Increasing numbers of states have begun exploring managed Medicaid programs as a means of achieving savings as their populations age. But unless officials provide crucial oversight, skilled nursing facilities could find themselves under even worse financial pressures. It’s something that states and their legislators need to keep in mind as they weigh options for managing […]
Category: Medicaid
Industry leaders had reason to cheer the federal government’s decision to boost Medicare rates for skilled nursing facilities, but the gain could end up only papering over the persistent reimbursement problems in the space. The Centers for Medicare & Medicaid Services (CMS) last week proposed a 2.5% increase to the Medicare market basket rate, a […]
The federal government on Wednesday signaled its intent to expand coverage options for Americans who qualify for both Medicare and Medicaid, though the states will largely be in the driver’s seat moving forward. In a letter to the 50 state governors from administrator Seema Verma, the Centers for Medicare & Medicaid Services (CMS) invited states […]
The state of Illinois bases its Medicaid reimbursements for nursing homes on calculations that are years out of date, leading to financial pressures that have closed 20 facilities in the state since March 2014. That’s according to a new report commissioned by the nursing home advocacy group Health Care Council of Illinois (HCCI). Capitol News […]
Oklahoma moved one step closer to boosting Medicaid payments for skilled nursing facilities, with Senate Bill 280 ready to proceed to the Senate for final approval after some floor amendments. Tulsa World first reported the news. Oklahoma is proactively trying to bolster its Medicaid rate, which ranks among the lowest in the country. Several cities […]
Skilled nursing facilities in the state of Pennsylvania lose an estimated $631 million per year caring for Medicaid residents, with non-profits taking a particularly large share of the stress. The state’s 221 non-profit nursing facilities lose an average of $82.16 per patient day on Medicaid beneficiaries, according to an April analysis from LeadingAge PA and […]
The leader of the Centers for Medicare & Medicaid Services (CMS) on Monday announced a “comprehensive review” of safety and quality standards for nursing homes, while also touting the progress made in recent years. “CMS is not waiting, and not settling for the status quo: I have directed my team at CMS to undertake a […]
The Centers for Medicare & Medicaid Services (CMS) last week made a small policy change that could have a major beneficial impact for skilled nursing providers that rely on Medicaid. CMS updated its guidance for the Patient-Driven Payment Model (PDPM), indefinitely extending a key workaround for states that base Medicaid rates on the existing Medicare […]
When skilled nursing operator Daybreak Venture fell behind on its rent payments to Omega Healthcare Investors, Inc. (NYSE: OHI), the real estate investment trust touted a Texas supplemental payment program as one of the tools that would help the operator turn its fortunes around. It’s a Medicaid program similar to others in various states, and […]
Massachusetts, which has already endured a wave of skilled nursing closures amid tight Medicaid reimbursements, could see 35 more buildings shut their doors without timely intervention from lawmakers, according to a leading trade group in the state. The Bay State has already lost 20 nursing facilities in the last year, according to the Massachusetts Senior […]
Eight skilled nursing facilities in Wisconsin operated by Dycora Transitional Health and Living have been placed into receivership, with an affiliate of landlord Golden Living Centers taking back control after a two-year break. The Fresno, Calif.-based Dycora on Thursday became the latest entrant in a string of receivership actions in Wisconsin, with the Milwaukee County […]
Medicaid spending forms the cornerstone of long-term services and supports (LTSS) as the population ages, but is facing increasing constraints as states try to navigate tight budgets — and managed Medicaid is emerging as an increasingly attractive option for states to do more with less. To try to combat some of the challenges and learn […]
Given their emphasis on rehabilitation and recovery, skilled nursing facilities aren’t typically places where patients receive palliative care. That’s despite the fact that only a small portion of nursing home residents who would benefit from such care usually receive it, according to one study published in 2017 by the Journal of the American Medical Association. […]
Despite the second straight year of declines in overall recoveries, the Department of Health and Human Services’ (HHS) top watchdog arm took back nearly $50 million in Medicaid reimbursements from nursing homes in fiscal 2018. The HHS Office of the Inspector General (OIG) this week reported a haul of $48.7 million from nursing providers accused […]
On paper, the Patient-Driven Payment Model (PDPM) will only affect one pillar of the payment equation for skilled nursing facilities. But as players start to unpack the coming rule changes, PDPM’s reach begins to extend far beyond Medicare. Medicare Advantage and Medicaid frequently base rate calculations on the existing Medicare structure, a pair of experts […]
Skilled nursing operators can’t control day-to-day Medicaid rates in their states, but they do have a broad toolbox that can help them avoid eligibility errors and oversights that can cause millions in losses. In an era of constricted Medicaid reimbursements, frontline staff can still play a crucial role in maximizing dollars, sb2 Inc. CEO and […]
After a high-profile bankruptcy in December of last year, Texas now has two bills that aim to provide some Medicaid reimbursement relief to skilled nursing providers in the state. The bills, Senate Bill 1050 and House Bill 3342, would establish a long-term care quality provider participation program (QPPP) in the state that provides additional compensation […]
The White House on Monday released a budget proposal that would substantially slash Medicare and Medicaid spending over the next decade. In part by adopting a site-neutral payment model for post-acute care under Medicare and converting the Medicaid system to block grants, the federal government would end up gutting more than $1 trillion from the […]
Across the U.S., Medicaid rates tend to fall short of the cost of nursing home care for beneficiaries. In the state of Massachusetts, the financial pressures have rendered many skilled nursing facilities unstable — and forced many of them to close. The trend has also forced many of them to leave bills unpaid, which spreads […]
Various industry stakeholders on Wednesday took to Capitol Hill for a hearing on safety standards at the country’s skilled nursing facilities, but one leading senator took the opportunity to sound the alarm over potential cuts to the Medicaid program. The Trump administration could move as soon as next week to publicly restart the fight over […]