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 […]
Category: Medicaid
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 […]
The need for Medicaid as stopgap coverage for long-term care is more apparent when looking at differences in race, gender and ethnicity, and rural versus urban status of the residents. This is according to an analysis conducted by ATI Advisory, which identified the impact of disparities and differences in resources – finances, insurance and social […]
Pennsylvania operator Comprehensive Healthcare Management Services was found guilty in a sprawling health care fraud case, following a five-week federal trial in Pennsylvania, involving two of its facilities. Brighton Rehabilitation and Wellness Center and Lebanon Rehabilitation and Wellness Center were found guilty of making false statements in connection with the payment of health care benefits […]
Nursing homes and the state associations that represent them continue to put pressure on legislators to match Medicaid rates with rising costs, and change how often rebasing occurs to give operators a more even playing field. In a lot of cases, Medicaid increases helped lessen the gap between costs and stagnant rates. But, legislators still […]
Operating a skilled nursing facility today is considered a difficult business with regulations and reimbursement woes making the space “tougher every day.” As a result, some operators say they regularly budget a loss for skilled nursing services, and if it weren’t for other lines of business, skilled nursing would be unsustainable. This dire view of […]
Nursing homes and continuing care retirement communities (CCRCs) made up $191.3 billion of national health expenditures in 2022, an increase from $181.1 billion in 2021, reaching levels close to the onset of the Covid-19 pandemic. Pre-pandemic, such expenditures sat between $162 billion and $174.1 billion between 2016 and 2019, according to a survey published by […]
As the skilled nursing industry heads toward a new year with continued labor shortages and reimbursement gaps, service repositioning and closures among operators are expected trends for the space. And although there are signs of positivity in the form of increased Medicaid reimbursement in some states, extensive rural closures are creating “nursing home deserts” and […]
Minimum Data Set (MDS) changes for 2024, along with updates to nursing home surveys were top of mind among representatives of the Centers for Medicare & Medicaid Services on Thursday, as the agency outlined its plans for next year in an Open Door Forum. CMS plans to release the MDS 1.19.1 in early 2024 with […]
In adjusting to new case-mix systems under the Patient Driven Payment Model (PDPM), the changes to reimbursement rates might be more widespread and large-scale than anticipated, posing financing threats to the nursing home sector because lenders are basing loans on rate projections that are expected to be scaled back. The goal of budget neutrality – […]
The costs of long-term care in every setting, including nursing homes, is considered out of reach for most seniors, averaging more than $100 per day nationwide. This is coupled with the fact that the majority of older adults with very low incomes will need such services and have the fewest resources to pay for them. […]
The past year or two have seen big wins in terms of increased Medicaid funding for nursing homes – a welcome relief as the sector faces staffing shortages amid a looming minimum staffing proposal, higher inflationary costs and rising acuity of resident needs. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) […]
One of the unintended consequences of the minimum staffing proposal may mean less utilization of nursing homes as residents are shifted to other means of care – a trend spurred by an expanded use of Medicaid waivers. Policymakers may opt for these as a safety net for access issues among seniors, especially in rural settings, […]
As nursing home operators continue to decry staffing shortages as a contributor to access issues for residents, new construction of facilities to meet demand appear to be lagging as well. New construction has become especially difficult for operators trying to add Medicaid beds for low income residents, given notoriously low reimbursement rates – which are […]
As nursing homes closures continue across the country, “nursing home deserts” are expanding, and the proposed federal staffing mandate is expected to exacerbate the problem. This is despite attempts to make the potential policy change easier for providers in rural markets, which are especially vulnerable to access issues. Operators in these areas point to the […]
States continue to take action on addressing wage disparities for nursing home staff even as the industry undergoes massive shifts marked by economic, operational and regulatory changes. Skilled nursing facility staff, as well as other health care workers in California, will slowly see their hourly wage increase to $25 over the next decade under a […]
More than a week after updates to the Minimum Data Set (MDS) went into effect, each section change seems to be emphasizing focus on the resident’s voice, which along with substantial coding changes – four years in the making – will require time to incorporate, experts said. Kevin Cezat, director of clinical excellence for Therapy […]
Ahead of the upcoming Minimum Data Set (MDS) changes on Oct. 1, the preparation of clinicians is mixed and may have a lot to do with company size and regional market, along with resources to stay apprised of reimbursement updates. Many clinicians feel stressed and overwhelmed by the adjustments, with some playing catchup to the […]
More than 280,000 residents, or nearly a quarter of all residents, could be impacted by the staffing mandate – if nursing home operators have no choice but to reduce their census in order to meet hourly requirements. The proposed federal mandate would require an estimated 102,154 additional full-time employees. That’s 80,077 certified nursing assistants (CNAs) […]
Subscribe
Receive industry updates and breaking news from SNN.