Medicaid’s Share of Nursing Home Revenue, Resident Days Hits Record High as Medicare Drops to Historic Low

Occupancy at the nation’s nursing homes stayed flat between the most recent two quarters, but the proportion of residents covered under Medicaid hit a record high — while the share of bread-and-butter Medicare residents fell to a record low. Medicaid accounted for exactly two-thirds, or 67.6%, of resident days at nursing facilities in the third […]

After 50 Years, PruittHealth Looks to the Future with I-SNP — and Staff Development Strategies from Disney

PruittHealth spent 2019 celebrating its 50th anniversary in the post-acute and long-term care space, but second-generation CEO Neil Pruitt, Jr. says his company — along with the rest of the industry — must focus on novel and creative strategies for surviving into the future. Pruitt sees potential in a variety of forward-thinking initiatives, from the […]

CMS to Have ‘Limited’ Survey Capacity for New Nursing Home Requirements of Participation

Confusion continues to reign over the final set of new requirements for Medicare- and Medicaid-certified nursing homes, as the federal government disclosed that it will have very little ability to enforce the rules until the middle of next year. The third and last update to the Requirements of Participation (RoPs) is set to take effect […]

HCR ManorCare Helps Alleviate $102.8M Loss at ProMedica’s Insurance Arm

After the non-profit ProMedica Health System took over the operations of HCR ManorCare in a blockbuster deal last year, the skilled nursing entity continues to help improve the system’s shaky financial results. The Toledo, Ohio-based ProMedica reported an operating loss of $102.8 million for its ProMedica Insurance Corporation arm for the nine-month period ending September […]

Record-Setting Nursing Home Fraud Case Ends in $44M Judgment

The former nursing home owner behind the largest criminal health care fraud case in U.S. history had already received a 20-year prison sentence, but a federal judge on Thursday added a $44 million payment to the punishment. Philip Esformes, who once ran a skilled nursing facility and assisted living chain with locations from Miami to […]

Nursing Home Receivership Raises Concerns Over Shortage of Respiratory Beds

One of two skilled nursing facilities in Connecticut with a respiratory unit was placed into voluntary receivership on November 5, raising concerns about access to such care in the state. The Republican-American first reported the news over the weekend. The state Department of Social Services (DSS) placed Waterbury Gardens for Nursing and Rehabilitation under the […]

Louisiana to Pay $13.4M to Settle Allegations of Inflated Medicaid Claims for Nursing Home Care

In a twist on typical allegations of Medicaid overpayments, the state of Louisiana will be paying back millions to the federal government. The Louisiana Department of Health (DOH) agreed to pay $13.42 million to settle allegations that it submitted inflated claims for long-term nursing home and hospice care, the federal Department of Justice (DOJ) announced […]

Citing ‘Shady’ Behavior, CMS Proposes Stricter Rules, Time Limit on Medicaid Payment Supplements

Nursing home providers in multiple states have won key funding increases through the use of novel Medicaid supplement programs — but the federal government now wants to keep a tighter leash on the models in order to curb overall Medicaid spending. The Centers for Medicare & Medicaid Services (CMS) on Tuesday proposed a rule that […]

Washington State Targets Medicaid Shortfall, But Not in Time for Some SNFs

Two different legislative proposals in the state of Washington call for a change in how the state calculates Medicaid reimbursement for skilled nursing facilities. But the changes – if they take effect – may not be in time to save more facilities from closure, according to one trade group. Northwest News Network first reported on […]

Why a 10% Medicaid Boost Wasn’t Enough to Save Nursing Homes From Closure

The state of South Dakota earlier this year passed a significant increase to Medicaid reimbursement for nursing facilities in the state, prompted by a rash of closures. But even with the extra dollars -– the state in April authorized a 10% increase in Medicaid reimbursement for nursing homes, which translated to a roughly $8-per-day increase […]

$240M Illinois Medicaid Funding Increase Remains Unclear: ‘It Could Be Eaten Up in Penalties’

Illinois lawmakers’ approval of a Medicaid reimbursement increase for skilled nursing facilities earlier this year came as welcome news to providers in a state notorious for its difficult operating environment. But key definitions related to the requirements for staffing are still being finalized, and the ramifications for the funding boost are still unclear. “The whole […]

Nursing Home Denials in CA Raise Concerns About Larger Move to Managed Medicaid

Managed Medicaid plans in California have, in some cases, denied coverage to patients for nursing facility care, raising concerns among long-term care advocates in the state about coverage by such plans. California Healthline, a publication of Kaiser Health News, reported the story earlier this week. California pays plans a monthly rate for every Medicaid beneficiary […]

US News Focuses on Resident Complaints, Staffing in New Set of Nursing Home Ratings

U.S. News & World Report on Tuesday released its 2019-2020 Best Nursing Homes ratings, which the publication has pitched as a more consumer-friendly alternative to the Centers for Medicare & Medicaid Services’ (CMS) Nursing Home Compare website. Analysts from the national news outlet have moved away from CMS’s five-star ratings to rely on their own […]

CMS Could Soon Crack Down on States’ Medicaid Payment-Boosting Programs for Nursing Homes

In multiple states, supplemental programs help skilled nursing facilities offset the low reimbursement for their services from Medicaid. But the federal government is starting to take a closer look at the programs, with an eye to increasing transparency, Andrea Maresca, senior vice president at the consulting firm Thorn Run Partners, said during a presentation on […]

Nursing Home Providers Sue Over NY’s Decision to ‘Damn the Torpedoes’ and Implement $246M in Medicaid Cuts

A coalition of nursing home providers in New York State on Thursday filed a lawsuit against the state’s Department of Health (DOH), alleging violations of federal and state law with regard to hundreds of millions in Medicaid funding cuts. “These rate reductions were motivated purely out of budgetary concerns, with no consideration for the residents […]

Bill Would Expand Nursing Homes’ Access to Federal Background-Check Database

A new piece of legislation before Congress would expand nursing homes’ ability to perform detailed background checks on potential employees, according to its sponsor. Sen. Kirsten Gillibrand, a New York Democrat, earlier this week announced a bill to improve health care worker hiring practices in an effort to reduce elder abuse. The initiative — known […]