Rise of Managed Medicaid Could Deepen Skilled Nursing Financial Woes

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 […]

Decades-Old Medicaid Rates Claim 20 Skilled Nursing Closures in Illinois — With More on the Way

The state of Illinois bases its Medicaid reimbursements for nursing homes on calculations that are years out of date, leading to financial pressures that have closed 20 facilities in the state since March 2014.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 One Step Closer to Boosting Medicaid Rates for Nursing Homes

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 […]

Non-Profit SNFs Bear Brunt of $631M Medicaid Funding Shortfall in PA

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 […]

Wave of Skilled Nursing Closures in Mass. Could Grow by 35 Without Medicaid Reform

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 […]

Golden Living Takes Back Control of 8 Dycora Skilled Nursing Facilities in Receivership

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 […]

Turn-Key CEO: Why Palliative Care Must Soon Come to Skilled Nursing

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. […]

OIG Takes Back $48M in Fraudulent Medicaid Payments as Nursing Homes Lead List of Open Cases

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 […]

PDPM’s Effects Could Stretch Far Beyond Medicare for Skilled Nursing Facilities

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 […]

Avoiding Million-Dollar Medicaid Eligibility Mistakes in Nursing Facilities

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 […]

Texas Floats Plans to Boost Medicaid Funding Through SNF Quality Program

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 […]

Trump Budget Plan Would Cut $845B from Medicare, $241B from Medicaid

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 […]

As Medicaid Rates Lag Behind Costs, Unpaid Nursing Home Bills Pile Up

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 […]