GAO: Managed Medicaid Programs for LTC Services Need National Oversight

The U.S. Government Accountability Office (GAO) has found “significant problems” with the managed long-term supports and services (MLTSS) covered by Medicaid and implemented through contracts with managed care organizations. The GAO made the discovery in a recent review of six states. In the report, which was released publicly on December 16, the GAO recommended a […]

ProMedica Senior Care’s Parker Sees Growth Ahead — Even as ‘Major Disruption’ Looms for Industry in Early ’21

When Welltower Inc. (NYSE: WELL) and health system ProMedica teamed up to take over nursing home giant HCR ManorCare in 2018, the players positioned the move as a way to vertically integrate a continuum that could follow a patient from the hospital, to a skilled nursing facility, to home health. The real estate investment trust […]

Nursing Home Providers Sue for Access to $153M in COVID-19 Medicaid Rate Boosts

Three senior living and care organizations in Pennsylvania filed suit against the state over $153 million in additional Medicaid funds allocated in response to the COVID-19 pandemic, charging the Keystone State with treating the money “as its own piggybank and disregarding the substantial need of the Commonwealth’s most vulnerable citizens.” The petition, filed on December […]

CMS to Resume Updates to Nursing Home Compare, Special Focus Facilities List in January

The federal government last week advised nursing homes that a variety of COVID-related freezes on updates to the public Nursing Home Compare database will end soon after the start of the new year. The Centers for Medicare & Medicaid Services (CMS) on January 27 will update quality and health inspection metrics on the consumer-facing resource, […]

Biden Nominates California Attorney General Becerra for HHS Secretary

President-elect Joe Biden has selected Xavier Becerra, the current attorney general of California and a critic of President Trump’s nursing home policies, to helm the Department of Health and Human Services (HHS) under the incoming administration, the New York Times reported Sunday. Prior to serving as California’s top prosecutor, Becerra represented the Los Angeles area […]

CMS Finalizes Proposed Cuts to Medicare Part B Therapy Services for 2021, Expands Telehealth Coverage

The federal government on Tuesday finalized its proposed physician fee schedule for the 2021 calendar year, formalizing cuts to Medicare reimbursement rates for therapy services provided to residents covered under Part B — while also expanding some telehealth flexibilities offered during COVID-19. The Centers for Medicare & Medicaid Services (CMS) in August floated a 9% […]

New Wave of ‘One-Sided’ Managed Care Contracts Could Lead to Payment Strains for Nursing Homes

Some aspects of the nursing home world do not change even during a global pandemic, and that includes the need to manage relationships with multiple payers. Several managed care organizations (MCOs) are now sending in their new contracts to skilled nursing providers as old agreements expire, Chad Bogar, the founder and CEO of the law […]

2021 Will See ‘Many Facilities Fail’ Without Federal, State Help

Nursing home and senior living providers in the not-for-profit sector are facing significant strains from the surge in COVID-19 nationwide. Leading into the Thanksgiving holiday, operators are pleading with those in the community to refrain from gathering amid challenges both operational and financial. “Nursing homes really are at the brink,” Deke Cateau, the CEO of […]

Curve Health Sees Value-Based Progress at Nursing Homes — Even If It’s Still Technically Fee-for-Service

The federal government has talked a big game about shifting toward value-based payments for Medicare and Medicaid providers, but fee-for-service reimbursements have remained a primary force governing operations in the post-acute and long-term care sector. COVID-19 has subtly shifted that dynamic, however — especially in the field of telemedicine, which has seen skyrocketing adoption rates […]

CMS, Medicare to Cover COVID-19 Antibody Drug in Nursing Homes

The federal government this week announced that Medicare will cover a recently approved antibody treatment for COVID-19 in a range of settings, including nursing homes. The Food and Drug Administration on Monday cleared on an emergency basis the use of bamlanivimab — a monoclonial antibody infusion — for adults with mild to moderate cases of COVID-19. […]

Verma: COVID-19 Shows LTC ‘Relies Too Heavily on Nursing Homes’

The nation’s top Medicare and Medicaid official this week called on states to boost their home- and community-based services for the elderly, arguing that the impact of COVID-19 on nursing homes has exposed a key flaw in the overall system. “The COVID-19 crisis has shone a harsh light on the human costs of a long-term […]

HHS Relaxes Rules for Using Provider Relief Funds to Cover Lost Revenue

The federal government this week amended its rules for how providers can use coronavirus relief funding, specifically removing limitations around covering lost revenues not directly related to COVID-19. The Department of Health and Human Services (HHS) announced the change in the wake of criticism from providers and some lawmakers. “In response to concerns raised, HHS […]

Pruitt: Funding for Private Rooms Top Challenge as Nursing Homes Look to ‘Learn from History’

The final report from the Coronavirus Commission for Safety and Quality in Nursing Homes contained plenty of ideas on how to keep residents and staff safer should COVID-19 resurge or if another pandemic hits the United States. While some of the onus falls on the federal government, nursing home operators must also raise the bar […]

SNN Survey: Most Providers Will Survive into 2021, But Capital Providers Remain Worried About Census

A recent Skilled Nursing News survey of nursing home operators found cautious optimism about the near-term future of the space, with a majority seeing a clear path to the future even without additional government support. At the same time, operators have largely been pouring that federal largesse — including CARES Act grants, Payroll Protection Program […]

Cold Storage, Medicaid Coverage: Inside the Walgreens, CVS Vaccination Deal for Nursing Homes

The federal government last week tapped a pair of retail pharmacy giants to distribute an eventual COVID-19 vaccine to nursing home residents across the country, and while there remain significant questions about the logistics of distributing an as-yet-unapproved vaccine, officials have continued to position the plan as the only workable solution to a massive public […]