The Louisiana Legislature on Tuesday rejected a bill that would have shifted the state’s long-term Medicaid model to a managed care system in an attempt to move more skilled nursing residents to the home-care setting. The Senate Health and Welfare committee voted down Senate Bill 357 in a 6-2 vote, The Advocate of Baton Rouge, La. reported. The bill […]
If Health and Human Services secretary Alex Azar has his way, the health care consumer of the future will select providers the way they currently decide where to eat or which knockoff iPhone charger to buy. “Imagine a day when health care delivery in the United States functions the way other parts of our economy […]
Post-acute care (PAC) providers, including skilled nursing facilities, may be out of the driver’s seat in the new bundled payments program from Centers for Medicare & Medicaid Services (CMS), but that doesn’t mean they need to sit on the sidelines. In fact, being proactive is one of the best things they can do position themselves […]
In a Valentine’s Day letter to top health officials, a group of influential Senate Democrats asked the Centers for Medicare & Medicaid Services (CMS) to reconsider certain rollbacks of nursing home regulations. In response, a leading industry group on Wednesday wrote back to the senators to clarify and rebut some of their points. “We think […]
Keeping nursing home residents out of the hospital can save them from the risks associated with both the transition to the hospital and the hospitalization itself — while also preventing reimbursement penalties. But doing that in the nursing home setting is more complicated than it might seem, according to a study from the Indiana University […]
Accountable care organizations (ACOs) only generate savings for the government if they accept risk, according to an analysis from the Kaiser Family Foundation. ACOs generated net savings of $47 million in 2016, the Menlo Park, Calif.-based non-profit found in an independent analysis of publicly available ACO data and previously unpublished numbers from the Centers for […]
A group of 12 Democratic U.S. senators slammed the Centers for Medicare & Medicaid Services in a letter sent last week, claiming that its leadership’s decision to ease regulatory restrictions on nursing homes has put seniors in danger. “We write with deep concern over a string of actions by the Centers for Medicare & Medicaid […]
Long-term care (LTC) groups in Michigan expressed alarm at the possibility of the state moving its $2.8 billion Medicaid nursing home and LTC services programs to managed care, according to a report in Crain’s Detroit Business. Under Section 1857 of the 2017-2018 state budget, the Michigan Department of Health and Human Services (MDHHS) must “explore the implementation […]
Annual expenditures on skilled nursing care will increase by 3.9% this year and keep rising through 2026, according to a new study from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. This rise in nursing home spending tracks with overall gains in outlays for health care services: Between 2017 and 2026, […]
The new proposed Department of Health and Human Services (HHS) budget was released on Monday, and it’s a mixed bag for skilled nursing providers. President Trump’s spending blueprint would make changes to Medicaid by creating a “market-based health-care grant” that could fund programs in addition to the traditional Medicaid program — a change that would […]
Now that the Senate’s compromise spending plan has become law, skilled nursing providers must figure out how to make do with fewer Medicare dollars over the next 10 years. The decline comes from a freeze in the Medicare market basket rate, which the new budget has set at 2.4% in fiscal 2019. The industry had […]
UPDATE: The Senate’s spending bill has passed both houses of Congress, and President Trump signed it into law Friday morning. Should the Senate’s attempt at passing a two-year budget succeed, skilled nursing operators could be in for another serious financial hit. “We are disappointed that the Senate budget proposal includes a $2 billion cut to […]
Just when it seemed like the skilled nursing industry had enough potential issues on its plate for 2018 — potential cuts to Medicaid and Medicare, ongoing reimbursement pressures, and staffing woes — the historically healthy stock market took a major tumble. Sabra Health Care REIT (NASDAQ: SBRA), Ventas Inc. (NYSE: VTR), and other health care […]
Morningside Ministries, a not-for-profit organization in San Antonio, Texas, that provides senior housing and care services, closed its Chandler Estate nursing home rather than risk lowering the quality of care under pressure from the state’s Medicaid system. The nursing home is slated to lock its doors this month, according to the San Antonio Express-News. And Morningside […]
Consumers are using the Five-Star Quality Rating System to make decisions about skilled nursing care — and there could be a major financial incentive for providers to earn that extra star. Adding a single star to a skilled nursing facility’s rating from the Centers for Medicare & Medicaid Services (CMS) boosts admissions in many cases, […]
After a combative confirmation process, the United States Senate has confirmed Alex Azar as the second Department of Health and Human Services secretary in the Trump administration. Azar, a former pharmaceutical executive with Eli Lilly & Co., received a 55-43 vote of support from the U.S. Senate, with six Democrats defecting from the pack to […]
Though the federal government officially shut down early Saturday morning, skilled nursing and other long-term care operators have little reason to worry about reimbursements — at least for the time being. Medicare and Veterans Affairs-related reimbursements must continue even if the government suspends discretionary spending, as these programs are mandatory. In addition, because state governments […]
A group of five nursing home providers sued the state of Illinois late last week in federal court, claiming that low Medicaid reimbursement rates in the Land of Lincoln could force them to shut down. The companies specifically accuse Felicia F. Norwood, director of the Illinois Department of Healthcare and Family Services, of violating federal […]
A federal judge last week threw out a $350 million False Claims Act judgment against a Florida nursing home provider, writing that its occasionally inaccurate record-keeping didn’t amount to deliberate fraud. In a fiery ruling, U.S. District Judge Steven D. Merryday wrote that the claims brought by a whistleblower against Salus Rehabilitation, LLC — namely […]
The Centers for Medicare & Medicaid Services (CMS) on Tuesday introduced a new alternative payment model, the Bundled Payments for Care Improvement Advanced (BPCI Advanced). The model, coming out of the Center for Medicare and Medicaid Innovation, is a voluntary bundled payment program that enables participants to earn additional payments for a beneficiary’s episode of care if quality is maintained […]
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