CMS Proposes Three-Year Extension, Additional Outpatient Coverage for CJR Bundled Payment Model

The federal government on Thursday issued a proposed rule that would extend the Comprehensive Care for Joint Replacement (CJR) bundled-payment model for an additional three years — while also expanding its reach to include outpatient procedures. Initially set to expire on December 31, CJR would remain active through the end of 2023 if the Centers […]

Nursing Home Operator Guardian Elder Care to Pay $15.5M in False Claims Act Settlement

Guardian Elder Care, a nursing home operator with more than 50 buildings, will pay $15.5 million to resolve federal accusations of medically inappropriate therapy practices, the Department of Justice announced Wednesday. The Brockway, Pa.-based Guardian faced allegations — brought by a pair of former employees — that the company pressured therapists to perform unnecessary services […]

Verma Touts Low SNF Provider Terminations, Wants to Give Operators Chance to ‘Turn Things Around’

The head of the Centers for Medicare & Medicaid Services (CMS) touted the agency’s changes around enforcement of quality and safety standards in a blog post published on Tuesday, as part of a series on its five-part strategy to improve care in nursing homes across the country. The strategy’s components include: strengthening oversight, enhancing enforcement, […]

‘CMS Loves That’: Moderate Therapy Shifts, Bureaucratic Reality Could Slow PDPM Changes

Despite steady reports of increasing reimbursements under the new Medicare payment model for nursing homes, at least one industry leader believes that the federal government will be happy with the early returns — and that any changes are fairly far down the road. Skilled nursing operators have not gone overboard with the strategy changes that […]

Lawmakers: Medicaid Supplement Crackdown Would Constrict Nursing Home Supply

A group of 27 U.S. representatives asked the Centers for Medicare & Medicaid Services (CMS) to rethink a proposal restricting Medicaid supplemental payments — claiming enforcement will lead to decreased services and fewer available nursing home beds. The controversial proposed rule, the Medicaid Fiscal Accountability Regulation (MFAR), would bring tighter regulations to state-based Medicaid supplemental […]

ManorCare Exceeds Expectations, in Talks to Strike Post-Acute Partnerships with Health Systems

Skilled nursing giant HCR ManorCare outperformed projections in its first full year as a tenant of Welltower Inc. (NYSE: WELL), the real estate investment trust (REIT) announced Thursday, and could soon expand its footprint to include partnerships with health systems outside of its current orbit. “[The] ManorCare portfolio did not hit our expectation; it exceeded […]

Task Force: To Save Top Nursing Homes, Government Should Encourage Lower-Performing SNFs to Exit

As nursing homes’ operating margins dwindle due to insufficient Medicaid reimbursements, one state task force is encouraging lower performing facilities to simply shut down — and make more room for the remaining properties to grab a piece of a shrinking pie. The Nursing Facility Task Force of Massachusetts released a report declaring that the state […]

400 Nursing Homes Have Closed Since Landmark 1987 Oversight Law — While Care Generally Improved

Since the landmark passage of a sweeping oversight bill in the late 1980s, hundreds of nursing homes have closed — while those that remained have increasingly taken on more difficult medical cases, according to new research from Brown University. The analysis, which focused on the effects of the Omnibus Budget Reconciliation Act of 1987 (OBRA […]

‘Pendulum Swung Too Far’: Therapists Raise Concerns Over Layoffs, Clinical Changes Under PDPM

It’s four months into the Patient-Driven Payment Model (PDPM), and despite some industry analysts pointing to early gains for nursing homes, many occupational, speech, and physical therapy advocates continue to criticize layoffs and changes to resident care patterns. On the operational side, the initial PDPM returns have been positive: For instance, 67% of nursing homes […]

White House: Site-Neutral Payment System for Post-Acute Care Would Save Medicare $100B

The Trump administration’s proposed fiscal 2021 budget, released Monday, put a price tag on a long-floated plan to unify Medicare reimbursements for post-acute services under a single, site-agnostic system: more than $101 billion over a decade. “The budget prioritizes use of the trust funds to pay for seniors’ healthcare and incentivizes quality and efficiency in […]

PDPM Layoffs Could Send Some Therapists to Home Health, But Former SNF Workers Not Targets

Both the skilled nursing and home health spaces are in the midst of shifts to new Medicare payment models, and despite widespread reports of therapy layoffs at nursing homes, a leading player in the home care space says it isn’t necessarily targeting the cohort of available therapists. Encompass Health Corporation (NYSE: EHC) has been monitoring […]

Omega to Divest Struggling Daybreak Skilled Nursing Portfolio, Cautiously Upbeat on Medicaid Crackdown

After multiple quarters of struggles with operator Daybreak Venture, Omega Healthcare Investors (NYSE: OHI) on Thursday announced a plan to largely purge the provider’s buildings from its portfolio. “During the course of the next several quarters, Omega anticipates transitioning, either through re-leases or sales, the vast majority of Daybreak’s existing Omega facilities,” chief operating officer […]

Bipartisan Group of 99 Lawmakers Calls on CMS to Rethink 8% Therapy Payment Cut

A group of 99 U.S. representatives, consisting of both Republicans and Democrats, this week asked the Centers for Medicare & Medicaid Services (CMS) for more information about a rule that could have a major impact on nursing home residents who receive therapy services. Under the 2020 Physician Fee Schedule (PFS) final rule, CMS implemented a […]

Ensign Rides High-Acuity Skilled Nursing Model to 6% Rate Gains Under PDPM

The Ensign Group (Nasdaq: ENSG) on Thursday announced that its skilled nursing facilities have seen rate increases of up to 6% under the new Medicare payment model, in part helping to drive the post-acute leader to another set of record earnings. The company’s established same-store facilities achieved those 6% gains, while Ensign’s transitioning facilities — […]

New Eventus CEO: Though ‘Neglected’ in Alternate Payment Models, Nursing Homes Can Outperform Hospitals

Once wary of accountable care organizations (ACOs) and other new payment models, nursing home owners and operators are beginning to turn in favor of these value-based care structures — in the hopes of gaining leverage in a complex skilled nursing market burdened by high costs of care and staffing pressures. And although the push to […]

SNF Providers Could Find Managed Care Relief By Banding Together in IPAs

Creating or joining an independent practice association (IPA) empowers providers to negotiate managed care plan services and rates, a potential game-changer for nursing home owners amidst Medicare Advantage headaches — pains that include shorter lengths of stay, or the elimination of skilled nursing stays altogether in favor of home care.  Providers might opt into an […]

Winners Still Outnumber Losers in Latest PDPM Analysis, But Length of Stay Trends Could Erase Rate Gains

The latest analysis of the new Medicare payment model for nursing homes again shows more operators scoring gains than suffering losses, but the change from the previous system may not be quite as straightforward — particularly as fee-for-service Medicare continues to lose ground to other payment sources. A little more than 67% of skilled nursing […]

Tips for Early PDPM Success: Demand More Data from Hospitals, Market Higher-Acuity Services

The early returns for the new Medicare nursing home payment model have been positive, but providers aren’t seeing gains by sitting back and watching the changes. Several key strategies for success have emerged in the Patient-Driven Payment Model’s first four months, with a particular focus on data — as well as clearly communicating the availability […]