Skilled Nursing News’ Hidden Gems of 2019

For the skilled nursing profession, 2019 will be synonymous with the Patient-Driven Payment Model (PDPM), and the top stories of the year reflect the importance of this shift. But PDPM is one of many moving parts in the skilled nursing world, and operators, landlords, and regulators alike made splashes in ways that had nothing to […]

Mixed Skilled Nursing Projections for 2020: Increased Demand, But Margin Pressure Continues

Increasing demand for skilled nursing services is a good sign for the industry, according to several experts who spoke on SNN’s annual outlook webinar, but a continued squeeze on margins may affect some facilities’ ability to keep their doors open in 2020.  Although the Patient-Driven Payment Model (PDPM) looks like good news, with increased reimbursements […]

The Top Skilled Nursing Trends of 2020 — and Beyond

As we prepare to close the door on the 2010s, we’re also about to say goodbye to a year that probably felt like a full decade for operators and investors in the post-acute and long-term care space. With a new Medicare payment model, continued Medicaid pressures, and a raft of regulatory attention from Washington, D.C., […]

Low Stars, Citations, Medicaid Problems: HUD Lenders Share Top Skilled Nursing Dealbreakers

Lenders who offer Department of Housing and Urban Development (HUD) loans consider skilled nursing financing to be a long-term relationship, so choosing clients carefully — and thinking about deals as partnerships for the long haul — is crucial for good-decision making. Because the federal government backs these products, which feature low interest rates and a […]

Medicaid’s Share of Nursing Home Revenue, Resident Days Hits Record High as Medicare Drops to Historic Low

Occupancy at the nation’s nursing homes stayed flat between the most recent two quarters, but the proportion of residents covered under Medicaid hit a record high — while the share of bread-and-butter Medicare residents fell to a record low. Medicaid accounted for exactly two-thirds, or 67.6%, of resident days at nursing facilities in the third […]

After 50 Years, PruittHealth Looks to the Future with I-SNP — and Staff Development Strategies from Disney

PruittHealth spent 2019 celebrating its 50th anniversary in the post-acute and long-term care space, but second-generation CEO Neil Pruitt, Jr. says his company — along with the rest of the industry — must focus on novel and creative strategies for surviving into the future. Pruitt sees potential in a variety of forward-thinking initiatives, from the […]

CMS to Have ‘Limited’ Survey Capacity for New Nursing Home Requirements of Participation

Confusion continues to reign over the final set of new requirements for Medicare- and Medicaid-certified nursing homes, as the federal government disclosed that it will have very little ability to enforce the rules until the middle of next year. The third and last update to the Requirements of Participation (RoPs) is set to take effect […]

HCR ManorCare Helps Alleviate $102.8M Loss at ProMedica’s Insurance Arm

After the non-profit ProMedica Health System took over the operations of HCR ManorCare in a blockbuster deal last year, the skilled nursing entity continues to help improve the system’s shaky financial results. The Toledo, Ohio-based ProMedica reported an operating loss of $102.8 million for its ProMedica Insurance Corporation arm for the nine-month period ending September […]

Record-Setting Nursing Home Fraud Case Ends in $44M Judgment

The former nursing home owner behind the largest criminal health care fraud case in U.S. history had already received a 20-year prison sentence, but a federal judge on Thursday added a $44 million payment to the punishment. Philip Esformes, who once ran a skilled nursing facility and assisted living chain with locations from Miami to […]

Nursing Home Receivership Raises Concerns Over Shortage of Respiratory Beds

One of two skilled nursing facilities in Connecticut with a respiratory unit was placed into voluntary receivership on November 5, raising concerns about access to such care in the state. The Republican-American first reported the news over the weekend. The state Department of Social Services (DSS) placed Waterbury Gardens for Nursing and Rehabilitation under the […]

Louisiana to Pay $13.4M to Settle Allegations of Inflated Medicaid Claims for Nursing Home Care

In a twist on typical allegations of Medicaid overpayments, the state of Louisiana will be paying back millions to the federal government. The Louisiana Department of Health (DOH) agreed to pay $13.42 million to settle allegations that it submitted inflated claims for long-term nursing home and hospice care, the federal Department of Justice (DOJ) announced […]

Citing ‘Shady’ Behavior, CMS Proposes Stricter Rules, Time Limit on Medicaid Payment Supplements

Nursing home providers in multiple states have won key funding increases through the use of novel Medicaid supplement programs — but the federal government now wants to keep a tighter leash on the models in order to curb overall Medicaid spending. The Centers for Medicare & Medicaid Services (CMS) on Tuesday proposed a rule that […]

Washington State Targets Medicaid Shortfall, But Not in Time for Some SNFs

Two different legislative proposals in the state of Washington call for a change in how the state calculates Medicaid reimbursement for skilled nursing facilities. But the changes – if they take effect – may not be in time to save more facilities from closure, according to one trade group. Northwest News Network first reported on […]

Why a 10% Medicaid Boost Wasn’t Enough to Save Nursing Homes From Closure

The state of South Dakota earlier this year passed a significant increase to Medicaid reimbursement for nursing facilities in the state, prompted by a rash of closures. But even with the extra dollars -– the state in April authorized a 10% increase in Medicaid reimbursement for nursing homes, which translated to a roughly $8-per-day increase […]

$240M Illinois Medicaid Funding Increase Remains Unclear: ‘It Could Be Eaten Up in Penalties’

Illinois lawmakers’ approval of a Medicaid reimbursement increase for skilled nursing facilities earlier this year came as welcome news to providers in a state notorious for its difficult operating environment. But key definitions related to the requirements for staffing are still being finalized, and the ramifications for the funding boost are still unclear. “The whole […]

Nursing Home Denials in CA Raise Concerns About Larger Move to Managed Medicaid

Managed Medicaid plans in California have, in some cases, denied coverage to patients for nursing facility care, raising concerns among long-term care advocates in the state about coverage by such plans. California Healthline, a publication of Kaiser Health News, reported the story earlier this week. California pays plans a monthly rate for every Medicaid beneficiary […]