CMS-Backed Clinical Program Drastically Lowers Avoidable Hospitalizations at SNFs

Potentially avoidable hospitalizations for long-stay nursing facility residents can be significantly reduced by embedding nurses and nurse practitioners, according to a new analysis. In turn, the strategy could substantially slash Medicare spending. That’s according to an independent evaluation of the OPTIMISTIC program prepared at the request of the Center for Medicare and Medicaid Innovation (CMMI). OPTIMISTIC was developed […]

Warren Presses HHS Pick Over Anti-Psychotic Drugs in Nursing Homes

President Trump’s pick to lead the Department of Health and Human Services faced pointed questions Wednesday about his former employer’s history with marketing anti-psychotic drugs to nursing home operators. Alex Azar, most recently a top executive at pharmaceutical giant Eli Lilly and Company (NYSE: LLY), pushed back against criticism of his former company’s history with […]

CMS Delays Enforcement of Smoking Rules, Other Phase 2 Requirements

Skilled nursing operators can breathe a little easier as the second phase of the new Requirements for Participation takes effect this week: The Centers for Medicare & Medicaid Services (CMS) has delayed penalties for several of the new requirements. For the next 18 months, CMS won’t take enforcement action — in the form of civil […]

Lawsuit Alleges Growing Trend of Improper Discharges at CA SNFs

At 83 years old, California resident Gloria Single is shining a light on what she and her allies believe is a growing issue at skilled nursing facilities (SNFs) in the state: the illegal “dumping,” or eviction, of residents. In March 2017, Single was evicted from Pioneer House in Sacramento, with no warning. Pioneer House—a SNF […]

AHCA: HHS Nominee Azar is Respected and Experienced

President Donald Trump tweeted Monday morning that he would nominate Alex Azar, a former executive with pharmaceutical giant Eli Lilly, as secretary of the Department of Health and Human Services. The nation’s largest skilled nursing provider association stands ready to work with Azar, the group stated, while others raised some concerns about what his nomination could mean […]

How Bundled Payments Can Keep SNFs on Top of Their Game

The home setting is fast becoming the preferred choice in delivering post acute care (PAC) for health care organizations in bundled payment settings, according to a recent industry report. But while health care providers are steering patients away from an institutionalized setting, one industry expert believes this realization should alert skilled nursing facilities (SNFs) and […]

CMS Takes Steps to Improve Medicaid

The Centers for Medicare & Medicaid Services (CMS) announced several ways it plans to improve the Medicaid program — including new proposals for reforms and fewer regulatory burdens, increased efficiency, and more transparency and accountability, according to CMS Administrator Seema Verma.  “Our vision for the future of Medicaid is to reset the federal-state relationship and […]

Health Care Spending Could Reach 40% of Federal Total by 2047

If current policies don’t change, federal spending on Medicare, Medicaid, and other health care programs will grow faster than any other category over the next three decades — eventually reaching 40% of the federal budget. The Congressional Budget Office (CBO) presented these statistics in a Wednesday presentation to the Council for Affordable Health Coverage and the American […]

Despite Not Covering Personal Care, Medicare May Be Paying for it Anyway

Medicare spends roughly three times more on beneficiaries who need help with two or more activities of daily living (ADLs) due to physical or cognitive impairments than those that don’t, according to a new study from the Long-Term Quality Alliance (LTQA). The group, which represents more than two dozen industry and consumer organizations with the goal of improving outcomes, examined […]

SNF Compliance Tips for Care Plan, Pharmacy, Smoking Requirements

Skilled nursing providers across the country continue to work hard as Nov. 28 approaches. That’s when the second phase of the new SNF Medicare and Medicaid requirements of participation take effect. The so-called “mega rule” is being implemented in three phases, and this second phase brings a host of new requirements. Here are a few […]

SNFs Renew Push to Change Three-Day Stay Rule

Skilled nursing facility (SNF) operators and industry advocates are urging the Centers for Medicare & Medicaid Services (CMS) to change a rule related to the way hospital stays are classified. The Observation Stays Coalition—a group formed in 2010 that includes organizations such as the American Health Care Association (AHCA) and AARP—is leading the charge against the […]

Skilled Nursing Facilities Cut Hospitalizations in CMS Initiative

A multi-year initiative from the Centers for Medicare & Medicaid Services (CMS) to lower hospitalizations in long-term care has its first set of finalized results, with data showing that the plan is working so far. CMS on Friday announced that all seven participating sites saw declines in hospitalizations. Six of the seven had statistically significant drops in […]

CMS Official: Focus on Intent of New SNF Regulations

Skilled nursing providers are trying to understand the details of sweeping new Medicare requirements and survey process changes. But SNFs should not get so preoccupied with the finer points that they lose sight of the fundamental goals that the Centers for Medicare & Medicare Services (CMS) intends to achieve with the updates. “The main point […]

AHCA CEO: Skilled Nursing Providers Must Branch Out to Survive

This year might have presented the hardest operating environment ever for skilled nursing operators, American Health Care Association (AHCA) President and CEO Mark Parkinson said this week at the organization’s annual conference in Las Vegas. Favorable demographics ultimately will be a boon to the sector, but in the meantime, there are some strategies that can […]

Quality, Scope of Medicare Advantage Plans Varies Widely

As Medicare Advantage becomes increasingly common in the skilled nursing space, consumers may still have trouble determining whether a plan works best for them — or even provides quality coverage with access to a wide variety of physicians and SNF care. And even if a potential MA enrollee finds a plan that appears to cover […]

House Democrats Ask CMS to Uphold Arbitration Ban

House Democrats on Wednesday called on Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to change her mind on reinstating the use of arbitration clauses in skilled nursing contracts. Referencing the recent problems at nursing homes in the aftermaths of Hurricanes Harvey and Irma, 46 Democratic representatives wrote a letter to Verma asking […]

Paying the Price: HHS Secretary Steps Down Amid Scandal

Department of Health and Human Services secretary Tom Price resigned from his post Friday amid an investigation into his use of private jets at taxpayer expense. The government spent more than $1 million for Price’s travel on private and military aircraft since May, according to Politico, which first reported on the secretary’s travel habits. Those […]

Nursing Home Complaints Up 33%, Some States Slow to Respond

Nursing home complaints handled by state authorities rose by one third between 2011 and 2015 — even as occupancy at skilled nursing facilities declined slightly. In addition, a handful of states accounted for the majority of late investigations, according to a new data brief from the Department of Health and Human Services’ (HHS) Office of the […]

Skilled Nursing Providers Have Mixed Feelings on Bundled Payments

Less than two-thirds of acute and long-term care providers have found that bundled payments both lower costs and improve care, according to a new survey, though the company behind the numbers says it’s a little more complicated than that. Archway Health, a Watertown, Mass.-based firm that advises health providers on bundled payment models, asked 70 […]

Skilled Nursing Occupancy Drops to Five-Year Low

Skilled nursing occupancy rates have dropped to their lowest levels in the last five years, and the bottom still may not be in sight. SNFs were 81.7% occupied in the second quarter of 2017, according to the most recent data from the National Investment Center for Seniors Housing & Care (NIC). That’s a drop from 82.7% in […]