As president and CEO of Saint Therese Senior Living for the last two years, Craig Abbott has been on a mission to change the idea of wellbeing by strengthening his organization’s workforce and making an urgent case for long-term care and accessibility to nursing homes as a community issue. “We set out a 10-year vision […]
American Healthcare REIT (NYSE: AHR) executives highlighted the strong performance of its Trilogy assets, praising Trilogy’s model for its diversity and flexibility in adjusting to changing market conditions, including possible cuts to Medicaid, and reimbursement for skilled nursing services. Additionally, the executives said that if the proposed Medicaid cuts were to be enacted, Trilogy would […]
A lawsuit against UnitedHealth Group over its wrongful denials of post-acute care under Medicare Advantage plans, including nursing home services, advanced following a court ruling on Thursday. The lawsuit filed in the U.S. District Court for the District of Minnesota claims that UnitedHealth’s use of an AI tool called nH Predict led to arbitrary coverage […]
Nursing home leaders are hoping that the Department of Health and Human Services’ (HHS) new chief, Robert F. Kennedy Jr., who was sworn in on Thursday, will commit to protecting Medicare and Medicaid and undoing the federal staffing mandate. Republican lawmakers are pushing for potential Medicaid cuts in their spending bill due to be finalized […]
During a heated first confirmation hearing on Wednesday, Robert F. Kennedy Jr. raised concerns over the practicality of the nursing home staffing mandate, acknowledging the risks it poses to access of care, especially in rural communities. He also shared his vision for lowering overall health care costs. Kennedy is seeking to lead the $1.7 trillion […]
As providers focus on building up the nursing home workforce, and in turn protecting access to care, many leaders in 2025 are prioritizing shift flexibility for staff while also launching new programs to better support hiring and retention. At the same time, investments in integrated health services and behavioral health are top of mind for […]
Older Americans that entered Medicare after the introduction of the Affordable Care Act (ACA) were found to have less hospitalizations, a reduction in medication use for chronic disease, and less out-of-pocket costs, compared to those that were on Medicare prior to ACA. Nursing home care was counted in out-of-pocket costs in a study published Friday […]
While 2025 remains a bit uncertain due to the federal staffing mandate and a new White House administration, leaders in the nursing home industry plan to continue working toward improving quality of care, addressing workforce challenges and advocating for fair regulation and reimbursements. Clif Porter, president and CEO of the American Health Care Association/National Center […]
For some nursing home providers, adding new business lines and more brick-and-mortar locations ensures greater longevity by providing better cushioning against larger economic forces. This philosophy allows for a lot of freedom when growing the business, and it keeps nursing home operators from sitting still in a challenging and constantly changing environment. According to Leslie […]
It’s no surprise that the Biden administration’s minimum staffing mandate was the source of Skilled Nursing News’ most-read story of 2024. From the proposal stage to its final form, our stories on the staffing mandate covered all aspects of its requirements as well as the legal and legislative challenges against it. Our stories about the […]
The nursing home industry has been on a wild ride this past year, with major regulation up in the air and a flip in the White House leaving operators unsure of whether they should applaud or brace for impact. Rhetoric surrounding the federal minimum staffing mandate has changed drastically throughout the year, with leaders condemning […]
Brian Thompson, the CEO of UnitedHealthcare, on Wednesday morning was fatally shot outside a hotel in Midtown Manhattan. Thompson was in NYC for a company investor conference, reports said; police on Wednesday afternoon were still looking for the gunman, who was last spotted in Central Park. Thompson’s death affects the leadership of one of the […]
The Centers for Medicare & Medicaid Services (CMS) is taking new steps to improve Medicare Advantage (MA) access and transparency, including reforms to prior authorizations and the use of AI tools to deny coverage, as outlined in the 2026 Medicare Advantage and Part D proposed rule, officials said during a call on Tuesday. The Contract […]
President-elect Donald Trump has picked Dr. Mehmet Oz, the renowned celebrity physician, to serve as administrator of the Centers for Medicare & Medicaid Services (CMS). The appointment was announced on Tuesday afternoon. “Our broken Healthcare System harms everyday Americans, and crushes our Country’s budget. Dr. Oz will be a leader in incentivizing Disease Prevention, so […]
Of the many significant factors affecting the skilled nursing industry in the last five years, Medicare Advantage was named as a major disruptor, as cost reports show a shift in operating margins with more facilities struggling financially. Stephen Taylor, principal of senior living and care segment leader for CliftonLarsonAllen (CLA), said MA has had “one […]
Optum is scaling back its Medicare Advantage Special Needs Plans for nursing home and assisted living residents in several regions. The health care services arm of insurance giant UnitedHealth Group (NYSE: UHG), Optum, made headlines earlier this year for workforce cuts. Now, the company is shutting down Institutional Special Needs Plans (I-SNPs) in several states, […]
While prior authorization has a legitimate role in Medicare Advantage coverage, the practice has expanded to the point of negatively affecting care. This aspect of MA needs to be right sized, and likely through legislation, nursing home leaders said. About 90%-plus of physicians, including those serving nursing home patients, have said that one or more […]
Medicare Advantage’s prior authorization process has resulted in higher denial rates among three of the largest health insurance providers, whose use of predictive AI tools raises serious concerns about patient care, according to a new report issued by a Senate subcommittee on Thursday. “[F]or beneficiaries of Medicare Advantage [prior authorization] has become not just a […]
Staffing shortages and increased acuity of patients are playing a big role in referral placement, along with preferences and prerequisites of referral sources. This is causing nursing homes and hospitals in high-demand areas to get creative with in-house offerings and hospital partnerships, as they are still experiencing bottlenecks in the referral process. At the same […]
Nursing homes and hospitals are developing closer ties and improving communication, and with this trend, admissions into nursing homes are expected to increase as rehospitalizations and excessive lengths of stay are also seen as declining. With rising acuity and staffing shortages of recent years, nursing homes have often been reluctant in admitting challenging cases that […]
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