Health and Human Services Secretary Alex Azar on Tuesday trumpeted the new payment model for skilled nursing facilities in a speech before a prominent trade group, positioning the plan as one piece of a larger change in the way the government pays for health care. The new Patient-Driven Payment Model (PDPM) incorporates the dual goals […]
Embattled skilled nursing provider Preferred Care has asked a federal bankruptcy judge to approve a settlement regarding allegedly falsified Medicare and Medicaid claims. Settling the pair of federal whistleblower lawsuits, filed in 2016 and 2017, would help accelerate Preferred Care’s Chapter 11 bankruptcy process, the provider argued in a filing submitted last week. Westlaw Practitioner […]
The state of New Mexico ranks at the bottom in terms of serious skilled nursing deficiencies per facility, according to a recent analysis conducted by a pair of news organizations. Out of the 74 facilities in the state certified by the Centers for Medicare & Medicaid Services, 36 had “serious deficiencies” between 2015 and 2018, […]
More than 30,000 nursing home residents in Louisiana are slated to receive notices that they could lose their Medicaid eligibility starting on Thursday as a result of budget cuts that passed the state’s House of Representatives. But the president of one provider organization would be “stunned” to see the budget pass the state Senate and […]
A federal lawmaker on Wednesday rolled out a plan to provide a long-term care benefit as part of Medicare, citing the aging U.S. population and skyrocketing costs. Rep. Frank Pallone, a New Jersey Democrat, unveiled the Medicare Long-Term Care Services and Supports (LTSS) Act, a discussion draft of a bill that would expand Medicare coverage […]
The Department of Health and Human Services (HHS) filed an objection to Orianna Health Systems’ bankruptcy plan, bringing the case into unsettled legal terrain. U.S. Attorney Erin Nealy Cox this week argued that HHS and the Centers for Medicare & Medicaid Services (CMS) have the ultimate control over the legal issues surrounding the transfer of […]
Managed care is on the rise in both Medicare and Medicaid, but skilled nursing and long-term care (LTC) providers don’t necessarily need to play catch-up. In fact, they have room to influence the direction of managed care in their states, according to a panel at the National Investment Center for Seniors Housing & Care (NIC) […]
Changes to the way Medicare reimburses providers of therapy services will change the game for skilled nursing operators, at least according to one industry analyst. The Resident Classification System, Version I (RCS-I) will replace the current fee-for-service Medicare therapy structure with a model that more closely tracks with larger trends toward value-based services, rewarding providers […]
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 […]
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