‘CMS is Watching’: Changing Therapy Patterns Raise Concerns About Skilled Nursing Audits, Care Quality

The first week of the new Medicare payment model for nursing homes has brought stories of rapidly shifting therapy patterns among some providers, and voices from the consulting and advocacy worlds are warning that any sudden movements could cause adverse effects — both immediately and down the road. The advent of the Patient-Driven Payment Model […]

Therapy’s PDPM Paradox: Clinicians Have More Control, But Smaller Rehab Staffs Needed for Now

The new Medicare payment model for nursing homes took effect this week with a bang, as therapists across the nation criticized a wave of staffing reductions in the immediate wake of the October 1 start date. Several companies implemented workforce cuts as the federal government shifted to the Patient-Driven Payment Model (PDPM), which moves incentives […]

Each Medicare Advantage Plan Can Treat PDPM Differently — and SNFs’ Mileage Will Vary

Skilled nursing providers looking for a simple answer to how managed care plans will react to the new Medicare payment model will likely have to face an inconvenient truth: It’s complicated. Private Medicare Advantage insurers didn’t have to follow the old Resource Utilization Group (RUG) model when deciding how to reimburse for skilled nursing services, […]

It’s Here: Skilled Nursing Providers, Investors Weigh in on PDPM Opportunities, ‘Stumbling Blocks’

The long wait is over: The new Medicare payment system for nursing homes has arrived. October 1 marks the official start of the Patient-Driven Payment Model (PDPM), just about 18 months after the federal government first announced the change in April 2018. Since then, the skilled nursing industry has trained a laser focus on preparations […]

Hospitals Also Face Length of Stay Pressures — and Skilled Nursing Can Help Ease The Burden

The relationship between skilled nursing facilities and their referring hospital partnerships can be a rocky one for both sides. But in an ideal world, it should be a partnership, with each willing to work together to achieve top patient and resident outcomes. For Sue Craft, the vice president of inpatient case management and post-acute services […]

New CMS Rule Requires Hospitals to Provide Skilled Nursing Quality Data at Discharge

The federal government issued a final rule on Thursday requiring hospitals to give patients access to more information about the post-acute provider choices available — including data on how their post-acute options perform on quality measures such as pressure ulcers, falls, and readmissions. This new rule will not have any impact on anti-steering regulations that […]

Four More Nebraska Nursing Homes to Close Amid Persistent Payment Crunch

Just about a week after changing hands, four skilled nursing facilities in Nebraska announced plans to soon shut down amid financial difficulties that their new owners blamed on a tough overall state budget landscape. The four facilities — Blue Hill Care Center in Blue Hill, Crestview Care Center in Milford, Mory’s Haven in Columbus, and […]

Skilled Nursing Operator Sees Financial Upside, Potential for Innovation in Assisted Living

Skilled nursing and senior living can seem worlds apart, with the former associated with health care and the latter with hotel-style touches like bistro dining and concierge serves. But one operator of skilled nursing facilities sees moving into assisted living as the best way to prepare for the future of both models. The Minneapolis-based Health […]

HUD Boosts Focus on Star Ratings, Care for Skilled Nursing Loans — Though Demand Remains Strong

The Department of Housing and Urban Development’s (HUD) lending program for skilled nursing facilities grabbed some negative headlines earlier this year, but a key financial player in the space says that demand for the products remains strong — though the government has placed increasing focus on star ratings and care quality when underwriting deals. “The […]

Skilled Nursing, Post-Acute Providers Must Embrace ‘Death of Dogma’ to Survive Shift to Episodic Care

As payers and hospital networks increasingly treat skilled nursing facilities as just one stop along an overall episode of care, operators in the space have received a variety of messages about how to survive: Bring data, get to know referral partners’ problems, demonstrate your worth. But a leader at a major Philadelphia-area hospital network took […]

Balancing Risks, Rewards of Targeting Higher-Acuity Residents in Skilled Nursing

Over recent years, as length of stay and reimbursement have declined in the skilled nursing space, one trend has risen steadily: the acuity of the patient population. It’s a trend that multiple executives in the skilled nursing field have observed, particularly as the industry prepares to pivot toward the new Patient-Driven Payment Model. But it’s […]

Omega CEO Pickett: Medicaid-Focused Model Can Work in Skilled Nursing

With capital chasing upside and new development dominated by high-end “medical resorts,” the availability of long-term care beds has emerged as a big-picture issue for the skilled nursing industry. While it may not be a nationwide problem just yet, certain markets — from Wisconsin to California — have begun to show the early signs of […]

Skilled Nursing Operators Shouldn’t Count on Investors to Share PDPM Optimism

With just two weeks to go before the new payment model for nursing homes takes effect, operators that have prepared for the changes could be expecting a significant boost in their Medicare reimbursements. But providers shouldn’t necessarily expect their investors to share in their optimism over the Patient-Driven Payment Model (PDPM). Over the course of […]