As inadequate funding squeezes nursing homes dry, with Medicare Advantage reimbursing lower than traditional Medicare, and Medicaid funding decades behind on meeting cost of care, facilities are shifting operations to optimize reimbursement. But even that may not be enough. Richard Gamache, CEO of Aldersbridge Communities in Rhode Island, has had to make such operating decisions […]
As Medicare Advantage continues to grow in the skilled nursing space, beneficiaries utilizing traditional Fee-For-Service Medicare have declined, and in turn reimbursement has dropped at an alarming rate. For every two beneficiaries that opted for MA, one FFS individual left the program in 2023, the first year the number of FFS beneficiaries declined in every […]
The threat of closure is ever present for nursing home operators, with low Medicaid reimbursements and workforce shortages amid a growing population of higher acuity patients complicating care. Since the start of the pandemic, six nursing homes in Rhode Island have closed their doors, forcing the relocation of more than 100 residents, Gov. Dan McKee […]
As so many in the nursing home space focus on Medicaid reimbursement, others are taking a closer look at improving rate setting methodology and how it can be optimized for facilities. Medicaid rates are in part influenced by fair rental value, which is determined after experienced housing experts perform an in-depth market valuation on the […]
Nursing facilities were among six provider types with the most patient abuse and neglect convictions tied to Medicaid than other provider types in 2023, as a whopping 841 criminal and civil patient and abuse complaints related to the sector – topping all other categories – are still open to investigation. There are 238 open nursing […]
Flaws with the Medicaid redetermination process are leading to an increasing number of existing nursing home residents being found ineligible for Medicaid coverage — creating headaches for nursing homes. This view is held by officials at several state health care associations, who spoke to Skilled Nursing News. Montana, for one, has Medicaid redetermination information being […]
The year ahead for Sabra Health Care REIT (Nasdaq: SBRA) presents a “terrific” opportunity for improved margins and potential dealmaking, with eyes on multiple asset classes, according to Sabra CEO Rick Matros. While the California-based real estate investment trust (REIT) has focused in the past couple years on diversifying its portfolio – namely adding behavioral […]
States are seeing in real time what a federal minimum staffing mandate may cost them, as a disagreement between Connecticut and its nursing homes has come to a head. The state owes its nursing homes $55 million for staffing requirements imposed between March 2023 and this past January when an enhanced version of the directive […]
It’s becoming harder than ever to operate standalone skilled nursing facilities amid inadequate government funding, and innovative business models that deal with challenges, especially those related to staffing, have and will be borne from necessity. “Innovative models are going to present themselves in some way to stop this train,” said Dan Hermann, president and CEO […]
Nursing home associations in Ohio have sued the state Department of Medicaid last week over a Medicaid rate that does not match what’s needed to meet quality incentives. Ohio’s rebasing process splits Medicaid funding into two categories, with 60% based on meeting certain quality incentives and 40% reserved for the “base rate,” or a calculation […]
Soaring costs associated with skilled nursing – and problematic payer sources – are making it harder for continuing care retirement communities (CCRCs) to provide such labor intensive post-acute care. CCRCs have to ask themselves some hard questions when it comes to what services they can reasonably offer, and if it’s worth it to keep open […]
In the midst of lagging Medicaid reimbursements, more nursing providers are pushing states to launch quality incentive programs that are designed to enhance care and reward high-performing long-term care providers. Twenty-four states already have them in place, and the latest to join this trend is Pennsylvania. And to that end, nursing home providers in Pennsylvania […]
Rural and small market areas continue to experience growing “nursing home deserts,” an increasing crisis for local officials and beneficiaries facing access issues. In Nebraska, for one, state data shows 29 facilities closed their doors in the past three years, leaving pockets of “nursing home deserts” across 20 counties, according to a report from KETV […]
The nursing home industry led the health care sector in wage growth while prices for skilled nursing services grew at the fastest pace at the end of 2023. Meanwhile, employment growth slowed to a crawl in December despite a desperate need to bolster the nursing home workforce. This is according to Altarum’s Health Sector Economic […]
Nursing home owners and advocates have long decried low Medicaid reimbursements to the sector across the U.S. And now leaders in New York state – home to one of the largest number of facilities – are uniting to forcefully demand change. Much like the rest of the country, closures, especially in Upstate New York, have […]
Given that a vast majority of long-stay nursing home residents are dual eligible for Medicare and Medicaid, residents and facilities alike can reap financial benefits while improving quality of care and reducing administrative burdens if federal and state policies better enabled a value-based care model that integrated the experiences of dual eligibles. This is the […]
Two more nursing homes in New Jersey have their Medicaid funding suspended following allegations of massive fraud by the owners related to their New York facilities. Deptford Center for Rehabilitation and Healthcare, and Hammonton Center for Rehabilitation and Healthcare will lose their Medicaid funding on May 24, according to the Office of the State Comptroller […]
The Office of the Inspector General (OIG) will be auditing nursing home survey practices this year with results expected in 2025, following concerns that third-party contractors may not have sufficient oversight in the space. OIG suggested closer scrutiny of the Centers for Medicare & Medicaid Services (CMS) regulatory practices when it came to surveys, given […]
Owners of nursing homes in New Jersey are being barred from the state’s Medicaid program after the abrupt closure of their facility last fall that displaced more than 70 residents, jeopardizing their safety. The suspension from the federal program for Gail and Ezra Bogner, who owned the now defunct Princeton Care Center and Woodland Behavioral […]
Deficiencies in nursing homes, both on average and those deemed more serious, have increased over time – partly as a result of decreasing staffing levels. Between 2015 and 2023, facilities with serious deficiencies, or violations of federal regulations, increased from 17% to 26%, according to a data note published on Friday by KFF. The average […]
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