Federal Judge Freezes COVID Vaccine Mandate for All Health Care Workers

A federal judge in Louisiana issued a nationwide preliminary injunction Tuesday, freezing the start of President Biden’s COVID-19 vaccine mandate for health care workers across the country. Judge Terry Doughty of the U.S. District Court for the Western District of Louisiana issued the decision — which affects more than 10.3 million health care workers in […]

Ivy Healthcare Seeks to Grow Skilled Nursing Footprint

When Ivy Healthcare Group looks to expands its geographic footprint — as it is now coming out of COVID — that conversation always starts with reimbursement. After acquiring its first assisted living facility in 2018, Ivy Healthcare Group added its first skilled nursing facility in 2019 where it developed an affinity for the sector. It […]

COVID Hasn’t Slowed Managed Care Growth as SNFs Look to Increase Participation

As skilled nursing facilities work to build back hospital referrals lost during COVID, one way some are opening themselves up to new patients is by increasing their participation in managed care despite the tighter margins that come with it. With skilled nursing occupancy still below pre-pandemic levels, operators simply are no longer in a position […]

CMS: Surveyor Vaccine Mandate Guidance is Forthcoming

The Centers for Medicare and Medicaid Services (CMS) is working on developing vaccine mandate guidance for surveyors, the government agency said during a stakeholder call last week. While the guidance is forthcoming, CMS is placing responsibility on state agencies to conduct safe surveys. Guidance will be relevant to surveyors within CMS, state surveyors and “non-nursing […]

Nursing Homes Will Have to Wait Longer for Phase 4 PRF Disbursements

Skilled nursing facilities may not receive their much-needed Phase 4 disbursement of Provider Relief Funds (PRF) until the new year, with disbursements delayed through January, the Health Resources and Services Administration (HRSA) said. Originally, skilled nursing operators expected to receive Phase 4 payments between mid-November and mid-December — and that timeframe has shifted to include […]

Optum Enlists Former ProMedica Leader to Build Out its Provider-Led I-SNP Services

Former ProMedica Senior Care President David Parker took on a new role at Optum this summer, putting his 30-plus years in skilled nursing executive leadership to good use as vice president of strategy for its complex care management division. Optum is the care delivery arm of UnitedHealth Group, and has offered value-based care plans for […]

Medicare FFS Improper Payments Reduced By $20.7B Since 2014, But Skilled Nursing Sees 2020-21 Increase

Aggressive corrective actions taken by the Centers for Medicare & Medicaid Services (CMS) led to a $20.72 billion reduction in Medicare Fee-for-Service (FFS) improper payments over seven years, the entity announced late Monday — for skilled nursing facilities, insufficient documentation was the primary reason for improper payments. Despite an overall reduction since 2014 lauded by […]

[UPDATED] CMS Guidance Tackles Survey Backlog, Lifts Nursing Home Visitation Limitations

The Centers for Medicare and Medicaid Services (CMS) on Friday issued two updates regarding survey and visitation guidance — steps to address the backlog of complaint and recertification surveys, and revising visitation to include “all residents at all times.” CMS said it will assist state survey agencies (SAs) with resuming surveys that took a backseat […]

Continued Skilled Nursing Staffing Challenges Slow Occupancy Gains

Despite slower than recent monthly gains, skilled nursing occupancy still increased in August for the seventh consecutive month, according to the most recent NIC MAP® Data, released by NIC MAP Vision. Property occupancy rose 14 basis points from July to August, sitting at 75.2% — that’s a 378 basis point gain from January, NIC MAP […]

CMS: Nursing Home Staff Must be Fully Vaccinated by Jan. 4

Medicare and Medicaid participating health care facilities, including nursing homes, will be required to have all staff members fully vaccinated by Jan. 4, according to an emergency regulation issued Thursday by the Centers for Medicare & Medicaid Services’ (CMS). The CMS regulation further states that facilities must establish a policy ensuring that staff have received […]

Short-Term Stay Nursing Home Patients Report Gaps in Care While Transitioning Home

The majority of patients who returned home after staying in a skilled nursing facility for a short-term stay said there were “substantial gaps” in their care, according to a survey conducted by the United Hospital Fund (UHF). Of 263 patients surveyed across eight New York nursing homes, rehabilitation centers and other skilled nursing facilities, 80% […]

CMS Finalizes 15% Cut to Therapy Assistant Services for 2022

The Centers for Medicare and Medicaid Services (CMS) on Tuesday finalized its Calendar Year (CY) 2022 Physician Fee Schedule (PFS), confirming a 1% cut to Medicare Part B physical and occupational therapy rates, down from the proposed 2% in July, and a 15% cut for services provided by therapy assistants. CMS specified the 15% cut […]

Milliman Report Shows $32.5B Value in Medicare Advantage

Medicare Advantage delivers $32.5 billion, or $123.36 per member per month, in additional value to beneficiaries, according to a report released Thursday by the Better Medicare Alliance (BMA). Hospital and physician services are 24% less expensive per month: $709.66 for MA plans per month and $935.67 for Medicare FFS. These statistics exclude administrative expenses and […]

Members of Congress Express Concern Over Biden Administration’s FFS Expansion

Medicare Advantage advocacy groups are concerned the Biden Administration’s Build Back Better reconciliation bill will, in expanding Medicare fee-for-service (FFS), disadvantage MA. Advocacy and research group Better Medicare Alliance (BMA) on Wednesday hosted Reps. Brett Guthrie (R-Ky.) and Terri Sewell (D-Al.) to discuss the legislation further, and implications for the Part C plan under Build […]

Nursing Homes Eye Behavioral Health, But the Service Line Can Come With a High Price Tag

Behavioral health has become an attractive — and sorely needed — service line for skilled nursing facilities, but operators often don’t have the resources for training, and reimbursements aren’t as good as serving higher acuity patients. Isolation tied to the pandemic, and the Centers for Medicare and Medicaid Services (CMS) “crusade” several years ago to […]

CMS Working With OSHA to Issue Staff Vaccine Mandate, On Track For Late October

The Centers for Medicare & Medicaid Services (CMS) is in the “rulemaking” stage of its development of a federal vaccine mandate for all health care workers employed by Medicare or Medicaid funded facilities, according to a CMS official. Dr. Lee Fleisher, CMS’ chief medical officer and director of the Center for Clinical Standards and Quality […]

Nursing Facilities Need to Weather the ‘Reimbursement Storm’ of Medicare Advantage

With Medicare Advantage revenue “significantly lower” than fee-for-service reimbursement, a new Zimmet Healthcare Services Group analysis says, skilled nursing facilities need to weather today’s “reimbursement storm” in order to make it to the incoming wave of baby boomers that will need facility services. In the meantime, Zimmet suggests operators utilize facility data to improve MA […]