Rise of Data Could Bring More False Claims Act Cases, CMS Scrutiny to Skilled Nursing

Attend any conference geared toward long-term and post-acute health care operators, and you’ll hear a common thread: Data is king. In a landscape defined by value-based payment models such as Medicare Advantage plans and accountable care organizations (ACOs), investing in data analytics has become almost a prerequisite for success. If a given operator can prove […]

550 Nursing Homes Closed from 2015-2019 — With Trend Accelerating Toward End of Decade

Nursing home closures are on the rise, regardless of geography and quality ratings, according to a recent report authored by industry trade group LeadingAge — raising the possibility of market-specific supply shortages in the near future. In fact, more than 550 facilities have closed between June 2015 and June 2019, with a steady increase in […]

Verma: CMS’s Nursing Home Oversight Push More ‘Internal’ Amid PDPM Shift

Seema Verma on Tuesday laid out a sweeping plan for data-driven oversight and enforcement across the health care spectrum, and took a similarly broad view of her agency’s regulatory plans when directly asked about potential changes to the new Medicare payment model for nursing homes. Specifically citing the early success of the agency’s recent push […]

I-SNPs vs. ACOs: Balancing the Skilled Nursing Risks, Rewards of Two Hot Payment Models

As the skilled nursing industry struggles to adapt to a new Medicare payment landscape, in-house Medicare Advantage plans have emerged as one of the hottest topics among leaders — while the space’s publicly traded behemoth has thrown its full support behind the separate accountable care organization (ACO) model. There may not be one set answer […]

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 […]