Oklahoma Joins Growing List of States Seeking More Nursing Home Funding

Three bills in the Oklahoma Legislature would increase funding for skilled nursing facilities while mandating a staffing increase, adding the Sooner State to a growing list of U.S. states that are trying to address funding shortfalls for nursing homes. The Oklahoman reported the news. On average, the state pays about $23 less than the cost […]

South Dakota Nursing Home Leaders See ‘Statewide Disaster’ Without Medicaid Increase

Nursing homes in the state of South Dakota are facing a $42 million annual shortfall in Medicaid reimbursement, which has led to the closure of several facilities. Without an increase, industry leaders said, the closings could lead to “statewide disaster.” The Argus Leader first reported the story. Nine nursing facilities have already closed, two are […]

CBO: Nursing Homes Account for 15% of All Medicaid Spending as Aging Population Drives Costs

Programs for Americans aged 65 and older will account for nearly half of all the federal government’s non-interest spending in the next decade, a new report from the Congressional Budget Office found, as the baby boom population continues to age into both Medicare and certain Medicaid benefits. Medicare, Medicaid, and Social Security spending will balloon […]

Report Revives Potential for Massive Medicaid Cuts Through Block Grants

A plan to fundamentally change the way the federal government funds Medicaid — which could lead to hundreds of billions in cuts — may be back on the table after seemingly dying two years ago. The Trump administration is currently mulling ways to convert Medicaid to a block-grant system, Politico reported late last week, reviving […]

Growth in Medicare Advantage Spending Far Outpaces Traditional Medicare

The growth in overall spending on nursing homes in the United States slowed for the second consecutive year in 2017, according to the latest analysis from the Centers for Medicare & Medicaid Services (CMS) — while Medicare Advantage spending skyrocketed. All payers spent $166.3 billion at nursing care facilities and continuing care retirement communities (CCRCs) […]

Maryland Provider Reaches $2M Settlement Over False Discharge Claims

An extended battle between a now-defunct nursing home operator and the state of Maryland reached a conclusion this week with a $2.2 million settlement. Neiswanger Management Services (NMS) agreed to pay that amount to dismiss allegations that it had improperly discharged Medicare residents and falsely billed the state’s Medicaid program, Maryland Medical Assistance. Back in […]

Medicaid Overpays Nursing Homes by $1B Per Year, Study Suggests

Nursing home providers typically operate on razor-thin margins, but a new study suggests that the Medicaid program may be overpaying operators by billions of dollars per year. A pair of economists from the University of California, Los Angeles and the University of Georgia this month published an extensive analysis of Medicaid spending in nursing homes, […]

Oklahoma Cities Snap Up Nursing Homes in Gamble for Federal Funds

Several small cities in Oklahoma now hold the licenses to operate dozens of nursing homes in the state, in the hopes of getting funds from a federal bonus payment program offered through the Centers for Medicare & Medicaid Services (CMS), Oklahoma Watch reported this week. Licenses for 46 nursing homes in the state are now owned by […]

Low Medicaid Rates Cause Skilled Nursing Crisis in Washington State

It’s unlikely that the state of Washington intended to put its skilled nursing facilities on the brink of disaster when it overhauled its Medicaid system in 2016, but leaders of both LeadingAge Washington and the Washington Health Care Association (WHCA) said that’s exactly what has occurred as providers across the state try to keep their […]

Data Drives Skilled Nursing Referral Partnerships, But Residents Ignore It

As referral networks narrow and skilled nursing providers feel increased pressure to prove their worth to hospitals and doctors, one government agency says residents still frequently miss the highest-quality options in their own areas. In its most recent report to Congress, the Medicare Payment Advisory Commission (MedPAC) asserts that many hospitals discharge post-acute care patients […]

Nursing Homes Settle $24M Medicaid Lawsuit in Rhode Island

Rhode Island reached a settlement with 59 nursing homes that sued the state over Medicaid reimbursement cuts, averting a potential $24 million cost to the state over three years. Under the terms of the consent order, Medicaid rates paid to the state’s nursing facilities — for both managed care and fee-for-service — will increase by […]

Nursing Homes Fight Back Against Medicaid Cuts with Lawsuit

A group of Montana nursing homes and assisted living facilities sued the state Monday to stop cuts to Medicaid reimbursements, The Associated Press reported. As part of spending decreases throughout the state government intended to address a budget shortfall, Montana’s Department of Public Health and Human Services (DPHHS) cut Medicaid provider reimbursement rates in January. In […]

Azar Touts PDPM But Warns ‘Entrenched Players’ of Challenges Ahead

Health and Human Services Secretary Alex Azar on Tuesday trumpeted the new payment model for skilled nursing facilities in a speech before a prominent trade group, positioning the plan as one piece of a larger change in the way the government pays for health care. The new Patient-Driven Payment Model (PDPM) incorporates the dual goals […]

Preferred Care Looks to Settle Lawsuits to Speed Up Bankruptcy

Embattled skilled nursing provider Preferred Care has asked a federal bankruptcy judge to approve a settlement regarding allegedly falsified Medicare and Medicaid claims. Settling the pair of federal whistleblower lawsuits, filed in 2016 and 2017, would help accelerate Preferred Care’s Chapter 11 bankruptcy process, the provider argued in a filing submitted last week. Westlaw Practitioner […]

Report Accuses New Mexico of Nursing Home Woes as Medicaid Lags

The state of New Mexico ranks at the bottom in terms of serious skilled nursing deficiencies per facility, according to a recent analysis conducted by a pair of news organizations. Out of the 74 facilities in the state certified by the Centers for Medicare & Medicaid Services, 36 had “serious deficiencies” between 2015 and 2018, […]