OIG Calls on CMS to Crack Down on Abuse in Nursing Homes, Other Settings

The federal government’s top health care watchdog on Wednesday released a new report accusing the Centers for Medicare & Medicaid Services (CMS) of not doing enough to monitor and punish elder abuse in nursing homes and other settings. The Department of Health and Human Services (HHS) determined that CMS could perform detailed analyses of diagnosis […]

Even as Demand Rises, Nursing Homes Face Major Behavioral Health Hurdles

Adding behavioral health services has frequently been floated as a way that nursing homes can diversify their offerings and attract new residents — particularly as demand for the treatment of depression and other mental health issues continues to grow among older Americans. But a significant swath of operators report persistent challenges in caring for residents […]

Skilled Nursing Dealmakers Could Be Overlooking PDPM’s Potential for ‘Biggest Year’ in Decades

The market will still need to determine whether the new Medicare reimbursement structure for nursing homes will be a net positive or negative for the industry, but at least one insider says buyers and sellers in the space aren’t optimistic enough. Current prices for skilled nursing facilities don’t typically account for the potential of cost […]

Under PDPM, Providers Should Expect Close Scrutiny of Nursing Records

The new Medicare model for skilled nursing facilities more closely links reimbursements with resident conditions — and making sure that facilities completely document those conditions will soon be an essential step for success. But because payment under the current Resource Utilization Group (RUG) system is driven primarily by therapy minutes, capturing those conditions on the […]

Genesis’s PDPM Math: 12% Expense Savings, Shift to Fixed-Cost Therapy Contracts

Once the new Medicare payment model for nursing homes takes effect this fall, skilled nursing giant Genesis HealthCare (NYSE: GEN) expects to see significant expense savings — while also changing the way it negotiates therapy contracts with its third-party clients. The Kennett Square, Pa.-based operator projects that the expanded opportunity for group and concurrent therapy, […]

CMS Chief Verma ‘Spending a Lot of Time on Nursing Homes’

The administrator of the Centers for Medicare & Medicaid Services (CMS) placed nursing homes among her top areas of focus for the months to come, though she provided scant few other details during a wide-ranging press conference this week. “I’m spending a lot of time on nursing homes,” Seema Verma said in a Wednesday afternoon […]

ACOs Cost Government Money, But Skilled Nursing Opportunity Remains Large

Accountable care organizations (ACOs) don’t always meet their intended goals of saving the government money, and while a new study shows that the model has led to losses in New York, its author asserts that the programs remain ripe for skilled nursing opportunities. Five years into the Medicare Shared Savings Program (MSSP), ACOs in the […]

PDPM Goes Beyond Therapy: Finding the Hidden Value in Skilled Nursing Ancillaries

At surface level, the new Medicare payment model for nursing homes revolves largely around therapy, as the federal government works to realign incentives and prevent what officials claim to be a wave of unnecessary services. Speech, occupational, and physical therapy account for three of the five components of the Patient-Driven Payment Model (PDPM), and providers […]

‘All Systems Are Go’ at CMS for PDPM, But Not All Providers Are Ready

The new Medicare reimbursement model for skilled nursing facilities remains on track for implementation this fall, but not everyone is ready — and operators need to look to the big-picture shifts in value-based care for inspiration as the clock keeps ticking. That’s according to a recent webinar from the Minneapolis-based consulting firm Health Dimensions Group […]

Ciena Looks to Build on Bundled Payment Success with Medicare Advantage

As the health care system continues to push skilled nursing providers in the direction of risk, the Ciena Group has relied on lessons learned from bundled payments as it looks at entering the world of Medicare Advantage. The fact that skilled nursing could not initiate episodes under the newest bundled payments model “pulled the rug […]

Cheat Sheets and Timely Visits: How SNFs Can Support Doctors’ Larger PDPM Role

Timely physician visits will play a central role in effectively capturing resident conditions — and reimbursements — under the new Medicare payment model. But with doctors seeing relatively few incentive changes amid the shift to the Patient-Driven Payment Model (PDPM), skilled nursing operators must find ways to make physician collaboration as easy as possible. Medical […]

ManorCare Sees Occupancy Boost as Welltower Plots 45-Building Capital Improvement Plan

Executives from Welltower Inc. (NYSE: WELL) have been largely mum about the company’s ongoing integration of HCR ManorCare’s skilled nursing facilities into its overall portfolio, but when pressed Tuesday, leaders hinted that the metrics are moving in the right direction. Occupancy at ManorCare SNFs has increased by more than 100 basis points, Welltower chief investment […]