The UnitedHealth Group (Nasdaq: UNH) allegedly paid bonuses to nursing homes in order to reduce hospital transfers of residents under its Medicare Advantage (MA) plans, according to an investigation conducted by The Guardian. The investigation revealed these cost-cutting practices saved the company millions, but endangered patient health; this included delayed or denied emergency hospital care. […]
The current nursing home market has its share of positives and negatives midway through 2025, with operators enjoying Medicare and Medicaid reimbursement increases as well as a decline in facility supply, creating higher competition among buyers. Buyers are being more aggressive in the acquisition process, he said, with fewer facilities available. Brokerage firms are seeing […]
During a Congressional hearing held Wednesday, U.S. Department of Health & Human Services (HHS) Secretary Robert F. Kennedy Jr. defended the Trump administration’s proposed cuts to top health agencies as lawmakers questioned HHS actions under his leadership – ranging from workforce reductions at HHS to spending cuts on scientific research, including research impacting older adults […]
Leadership changes within insurance giant UnitedHealth Group (NYSE: UHG) and its subsidiary Optum have rattled the company from the inside out, with UHG CEO Andrew Witty abruptly resigning on Tuesday, replaced with Chairman Stephen Hemsley who was CEO for UnitedHealth prior to stepping down in 2017. The news comes on the heels of new leadership […]
Therapy in nursing homes has been shaped in recent years by the shift to a patient-centered model, with providers pointing to staff shortages, reimbursement changes, and the influence of Medicare Advantage plans as factors making it harder to tailor programs. Certainly, higher expectations from therapy-based clinical outcomes is changing the therapy market landscape, said Brian […]
The Centers for Medicare & Medicaid Services (CMS) issued a final rule Friday to modernize and improve several Medicare programs, including Medicare Advantage (MA), but it does not include new restrictions on MA plans’ use of artificial intelligence. The rule for contract year 2026, effective June 3, introduces changes to prescription drug coverage, the Medicare […]
A bill to reform prior authorization requirements for Medicare Advantage (MA) – a massive burden that nursing home operators have been trying to change for some time – was reintroduced on Capitol Hill Thursday. Nursing homes have long argued that this aspect of MA needs to be right-sized through legislation. The Reducing Medically Unnecessary Delays […]
For organizations hoping to draw out savings from value-based care, added administrative burdens might be a source of hesitation. However, some operators are successfully turning to technology offerings that maximize reimbursement, pinpoint essential data, and include platforms already used by referral partners and managed care organizations (MAOs). AI programs can help “tease out” some of […]
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 […]
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