Rick Matros, CEO of Sabra Healthcare REIT (Nasdaq: SBRA), has seen financing come back in a much bigger way for senior housing, compared to nursing homes. Lenders are a lot more selective, and facilities are still recovering from the pandemic years. In terms of the types of financing, particularly with the U.S. Department of Housing […]
Category: Medicaid
Medicaid payment rates are insufficient to cover the costs of care, according to a new study that highlights the growing financial challenges faced by nursing homes serving Medicaid residents. The research, conducted by the LeadingAge LTSS Center at the University of Massachusetts Boston and Miami University, reveals a widening gap between Medicaid reimbursement rates and […]
New York nursing home operator Centers Health Care must pay $45 million to settle civil charges related to Medicaid fraud, patient neglect and mistreatment. The office of New York Attorney General Letitia James filed a civil lawsuit against owners Kenneth Rozenberg and Daryl Hagler in 2023 alleging fraud and neglect incidents across several facilities, and […]
A new study on Medicaid payment rates from 44 states shows Medicaid payment rates among nursing homes on average don’t adequately cover today’s costs. Meanwhile, higher staffing levels often correlate with lower Medicaid payment-to-cost ratios. And, nonprofits appear to have the lowest payment-to-cost ratio for Medicaid. Medicaid rates only covered bout 82 cents per every […]
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 […]
More state grant funds are being distributed to nursing homes in Minnesota, as part of a $173.5 million initiative. In 2023, Minnesota Governor Tim Walz, who is also the Democratic vice presidential nominee, and the state legislature, signed off on a $300 million bipartisan package to address the crisis facing nursing homes across the state. […]
As the Medicaid payment system transitions across states from RUGS to the Patient-Driven Payment Model (PDPM), nursing home operators must be wary of misconceptions – including that the transitions will always lead to additional Medicaid funds being available – while putting in place the right practices to ensure appropriate payments. The complexities of Medicaid transitions […]
Delivering care to dual eligible nursing home residents can be complex with so many payers involved in the industry, but aligning incentives, quality measures and tools for providers can help operators serve this demographic. Dual eligible residents, or those that can receive benefits from both Medicare and Medicaid, often find themselves in a “tangled web […]
Oklahoma on Monday approved a nearly $29 million Medicaid funding increase for nursing homes attracting additional federal dollars to improve provider rates. It’s unclear if the rate increase would be enough to meet the upcoming federal minimum staffing standard. The Oklahoma Health Care Authority Board (OHCA) approved the increase after the 2024 legislature called on […]
Nursing home operators say the civil monetary penalty (CMP) expansion is proving to be one of the most problematic features of the 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule. Initially, there was excitement for the Medicare payment increase, but this has turned to dread for operators who are already dealing with […]
In the wake of Indiana’s transition to managed care for Medicaid services on July 1st, nursing home operators across the state are grappling with significant financial uncertainties due to delayed reimbursements, leaving many small facilities struggling to make payroll for their employees. Jeff Huffman, chief operations officer of The Strategies, a family-owned long-term care organization […]
Nursing homes in Ohio will soon receive financial incentives for each additional private room they offer, thanks to a proposal recently greenlit by the Centers for Medicare & Medicaid Services (CMS). The initiative, set to launch in the coming months, was developed by the Ohio Department of Medicaid and revises the reimbursement structure for Medicaid-funded […]
Georgia nonprofit A.G. Rhodes’ CEO, Deke Cateau, is all about solutions. To that end, he has had a busy couple of years, successfully expanding one of the operator’s three campuses to be all private rooms with a dementia area built with the household model in mind – a $37.5 million endeavor. Cateau said he would […]
Nursing home operators in Florida will see an 8% increase in their Medicaid funding, or $247.8 million – that amounts to $470,000 per facility. Gov. Ron DeSantis this week signed the Focus on Florida’s Future Budget for Fiscal Year 2024-2025, which included the significant Medicaid funding increase to support the growing demand for caregivers and […]
Operators have been opting for different payer sources other than Medicare Advantage plans given its persistent challenges. Medicare Advantage’s lower reimbursement rates compared to traditional Medicare and higher administrative burdens tied to prior authorizations and payment denials, have caused operators to seek even Medicaid as an alternative payer, emboldening efforts by advocacy groups to push […]
Expenditures for Nursing facilities and continuing care retirement communities (CCRCs) is expected to reach $237.6 billion in 2026, and $337.4 billion by 2032, according to data released Wednesday. Nursing homes and CCRCs have been increasing steadily since 2021, states a report prepared by the Office of the Actuary (OACT) at the Centers for Medicare & […]
Nursing and residential care facilities had the highest wage growth of any health care setting in April at 4.5% year over year, which was followed by ambulatory health care services at 3.2% and hospitals at 3.1%. The sector also added 9,300 jobs in April despite a “cool month” for the economy, according to economic indicators […]
More nursing homes owned by Centers Health Care are being investigated for alleged Medicaid fraud, while also having been plagued with serious safety concerns. The 240-bed Hammonton Center and Deptford Center for Rehabilitation and Healthcare in New Jersey, join other facilities owned by Centers Health that are under investigation, according to a report from the […]
Recently released statistics for post-acute care in some states point to a trend away from nursing home stays, as closures mount due to labor troubles and low reimbursement rates. According to the Boston Federal Reserve’s latest report on nursing home closures that was released Tuesday, more of New England’s older adults are aging in place, […]
If there’s no additional funding for the minimum staffing rule, well over 5% of existing facilities will close, depending on how successfully operators can pivot to meet the standard. The rates of closure may even reach 10% to 15%, depending on the market, cautioned sector leaders attending the LTC100 conference this week. Steve Nee, CEO […]
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