Skilled Nursing Admissions Dropping in Tandem with Lower Hospital Use

Admissions to skilled nursing facilities have declined in a manner consistent with a drop in inpatient hospital usage, according to the Medicare Payment Advisory Commission’s (MedPAC) most recent data book. That’s just one of the conclusions from the statistics, released last month by MedPAC — a non-partisan agency that advises Congress on Medicare issues.  For […]

Uncertainty Surrounds New ‘Arbitrary’ Skilled Nursing Payment Rules

Early reactions to the finalized skilled nursing payment rules from the Centers for Medicare & Medicaid Services (CMS) are in, with one leading provider group issuing a stark warning about the days ahead. “While the skilled nursing profession welcomes a new payment model, we are concerned with the language in this rule about the Patient-Driven […]

CMS Finalizes New Skilled Nursing Payment Rules, Predicts $820M Funding Boost

The Centers for Medicare & Medicaid Services (CMS) on Tuesday finalized its skilled nursing payment updates for fiscal 2019, formally enshrining the Patient-Driven Payment Model (PDPM) and other changes in a final rule. Under the finalized proposal, the PDPM — which will see therapy payments based increasingly on the complexity of patients’ clinical needs, and […]

CMS Hits 1,400 Nursing Homes with One-Star Reviews Over Staffing Concerns

Less than a month after a New York Times story revealed concerns about insufficient nursing home staffing levels, the Centers for Medicare & Medicaid Services (CMS) handed out nearly 1,400 one-star reviews. Last week, when CMS updated its Five-Star Quality Rating System for nursing homes, 1,387 facilities received one-star ratings for staffing coverage, according to […]

Iowa Nursing Home Lobbyists Praise Lowered Fines Under Trump

Nursing home lobbyists in Iowa thanked federal regulators for lowering fines on facilities and asked them to “pursue a more collaborative — and less punitive — role” in nursing home regulation, the Des Moines Register reported Wednesday. In a July 7 phone call arranged by U.S. Sen. Charles Grassley, R-Iowa, Iowa Health Care Association (HCA) President Brent […]

Skilled Nursing Facilities Rank Low on Operators’ Investment Wish Lists

Skilled nursing facilities lag far behind home health and other long-term care settings among providers’ investment outlooks, according to a new survey of major health care providers. Just 12% of organizations surveyed by consulting and advisory firm BDO said they were making investments in skilled nursing care as part of their two-year plan to 2020 […]

Having an In-House Insurance Plan Could Signal PDPM Success

Some skilled nursing providers have turned to in-house insurance plans to take more control of the care process, and the move could pay off if the government’s new proposed reimbursement model is finalized. The Patient Driven Payment Model (PDPM), which the Centers for Medicare & Medicaid Services (CMS) proposed in April, would overhaul skilled nursing reimbursements […]

How Skilled Nursing Providers Can Win Under Value-Based Purchasing

Skilled nursing facilities have until October to prepare for the new Value-Based Purchasing (VBP) model, and the stakes are high: Starting this fall, SNFs will automatically lose 2% of their Medicare funding, which they can earn back by hitting certain key quality benchmarks. Providers that have already participated in risk-based accountable care organizations (ACOs) will […]

PDPM Could Create New Challenges for Skilled Nursing, AHCA Says

A newly proposed payment system overhaul for the skilled nursing industry could create new challenges for the sector, according to public comments by trade groups and other stakeholders submitted on the Federal Register. Namely, the American Health Care Association (AHCA) believes the payment system, as proposed by the Centers for Medicare & Medicaid Services (CMS) in […]

Despite Shorter Stays, Medicare Advantage Improved Skilled Nursing Outcomes

Patients enrolled in Medicare Advantage (MA) plans had a shorter rehabilitation stay in a skilled nursing facility and were more likely to be successfully discharged to the community, compared with patients on fee-for-service (FFS) Medicare, according to a new study published in PLOS Medicine. MA patients were also less likely to experience a 30-day hospital […]

Bundled Payment Lessons Still Relevant for Skilled Nursing Providers

In a post-acute landscape dominated by the rise of Medicare Advantage and the looming changes to therapy payments, the Bundled Payments for Care Improvement (BPCI) program has fallen somewhat by the wayside. That’s partially because post-acute providers — including skilled nursing operators and home health agencies — can no longer be episode initiators under the upcoming BPCI […]

Data Drives Skilled Nursing Referral Partnerships, But Residents Ignore It

As referral networks narrow and skilled nursing providers feel increased pressure to prove their worth to hospitals and doctors, one government agency says residents still frequently miss the highest-quality options in their own areas. In its most recent report to Congress, the Medicare Payment Advisory Commission (MedPAC) asserts that many hospitals discharge post-acute care patients […]

MedPAC Again Calls for Skilled Nursing Payment Cuts in Mixed PDPM Review

The Medicare Payment Advisory Commission (MedPAC) issued a mostly positive assessment of the new proposed payment rules for skilled nursing facilities, but the organization wants change to come faster than planned. Citing the similarity between the new Patient-Driven Payment Model (PDPM) and the now-shelved Resident Classification System, Version I (RCS-I), MedPAC asserted that the planned […]

Operators Report Rising Length of Stay Pressure Under New Payment Models

Skilled nursing facilities are feeling pressure from several fronts to discharge patients within a specified time to meet strict length-of-stay (LOS) goals, according to a study recently published in Health Services Research. Those include Medicare policy changes and market-based pressures, particularly from Medicare Advantage (MA) plans and hospitals participating in accountable care organizations (ACOs) and bundled […]

Signature HealthCARE to Pay $30M to Resolve FCA Claims Related to Rehab

Signature HealthCARE will pay more than $30 million to resolve allegations that it violated the False Claims Act (FCA) by knowingly submitting false claims to Medicare for rehabilitation therapy services. The settlement resolves allegations leveled in a lawsuit by Kristi Emerson and LeeAnn Tuesca, former Signature therapy employees, filed in federal court in Nashville, Tenn., and […]