CMS to Merge Nursing Home Compare into Single, Cross-Continuum Database

The federal government on Thursday announced a major shake-up to its consumer-facing database of skilled nursing facility quality information, revealing plans to merge Nursing Home Compare into a more comprehensive website that features data about care sites across the continuum. Sometime later this year, the Centers for Medicare & Medicaid Services (CMS) will combine all […]

Why 2020 Could Be the Year of PDPM Exits — and the Skilled Nursing-Led ACO

The consulting firm Avalere Health, based in Washington, D.C., has had a front-row seat for the changes shaping the health care world, including the post-acute sphere. For skilled nursing facilities, many of those changes have felt like one punch after another, ranging from the rise of Medicare Advantage enrollment to the federal government’s encouragement of […]

Genesis Continues ACO Push with Senior Living Properties Partnership

National skilled nursing giant Genesis HealthCare (NYSE: GEN) continued its drive to bring more outside operators into its accountable care organization (ACO) this week, announcing a new accord with Senior Living Properties. Under the terms of the deal, the Fort Worth, Texas-based Senior Living Properties will see some of its buildings — along with select […]

Three Months into PDPM, Teasing Out Therapy Opportunities — and Fixing Common Mistakes

Three months into the Patient-Driven Payment Model (PDPM), operators are still strategizing how to best streamline coding and reimbursements. Some are beginning to glean positive results with increased margins, whether it’s through an increase in more efficient group and concurrent modalities or a reduction in therapy headcounts — or both. But operators still have areas […]

Pending Part B Changes Could Have Major Impact on Nursing Home Finances, Therapy Staffing

Early returns for the new Medicare Part A reimbursement system for nursing home operators appear positive, but some industry advocates warn that more Part B pain could be coming over the next few years, both for therapists and skilled nursing providers. And although the exploding senior population represents heavy demand for therapy services, some leaders […]

Editor’s Take: Skilled Nursing Industry Shouldn’t Block Out the Long-Term View When Making PDPM Changes

Just about every major policy change, no matter how well intentioned, has butterfly effects that no one can foresee — along with changes that, while foreseen, still can cause real harm to real people. The news of therapy layoffs and hour reductions that swept through the skilled nursing world earlier last year fell into the […]

CMS Chief Medical Officer to Leave for Role With Insurance Giant Humana

The chief medical officer at the Centers for Medicare & Medicaid Services (CMS) will be leaving the agency next month to take a new position with health insurance heavyweight Humana (NYSE: HUM). Modern Healthcare first reported the news Thursday. CMS confirmed to Modern Healthcare that Goodrich, who has also served as director of the Quality […]

Skilled Nursing Executive Outlook: ‘Question of Nursing Homes’ Viability Will Continue’ in 2020

Though the early days of 2020 have brought some optimism around the state of the post-acute and long-term care industry, executives in the space continue to emphasize that the coming 12 months could bring make-or-break decisions for operators and their partners. One day after American Health Care Association (AHCA) CEO Mark Parkinson told SNN that […]

AHCA’s Parkinson: PDPM is Running Above Budget-Neutral, But Clawbacks Aren’t Inevitable

Early analyses of the new Medicare payment model for nursing homes indicate that operators may be pulling in more money than the federal government intended — leading to widespread speculation that adjustments could be coming sometime in 2020. American Health Care Association (AHCA) president and CEO Mark Parkinson agrees with the idea that the Patient-Driven […]

Verma: Overhaul Led to Significant Growth in ACOs Taking on Risk, But Verdict Out on Spending

A federal overhaul to the Medicare Shared Savings Program (MSSP), implemented late in 2018, has led to an increase in the number of accountable care organizations (ACOs) taking on downside risk. The redesign of the program, dubbed “Pathways to Success,” generally required new ACOs to take accountability for spending increases after two years; previously ACOs […]

Confessions of a Therapist Post-PDPM: ‘You’re Not Valuable to Them Because You’re Not Making Money’

Among the many early takeaways from the new Patient-Driven Payment Model (PDPM), perhaps the most immediate was its effect on rank-and-file therapists who work at skilled nursing facilities. Almost instantly after the PDPM shift on October 1, Skilled Nursing News received a flurry of e-mails from therapists who were laid off or saw their hours […]

Median Skilled Nursing Margin Breaks Even, But ‘Long-Term Financial Viability is Uncertain’

The margins for skilled nursing facilities finally broke out of the red and to break-even levels, according to the latest benchmarking report from consulting firm Plante Moran. But occupancy remained stagnant from 2017 to 2018, and staffing costs continue to increase. And Medicaid remains the elephant in the room when it comes to making the […]

Bundled Payments for Joint Replacements Saved Medicare Money — with No Quality Declines

A major bundled payment program for hip and knee replacement episodes has produced savings for the government without corresponding declines in quality, according to a new study — confirming the central motive behind a program that has drawn the ire of post-acute operators. The Bundled Payments for Care Improvement model (BPCI) seeks to both decrease […]

CMS Taps Anthem Vet Smith for Top Innovation, Value-Based Care Posts

The federal government on Monday announced the appointment of Brad Smith, a health care and insurance industry veteran, as the next head of the Center for Medicare & Medicaid Innovation (CMMI). Smith, previously the chief operating officer at insurance giant Anthem’s diversified business group, will additionally serve as senior advisor for value-based transformation to Department […]

CMS to Remove Section G from Minimum Data Set in Fiscal 2021

The federal government in late December released draft updates to a key set of paperwork for nursing home staff, revealing a potential change ahead for 2020 and beyond. The Minimum Data Set (MDS) will no longer include Section G, the Centers for Medicare & Medicaid Services (CMS) announced in late December. “Please note that Section […]

Skilled Nursing News’ Hidden Gems of 2019

For the skilled nursing profession, 2019 will be synonymous with the Patient-Driven Payment Model (PDPM), and the top stories of the year reflect the importance of this shift. But PDPM is one of many moving parts in the skilled nursing world, and operators, landlords, and regulators alike made splashes in ways that had nothing to […]

Mixed Skilled Nursing Projections for 2020: Increased Demand, But Margin Pressure Continues

Increasing demand for skilled nursing services is a good sign for the industry, according to several experts who spoke on SNN’s annual outlook webinar, but a continued squeeze on margins may affect some facilities’ ability to keep their doors open in 2020.  Although the Patient-Driven Payment Model (PDPM) looks like good news, with increased reimbursements […]

PDPM, Secret Lists, and New Rules: The Top Skilled Nursing Stories of 2019

In perhaps the least surprising news of the year, the new Medicare payment model for nursing homes dominated the list of most-read stories on Skilled Nursing News in 2019. But the Patient-Driven Payment Model (PDPM), for all its impact on the post-acute and long-term care space over the last 12 months, wasn’t the only story […]