Rapid Medicare Advantage Expansion into Home Health, Senior Living Could Accelerate Pressures on Skilled Nursing

When the Centers for Medicare & Medicaid Services (CMS) moved to allow Medicare Advantage plans to cover more options for care at home, skilled nursing providers could be forgiven for not paying much attention. It’s a move with more immediate impact to home care and home health companies, as well as senior living providers. Medicare […]

Sabra CEO Matros Has ‘No Sympathy’ for Third-Party Therapy Companies Amid Switch to PDPM

The new Medicare payment model for nursing homes has brought significant upheaval around therapy provision — an outcome that one prominent CEO in the space says therapy companies should have seen coming sooner. Given all of the warning signs from Washington and Baltimore — dating back to when the federal government was planning on implementing […]

SNN Poll: 43% of Operators, Vendors Have Laid Off Therapy Staff Post-PDPM

News of therapy layoffs swept through the skilled nursing industry in the weeks after the implementation of the Patient-Driven Payment Model (PDPM), and a new poll from Skilled Nursing News finds that more than 40% of operators and therapy vendors have made some kind of staffing reductions post-October 1. A little more than 43% of […]

CMS Penalties Fund Program Designed to Reduce Readmissions, Improve Skilled Nursing Outcomes

Thirty nursing homes in the state of Washington will benefit from a federal program that injects penalty recoveries back into initiatives that boost nursing home quality — and the ramifications of the funding could go well beyond the facilities in that one state. The grant, totaling more than $644,000, comes from the Centers for Medicare […]

ACOs Saved Medicare $3.53 Billion, New Analysis Finds

Accountable care organizations (ACOs) have reduced spending by $3.53 billion from 2013 to 2017, and after accounting for shared savings bonuses, saved the federal government $755 million. That’s according to a new evaluation by the Washington, D.C.-based consulting firm Dobson DaVanzo & Associates, conducted on behalf of the National Association of ACOs (NAACOS), which represents […]

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 […]

Nursing Home Dialysis Demand Drives Post-PDPM Push to Specialty Services

Dialysis services have recently been highlighted as a major growth area under the new Patient Driven Payment Model (PDPM) — both financially and clinically — especially as reimbursements are recalibrated for higher acuity patients. In July, the Centers for Medicare & Medicaid Services (CMS) rolled out the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) model, […]

Skilled Nursing Admissions Drop Across the Country as Home Health Discharges Pull Ahead

In another sign of the shifting paradigm in post-acute care, home health agencies beat out the skilled nursing setting as the most likely post-acute referral destination — while SNF admissions dropped in all 50 states from last year. That’s according to the 2019 Industry Trend Report from Trella Health, which analyzes Medicare Part A and […]

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 […]

Early PDPM Claims Data Reveals Far More Winners Than Losers, ‘Impossible Combinations’ of Conditions

The first round of claims data under the new Medicare payment model for nursing homes shows that the majority of operators are seeing reimbursement boosts — while some are also making key billing mistakes that could result in missed payments for certain services. The average skilled nursing facility saw Medicare reimbursements of $614.96 per patient […]

Looming 8% Cut to Therapy Payments Could Have ‘Major Impact’ on Residents, Operators

There’s been significant attention focused on the potential for therapy reductions and reimbursement shifts amid the transition to the Patient Driven Payment Model (PDPM) on October 1, but concerns may soon be shifting to another looming therapy change — this time under Medicare Part B. The Centers for Medicare and Medicaid Services (CMS) has proposed […]

Some Medicare Contractors Holding Up Claim Payments Amid the Shift to PDPM

Some of the private insurance companies that process Medicare claims on behalf of the federal government are holding up claims for skilled nursing facilities after the implementation of the Patient-Driven Payment Model (PDPM) in October. But it’s not clear how widespread that is, BKD director John Harned and senior managing consultant Sherri Robbins said on […]

Moody’s: PDPM Has Potential to Stabilize Rents for Skilled Nursing REITs

Skilled nursing facilities will become more financially stable under the new system for Medicare reimbursement – which is a good sign for their landlords, according to Moody’s. Specifically, the stabilized cash flows under the Patient-Driven Payment Model (PDPM) are set to improve real estate investment trusts’ (REIT) credit standing, allowing more investments in this sector, […]

PDPM Therapy Changes, Staff Reductions to Bring Genesis $30M in Annual Savings

Prior to the advent of the new Medicare payment model for skilled nursing facilities, Genesis HealthCare (NYSE: GEN) CEO George Hager predicted that his company would see expense reductions of 12% — primarily through an increased emphasis on group and concurrent services. So far, at least according to Hager, the company has come through on […]

Omega Looks to Cut Daybreak Skilled Nursing Exposure After Performance ‘Deteriorated Further’

Despite showing long-term optimism about Daybreak Venture, executives at Omega Healthcare Investors (NYSE: OHI) on Wednesday revealed an ongoing plan to replace the struggling skilled nursing operator at many of its facilities in Texas. The two parties have mutually agreed to work toward a deal that would “selectively downsize” Daybreak’s footprint across the Lone Star […]