HHS Relaxes Rules for Using Provider Relief Funds to Cover Lost Revenue

The federal government this week amended its rules for how providers can use coronavirus relief funding, specifically removing limitations around covering lost revenues not directly related to COVID-19. The Department of Health and Human Services (HHS) announced the change in the wake of criticism from providers and some lawmakers. “In response to concerns raised, HHS […]

SNN Survey: Most Providers Will Survive into 2021, But Capital Providers Remain Worried About Census

A recent Skilled Nursing News survey of nursing home operators found cautious optimism about the near-term future of the space, with a majority seeing a clear path to the future even without additional government support. At the same time, operators have largely been pouring that federal largesse — including CARES Act grants, Payroll Protection Program […]

CMS ‘Quiet’ on PDPM-Related Enforcement Even as Rates Rise, But Managed Care More Prone to Denials

The Patient-Driven Payment Model (PDPM), the overhaul to Medicare reimbursement for skilled nursing facilities that took effect in October of 2019, has proven its worth as a mechanism for paying for nursing care during a global pandemic. It has, however, been “anything but revenue-neutral,” at least in terms of how much money the government is […]

Cold Storage, Medicaid Coverage: Inside the Walgreens, CVS Vaccination Deal for Nursing Homes

The federal government last week tapped a pair of retail pharmacy giants to distribute an eventual COVID-19 vaccine to nursing home residents across the country, and while there remain significant questions about the logistics of distributing an as-yet-unapproved vaccine, officials have continued to position the plan as the only workable solution to a massive public […]

Medicare Advantage Growth Outpaced Traditional Medicare, 60% to 5%, Over Six Years

Medicare Advantage (MA) has seen dramatic enrollment growth over the past six years, significantly outpacing traditional Medicare, according to a report commissioned by the Better Medicare Alliance released October 15. The report, prepared by the actuarial firm Milliman, examined the growth in enrollment in MA and the similarities and differences between enrollees in that program […]

CMS to Relax Medicare Billing Rules to Speed COVID-19 Vaccine Distribution in Nursing Homes

The federal government on Friday announced its intention to relax restrictions around billing Medicare for immunization in nursing homes, with the stated goal of speeding the eventual distribution of a COVID-19 vaccine. Skilled nursing facilities are typically required to bill Medicare directly for immunizations under the terms of the Social Security Act, even if the […]

Verma: Alternative Payment Model Performance ‘Deeply Concerning,’ More Mandatory Programs Ahead

The nation’s top Medicare official this week expressed serious disappointment in the performance of alternative Medicare payment models, citing key design flaws and promising more mandatory programs to come. The Centers for Medicare & Medicaid Services (CMS) recently completed an analysis of several early attempts at value-based payment structures, with administrator Seema Verma disappointed in […]

Genesis’s LTC ACO Pulls in $18.8M in Shared Savings for 2019

LTC ACO, the accountable care organization (ACO) launched by Genesis HealthCare (NYSE: GEN), brought in $18.8 million for the nursing home operator under the Medicare Shared Savings Program (MSSP) during the 2019 program year. The ACO achieved sufficient Medicare fee-for-service savings among its 5,800 beneficiaries to trigger the payment, which translates to $17 million in […]

Medicare Advantage’s Strength During COVID-19 to Drive Expansion into New Markets, 50% Adoption by ’24

While the skilled nursing landscape continues to struggle both operationally and financially during the COVID-19 pandemic, those same negative forces have only served to strengthen private health plans — putting Medicare Advantage in an even better position to continue its growth. Cratering census and sharp declines in elective surgeries, while fiscally devastating for nursing homes, […]

After Cutting Readmissions Up to 50%, Northwell Looks to Expand Nursing Home Telehealth Network

After scoring significant successes in reducing hospital readmissions among its own nursing homes with telehealth, a major hospital network is looking to market its virtual interventions to a wider swath of post-acute and long-term care facilities. Northwell Health, the largest health care provider in New York State, saw rehospitalizations decline by up to half at […]

Skilled Nursing Residents Shut Out of New End-Stage Renal Disease Payment Model

The Centers for Medicare & Medicaid Services (CMS) on Friday announced the finalization of a new kidney-care payment rule, but the regulation specifically exempts patients who are receiving their dialysis treatment in the nursing home. The End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model is intended to test whether greater use of home dialysis and […]

Fresh Off Private Equity Pickup, Wound Care Provider AMT Seeks Skilled Nursing Expansion

A leading wound care provider sees expansion opportunity in both skilled nursing and the home despite the ongoing strains of COVID-19, with a recent private equity investment to back it up. American Medical Technologies in late August announced its acquisition by private equity firm One Equity Partners and investment management company The Silverfern Group, capping […]

Grabowski: As Case Counts Rise and PPE Issues Persist, Nursing Homes Face Grim ‘Groundhog Day’

As COVID-19 continues to bring sickness and death to American nursing homes, Harvard University professor David Grabowski has become one of the most-quoted experts on the steps that operators and the government should take to stem the tide. But as the summer turns to fall during a pandemic that started in late winter, the long-term […]

Skilled Nursing Distress Looms as CARES Funding Ebbs: ‘Bills Are Starting to Come Due’

Billions of federal stimulus dollars have kept the skilled nursing sector afloat during the COVID-19 pandemic, but as the most recent distributions hit operators’ bank accounts, storm clouds are still gathering in the distance. While nursing home operators may have been spared the immediate financial woes that hit businesses in a variety of other sectors, […]