An extended battle between a now-defunct nursing home operator and the state of Maryland reached a conclusion this week with a $2.2 million settlement. Neiswanger Management Services (NMS) agreed to pay that amount to dismiss allegations that it had improperly discharged Medicare residents and falsely billed the state’s Medicaid program, Maryland Medical Assistance. Back in […]
The Centers for Medicare & Medicaid Services on Friday unveiled a proposal that the agency says will expand telehealth coverage to enrollees in Medicare Advantage plans. Under the proposed rule, which would take effect in calendar year 2020, Medicare Advantage plans could cover telehealth services for both rural and urban enrollees, as well as in-home […]
Investors frequently point to “headline risk” as a reason to beware the skilled nursing space, typically referring to the kinds of negative press that arise due to natural disasters and lapses in care for vulnerable seniors. But a top executive at the nation’s largest skilled nursing real estate investment trust (REIT) says the prolonged staffing […]
Despite concerns about its impending doom, the financial outlook for the Medicare program has improved considerably from where it was 10 years ago. That said, Medicare remains an extremely expensive program, Alicia Munnell and Anqi Chen, both of the CRR, noted in a research brief published last week. “U.S. health care costs as a percentage of […]
As the skilled nursing industry prepares for a shift away from therapy as a primary reimbursement driver, a new study raises questions about the use of high-intensity therapy minutes at the end of residents’ lives. Between 2012 and 2016, ultra-high rehabilitation services provided to nursing home residents in their final month of life spiked 65%, […]
As the Centers for Medicare & Medicaid Services continues to crack down on preventable hospitalizations, skilled nursing providers have a keen financial interest in keeping residents out of the acute setting. Now a new study finds that retaining residents at the skilled nursing facility has no bearing on their mortality rates — with an expensive […]
Hospitals continue to discharge a fairly consistent share of their patients to skilled nursing facilities, but home health has seen a spike in admissions amid a shifting reimbursement landscape and changing consumer preferences. Acute-care hospitals released 22% of their patients into skilled nursing facilities during the first quarter of 2018, according to data released Wednesday […]
Of all the changes coming to the skilled nursing industry when a new payment model takes effect next fall, the most pressing may be one of the most basic: Starting in October 2019, providers will have a single opportunity to set themselves up for financial success with a patient’s initial assessment. The Patient-Driven Payment Model, […]
Skilled nursing provider Signature HealthCARE faced a a series of financial headwinds over the past two years. The provider’s problems ranged from issues paying the rent to major landlords Sabra Health Care REIT (Nasdaq: SBRA) and Omega Healthcare Investors, Inc. (NYSE: OHI) to a government investigation related to the False Claims Act (FCA). The Louisville, Ky.-based operator, […]
Accountable care organizations (ACOs) need time to work out their growing pains before producing savings for the government, according to a new study from a top health care consulting firm — and a major assumption about risk might not actually be true. ACOs active for four years or longer accounted for just about all of […]
Several small cities in Oklahoma now hold the licenses to operate dozens of nursing homes in the state, in the hopes of getting funds from a federal bonus payment program offered through the Centers for Medicare & Medicaid Services (CMS), Oklahoma Watch reported this week. Licenses for 46 nursing homes in the state are now owned by […]
Assisted living facilities have increasingly represented a viable alternative to skilled nursing for many older consumers, and a recent study found that the rise of lower-acuity senior housing has a direct impact on SNFs’ profit margins. The addition of every 10 assisted living beds — per 1,000 residents over the age of 65 in a […]
Hurricane Florence prompted skilled nursing evacuations throughout the Eastern seaboard, and the Centers for Medicare & Medicaid Services (CMS) this week issued a series of emergency orders to alleviate the pressure on operators and beneficiaries as they weather the storm. Administrator Seema Verma formally waived the three-day hospital stay requirement for Medicare skilled nursing coverage […]
A new analysis from a group of more than 300 accountable care organizations (ACOs) argues that the groups generated much more in savings than official estimates would suggest. The announcement from the National Association of ACOs (NAACOS) claims that ACOs generated gross savings of $1.84 billion for Medicare, almost double the $954 million estimated by […]
Last week, two leaders of the powerful House Ways and Means Committee — chairman Kevin Brady and health subcommittee chairman Peter Roskam — called on the Centers for Medicare & Medicaid Services (CMS) to slash red tape for skilled nursing and other long-term care providers. “There is a real opportunity to get red tape out […]
Value-based arrangements generate much of their savings by shifting spending away from the post-acute setting, according to recent government announcements. That ups the already-high pressure on skilled nursing facilities to lower patient length of stay while maintaining quality of care. To cope, they’ll have to make themselves invaluable to both referral sources and payers who […]
Two leaders of the powerful House Ways and Means Committee this week asked the Centers for Medicare & Medicaid Services (CMS) to ease regulatory burdens on skilled nursing facilities. In multiple letters to CMS administrator Seema Verma, Rep. Kevin Brady and Rep. Peter Roskam called for reduced compliance burdens for post-acute care providers, hospitals, and […]
For better or for worse, the federal government’s star-rating system for ranking skilled nursing facilities has taken on outsized importance as preferred provider networks narrow and Medicare Advantage plans demand better and better quality. The ratings from the Centers for Medicare & Medicaid Services, therefore, have become a quick and seemingly formal way to separate […]
New research takes aim at the long-term care hospital (LTCH), suggesting that the federal government could save billions if it paid those providers the same way as skilled nursing facilities — or just replaced them with SNFs altogether. “We find that most LTCH patients would have counterfactually received care at skilled nursing facilities … and […]
As hospitals’ preferred discharge networks narrow, high-level thinkers and consultants in the skilled nursing space have long preached the importance of certain key metrics: shorter lengths of stay, lower readmissions, and less overall Medicare spend. Now a new study shows those concerns are grounded in reality. In the years leading up to the creation of […]
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