Congress Extends 2% Medicare Sequestration Holiday Through End of 2021

Skilled nursing facilities and other health care providers will receive 2% more in Medicare reimbursements through the end of 2021 after President Biden signed a long-awaited sequestration moratorium bill into law Wednesday. Congress in late March 2020 suspended the 2% sequestration cut as the coronavirus crisis began to gain steam, and late last year bumped […]

CMS Ends Nursing Home COVID Waivers Related to Discharges, Transfers, and MDS Timelines

The Centers for Medicare & Medicaid Services (CMS) announced on April 8 that it is ending several emergency regulatory waivers that were designed to give nursing homes flexibility in responding to the COVID-19 pandemic — specifically related to patient transfers and discharges, as well as the timeframe requirements for completing and transmitting a patient’s Minimum […]

PDPM Adjustments, Smaller Medicare Raise Show CMS ‘Ready to Pull Back’ on COVID Aid to Nursing Homes

As the federal government’s approach toward nursing homes and COVID-19 continues to shift from emergency support to reflection and reform, analysts are increasingly warning that the coronavirus-era gravy train could soon come to an abrupt stop. In particular, the past week has brought three pieces of news that may signal trouble ahead for operators and […]

CMS to Adjust PDPM ‘As Quickly as Possible’ Amid Evidence of $1.7B Nursing Home Payment Increase

The federal government is mulling several options to recalibrate the Medicare payment structure for skilled nursing facilities as it seeks to achieve its intended goal of budget neutrality — with the aim of shutting off excess payments sooner rather than later. The Centers for Medicare & Medicaid Services (CMS) this week determined that the Patient-Driven […]

CMS Proposes $444M Medicare Boost for Nursing Homes, Calls Out ‘Unintended’ $1.7B PDPM Gain

The federal government on Thursday announced a proposed 1.3% boost to nursing home Medicare reimbursements for fiscal 2022, while also raising the specter of a potential adjustment to the new Patient-Driven Payment Model. That increase from the Centers for Medicare & Medicaid Services (CMS) works out to a total gain of $444 million, according to […]

MACs to Temporarily Hold Claims as 2% Medicare Sequestration Cuts Sit in Congressional Limbo

The pandemic prompted Congress to pause an across-the-board Medicare rate cut that had been in effect since the Obama administration, but a stalemate in Washington over extending the relief will bring a slight payment hiccup over the coming weeks. While both houses of Congress have approved extensions of the 2% Medicare sequestration holiday, they did […]

PruittHealth Rolls Out Joint Commission Accreditation at All 91 Southeast Nursing Facilities

PruittHealth last week announced that all 91 of its skilled nursing facilities in the Southeast region will be required to undergo Joint Commission Nursing Care Center Accreditation, with the facilities in Georgia slated to go first. The SNFs will be required to undergo accreditation to achieve the Gold Seal of Approval; accreditation from the Joint […]

Senate Narrowly Confirms Becerra as HHS Secretary

The U.S. Senate on Thursday confirmed California attorney general Xavier Becerra as secretary of the Department of Health and Human Services (HHS) by a 50-49 margin, almost entirely along party lines. Sen. Susan Collins of Maine was the only Republican who voted to confirm Becerra. Becerra was nominated by President Joe Biden in early December […]

MedPAC: Freeze Medicare Raises for Nursing Homes in ’22, But ‘Proceed Cautiously’ on Recommending Cuts

The top federal Medicare advisory body this week formally recommended against raising rates to skilled nursing facilities in fiscal 2022, arguing that the sector will eventually recover from COVID-era financial strains. “While the projected level of payments indicates that payments need to be reduced to more closely align aggregate payments and costs, the lasting impacts […]

Nursing Home Industry Targets RN Staffing, PPE Stockpiles in Reform Pitch — But Ownership Untouched for Now

The two largest trade groups for nursing homes proposed a policy agenda to address the systemic issues in the sector illuminated by COVID-19, with reforms centered on improving nursing hours, staff retention and infection control — in addition to increasing reimbursement from Medicaid, the largest payer for nursing home care, to cover the costs. The […]

Less Than 3% of Nursing Homes Received Maximum Rewards Under ‘Flawed’ Medicare VBP Model

The federal government’s sole attempt at linking nursing home Medicare reimbursements with outcomes is broken and requires an overhaul, the Medicare Payment Advisory Commission (MedPAC) determined. The Skilled Nursing Facility Value-Based Payment (SNF VBP) Model has rewarded strikingly few facilities while the majority have lost money — though the amounts involved in either direction were […]

Home Health Giants Find Partners in Speeding Skilled Nursing Diversions Amid COVID ‘Fear Factor’

Home health operators aren’t the only players in post-acute and long-term care looking to capitalize on a weakened skilled nursing sector: As health systems and managed care insurers look to adapt their offerings to the post-COVID tastes of their patients, home health providers may find themselves with significant regulatory and payment tailwinds as they work […]

Therapy Staffing Dropped Up to 10% at Nursing Homes in Wake of PDPM — Mostly Through Contract Cuts

Therapist staffing coverage at nursing homes fell up to 10% after the October 2019 implementation of a new Medicare payment model, a new study has determined — with the cuts coming primarily on the backs of contracted employees and not full-time skilled nursing facility staffers. Physical and occupational therapist staffing was 6% lower in the […]

To Get Ahead of PDPM Audits, Skilled Nursing Facilities Target Top Areas of Payment Focus

When the overhaul of Medicare Part A reimbursement for nursing homes took effect in October 2019, predictions of audits and the potential for drastic changes came close on its heels. After all, the Patient-Driven Payment Model (PDPM) was meant to be revenue-neutral, meaning that the Centers for Medicare & Medicaid Services (CMS) would not spend […]

TapestryHealth, Rosie Ink Deal to Expand Nursing Home Telehealth, Remote Monitoring Systems

The widespread embrace and expansion of telehealth may go down as one of the top long-term positive developments to come out of the COVID-19 pandemic, and a pair of tech players in the nursing home space this week announced a new partnership aimed at building on that momentum. Telemedicine provider and primary care practice TapestryHealth […]

Matros: Home Health Shifts ‘A Good Thing’ Ahead of Looming Capacity Crunch, But Nursing Homes Still Vital

Whether or not home health providers can maintain the volume they siphoned away from skilled nursing facilities during the pandemic has emerged as a top question for policymakers and financial analysts alike. A permanent shift from SNF to home could portend financial and operational chaos for a sector already battered by COVID-19, the thinking goes, […]

Amid Stalled HHS Confirmation, Frontrunner Emerges for CMS Chief: Report

The Biden administration is leaning toward the selection of former federal health official and current Manatt Health managing director Chiquita Brooks-LaSure for the administrator of the Centers for Medicare & Medicaid Services (CMS), Politico reported this week. Brooks-LaSure held posts at CMS and the Department of Health and Human Services (HHS) under President Obama, with […]

Despite Hands-Off Approach from CMS, PDPM Pitfalls Remain for Nursing Home Operators, Investors

Against the backdrop of the COVID-19 pandemic, the federal government has left its new Medicare payment system for nursing homes virtually unchanged since the original rollout in October 2019 — but that doesn’t mean operators and investors should assume the status quo will last forever. The Centers for Medicare & Medicaid Services (CMS) and its […]