Behind the Rise of ‘Conveners’: Nursing Home Operators Must Understand Risks, and Possible Benefits, of Managed Care Middlemen

As the skilled nursing industry shifts towards managed care plans like Medicare Advantage and Medicaid managed care, “conveners” have become essential in managing care for specific patient populations, especially for long-term care residents and dual-eligible individuals. And while conveners have helped nursing homes and health care providers adapt to the changing landscape and achieve better […]

Significant Changes to High-Risk Drugs’ Coding in MDS Will Require Training at Nursing Homes

The Centers for Medicare & Medicaid Services (CMS) has introduced significant changes regarding medication coding related to certain high-risk drugs that will go into effect on Oct. 1 with the updates to the Minimum Data Set. These changes to MDS are focusing on specific medications, including antipsychotics, anti-anxiety medications, antidepressants, hypnotics, anticoagulant antibiotics and opioids. […]

‘Whole System Is Broken’: Nursing Home Operators in National Coalition Say Long-Term Care Will Need a Generation to Fix

In the aftermath of issuing a series of action plans, the Moving Forward Nursing Home Quality Coalition – a national coalition of 120 nursing home stakeholders – held a meeting Wednesday to share more details about the action plans to improve quality in nursing homes, with providers present saying that the coalition’s work is a […]

Nursing Homes’ Need for ‘Another Layer of Expertise’ Drives Pipeline of Specialist Roles

Clinical speciality services are growing within nursing homes to address needs of a population with higher acuity – but there are some sizable side benefits to this trend. Operators and other community institutions are working to accommodate the need for certain types of care in the nursing home through partnerships. Not only are nursing home […]

Priority Management CEO: Empowering Local SNF Leadership Proves Fruitful

Priority Management CEO Rick Forscutt said that the one word to describe his skilled nursing operation would be empowerment since the company has decided to give local skilled nursing facility leadership more authority to make business decisions. Forscutt said this decision has led his company to get better results clinically, culturally, and financially, despite continued struggles […]

Operators Navigate Interpretation Challenges Surrounding Elopement Regulations

Skilled nursing operators across multiple regions are grappling with how to better handle resident elopement in the face of a narrowly applied definition of elopement by surveyors, a trend that doesn’t help residents at risk and causes facilities to dock up high financial penalties. Elopement refers to situations where a resident leaves the premises without […]

‘We’re Onto Something’: Nursing Homes Focus on Speciality Programs to Meet Evolving Resident Needs

Rising acuity at nursing homes has meant a greater need for the presence of various clinical specialties at facilities. But navigating better interdisciplinary team care is a complicated matter, made more so with staffing shortages, tighter regulation and lower reimbursements. As the needs of the nursing home population continue to evolve, many providers believe it’s […]

Success Stories, Medicare Advantage Trends Drive I-SNP Growth in Nursing Home Sector

With the end of the public health emergency, industry stakeholders said the development of Institutional Special Needs Plans (I-SNPs) are of more interest to skilled nursing operators than ever before. Mark Price, Chief Executive Officer of Curana Health, said the interest level in I-SNPs has significantly increased in the past few months. “With the end […]

‘Still Losing Money:’ Care Initiatives CEO Warns of SNFs Forced to Sell or Close, Keeps Focus on Ancillary Growth

While many states have enacted long-anticipated Medicaid rebasing, some nursing home leaders say it’s too little too late. States like Iowa, with smaller facilities largely run by independent owners, are seeing closures despite receiving $15 million to increase Medicaid reimbursement rates beginning July 1. Reality has hit many such independent owners, according to Michael Beal, […]

‘Astronomical’ Medicare Advantage Denials, Pre-Auth Issues Cause Outcry from Nursing Homes

The Medicare Advantage preauthorization process and denials of care are a growing concern across the continuum, and nursing home operators and advocates — as well as federal lawmakers — are pushing more urgently for change. Such concerns are not new, and already some action has been taken: the Centers for Medicare & Medicaid Services (CMS) […]

Medicare Rules Create Barrier to SNF Care for Cancer Patients, Burden Facilities with Costs

Concerns about lack of skilled nursing access for cancer patients, as well as oncology-related costs borne by skilled nursing facilities, have prompted operators to call for action from the Centers for Medicare & Medicaid Services (CMS). Several nursing home professionals raised this issue in comments to CMS’ proposed Medicare payment update for 2024. One oncology […]

‘Worst Possible Time’: SNF Operators Hope for Acuity Adjustments, Waivers Ahead of Staffing Mandate

As the skilled nursing sector awaits the proposed federal staffing mandate, leading industry operators renewed calls for funding the initiative, and said the Centers for Medicare & Medicaid Services (CMS) should carry it out in phases while also adjusting staffing ratios based on the acuity of the resident populations being served. Speaking at Skilled Nursing […]

ChatGPT and Beyond: How Artificial Intelligence is Shaping the Future of Nursing Home Operations

Use of artificial intelligence (AI) has been steadily increasing at nursing homes, as the technology begins to deliver on its promises to improve efficiencies in a wide variety of areas, from clinical outcomes to back-office work. And while ChatGPT is the attention-grabber these days, natural language processing is but one of the ways AI is […]

Why Nursing Homes Should Expect Far-Reaching Effects from CMS’ Expanded VBP Measures

Value-based care program (VBP) measures proposed by the Centers for Medicare & Medicaid Services (CMS) have long loomed over skilled nursing operators, and now it seems more are finally on their way for 2026. Staffing-related measures, rehospitalization, discharge and infection prevention are all areas of focus for CMS’ proposed and finalized measures alike. Moreover, proposals […]

‘Money Where Our Mouth Is’: Nursing Homes Pursue Post-Pandemic Culture Shift to Win Workers, Residents

Coming out of the pandemic, some operators are beginning to show their ‘personality’ again, and rebuild a unique environment that allows nursing homes to better compete not just for residents, but for employees as well. That is especially true in continuing care retirement communities (CCRCs), according to Leah Klusch, executive director of The Alliance Training […]

MDS Changes Could Have Ripple Effects on Nursing Home Readmissions, Citations

Staying informed about upcoming changes to the Minimum Data Sets (MDS) will be vital for skilled nursing operators come October, when the new changes are implemented. These changes include more finely-tuned definitions and more data collection. Section GG of MDS, which measures the functional status and goals of residents in their self-care, mobility, and communication […]