement.  And these assessment requirements have increased, resulting in criticism from industry experts on both their value and the added burdens that these might […]

[UPDATED] CMS Issues Final Rule For Transparency in Ownership of Nursing Homes

The Biden-Harris Administration announced Wednesday a final rule requiring skilled nursing facilities (SNFs) to disclose additional ownership and management information. The final rule, displayed on the Federal Register by the Centers for Medicare & Medicaid Services (CMS), implements portions of the Affordable Care Act. Nursing homes must submit ownership disclosures within a year of the […]