HHS Secretary Wants Providers to Take Amazon, Yelp’s Lead

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 […]

Industry Responds to Democrats’ Call for Skilled Nursing Scrutiny

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 […]

‘Avoidable’ Nursing Home Discharges Might Be Hard to Avoid

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 […]

Assuming Risk Key to Medicare Savings Under New Payment Models

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the Menlo Park, Calif.-based non-profit found in an independent analysis of publicly available ACO data and previously unpublished numbers from the Centers for […]

Democrats Ask CMS to Halt Skilled Nursing Regulatory Rollback

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 […]

Michigan Considers Moving Long-Term Medicaid to Managed Care

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 […]

Spending on Nursing Care to Increase Steadily Through 2026

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, […]

HHS Proposes New Payment System for Skilled Nursing Providers

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 […]

Senate Budget Plan Cuts $2 Billion from Skilled Nursing Facilities

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 […]

Volatile Market, Rising Interest Rates Add to Skilled Nursing Pressures

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 […]

Non-Profit Texas SNFs Forced to Close Amid Low Medicaid Rates

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 […]

Why Getting an Extra CMS Star Can Boost a SNF’s Census

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, […]

Azar, Open to Medicaid Caps, Confirmed as HHS Secretary

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 […]

What SNFs Can Expect During a Government Shutdown

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 […]

Skilled Nursing Providers Sue Illinois Over Medicaid Rates

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 […]

Federal Judge Tosses $350M False Claims Act Penalty Against Provider

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 […]

CMS Rolls Out New Bundled Payment Model

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 […]

Medicaid Increases May Boost SNF Quality More Than Competition

The free market alone might not be enough to boost skilled nursing facility (SNF) quality, according to a new National Bureau of Economic Research working paper. The paper, “Incentivizing Better Quality of Care: The Role of Medicaid and Competition in the Nursing Home Industry,” simulated the effects of policies in Pennsylvania that either raised regulated Medicaid […]