New Medicaid Feature Aims to Reduce Nursing Home Enrollments in Pa.

Pennsylvania has unveiled a new Medicaid feature designed to reduce the number of nursing home enrollees in years to come. Under the Community HealthChoices initiative, insurers will be paid to manage Medicaid’s long-term care services with a financial incentive meant to prioritize in-home care for enrollees. The state is rolling out the program in 14 southwestern counties […]

Skilled Nursing Spending Growth Slowed in 2016

Overall spending on skilled nursing care slowed in 2016, according to the most recent report from the Centers for Medicare & Medicaid Services (CMS). In all, payers spent $162.7 billion on care at nursing homes and continuing care retirement communities (CCRCs), an increase of 2.9% from 2015. That’s slower than the 3.7% growth between 2014 […]

Post-Acute Crunch at Non-Profit CCRCs Predicted for 2018

Post-acute concerns could be a thorn in the side of non-profit continuing care retirement community (CCRC) operators next year. Citing industry-wide declines in census, admissions, and revenues amid changing payment models, Fitch Ratings, Inc. identified skilled rehabilitation care as a main concern for non-profit CCRCs in an otherwise sunny report about the state of the industry issued […]

Care Coordination in ACOs Might Not Actually Drive Savings

Accountable care organizations (ACOs) are built on a basic premise: By working together, providers across the health care continuum can save Medicare money and boost quality. But the largest share of the savings may simply come from shifting patients out of skilled nursing and home health settings, a new study suggests — and not on […]

SNFs Could Emerge as ‘Net Losers’ Under GOP Tax Plan

Senate Republicans passed their version of comprehensive tax reform in the early hours of Saturday morning, and while lawmakers in both houses still need to weigh in on a compromise bill, fears about the legislation’s impact are coursing through the long-term care industry. Skilled nursing operators could be the “net losers” under the GOP-led tax […]

Opinion: Nursing Homes Need to View Regulators as Partners — Or Perish

My job involves combing through Google Alerts in search of the latest filings and nuggets of news about the skilled nursing industry. Most are false positives — especially during the autumn, when my alert for “SNF” returns more information about the coming week’s Sunday Night Football matchup than skilled nursing facilities. But ever since I […]

CMS Officially Scraps Mandatory Cardiac Bundles

The Centers for Medicare & Medicaid Services (CMS) on Thursday finalized the cancellation of the mandatory hip fracture and cardiac bundled payment models, and in the same move, also implemented changes to the Comprehensive Care for Joint Replacement (CJR) model. Specifically, CMS is reducing the number of mandatory geographic areas participating in the CJR model, […]

CMS-Backed Clinical Program Drastically Lowers Avoidable Hospitalizations at SNFs

Potentially avoidable hospitalizations for long-stay nursing facility residents can be significantly reduced by embedding nurses and nurse practitioners, according to a new analysis. In turn, the strategy could substantially slash Medicare spending. That’s according to an independent evaluation of the OPTIMISTIC program prepared at the request of the Center for Medicare and Medicaid Innovation (CMMI). OPTIMISTIC was developed […]

Warren Presses HHS Pick Over Anti-Psychotic Drugs in Nursing Homes

President Trump’s pick to lead the Department of Health and Human Services faced pointed questions Wednesday about his former employer’s history with marketing anti-psychotic drugs to nursing home operators. Alex Azar, most recently a top executive at pharmaceutical giant Eli Lilly and Company (NYSE: LLY), pushed back against criticism of his former company’s history with […]

CMS Delays Enforcement of Smoking Rules, Other Phase 2 Requirements

Skilled nursing operators can breathe a little easier as the second phase of the new Requirements for Participation takes effect this week: The Centers for Medicare & Medicaid Services (CMS) has delayed penalties for several of the new requirements. For the next 18 months, CMS won’t take enforcement action — in the form of civil […]

Lawsuit Alleges Growing Trend of Improper Discharges at CA SNFs

At 83 years old, California resident Gloria Single is shining a light on what she and her allies believe is a growing issue at skilled nursing facilities (SNFs) in the state: the illegal “dumping,” or eviction, of residents. In March 2017, Single was evicted from Pioneer House in Sacramento, with no warning. Pioneer House—a SNF […]

AHCA: HHS Nominee Azar is Respected and Experienced

President Donald Trump tweeted Monday morning that he would nominate Alex Azar, a former executive with pharmaceutical giant Eli Lilly, as secretary of the Department of Health and Human Services. The nation’s largest skilled nursing provider association stands ready to work with Azar, the group stated, while others raised some concerns about what his nomination could mean […]

How Bundled Payments Can Keep SNFs on Top of Their Game

The home setting is fast becoming the preferred choice in delivering post acute care (PAC) for health care organizations in bundled payment settings, according to a recent industry report. But while health care providers are steering patients away from an institutionalized setting, one industry expert believes this realization should alert skilled nursing facilities (SNFs) and […]

CMS Takes Steps to Improve Medicaid

The Centers for Medicare & Medicaid Services (CMS) announced several ways it plans to improve the Medicaid program — including new proposals for reforms and fewer regulatory burdens, increased efficiency, and more transparency and accountability, according to CMS Administrator Seema Verma.  “Our vision for the future of Medicaid is to reset the federal-state relationship and […]

Health Care Spending Could Reach 40% of Federal Total by 2047

If current policies don’t change, federal spending on Medicare, Medicaid, and other health care programs will grow faster than any other category over the next three decades — eventually reaching 40% of the federal budget. The Congressional Budget Office (CBO) presented these statistics in a Wednesday presentation to the Council for Affordable Health Coverage and the American […]

How SNF Executives Can Lobby Lawmakers Without Leaving the Building

Fresh off a battle that nearly saw wholesale changes to the Medicaid program, skilled nursing lobbyists say the work isn’t over — and that operators on the front lines can often be the most effective voices in reaching Washington. One of the primary reasons that Congress came so close to gutting Medicaid as part of […]

Inside Florida’s Shift to a Prospective Payment System for SNFs

As skilled nursing providers in Florida brace for the introduction of a prospective payment system (PPS) for nursing home reimbursements under the state’s Medicaid program, the state legislature has required the formation of a working group to ease the transition. Under the new law—set to take effect in 2018—the state will switch its Medicaid reimbursement policy from […]

House Democrats Ask CMS to Uphold Arbitration Ban

House Democrats on Wednesday called on Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to change her mind on reinstating the use of arbitration clauses in skilled nursing contracts. Referencing the recent problems at nursing homes in the aftermaths of Hurricanes Harvey and Irma, 46 Democratic representatives wrote a letter to Verma asking […]

Paying the Price: HHS Secretary Steps Down Amid Scandal

Department of Health and Human Services secretary Tom Price resigned from his post Friday amid an investigation into his use of private jets at taxpayer expense. The government spent more than $1 million for Price’s travel on private and military aircraft since May, according to Politico, which first reported on the secretary’s travel habits. Those […]