CMS Expands Nursing Home Telehealth Coverage, Waives HIPAA Penalties During COVID-19 Outbreak

The Trump administration on Tuesday announced an emergency expansion of telehealth coverage for Medicare beneficiaries amid the COVID-19 outbreak, removing multiple regulatory barriers to doctors providing remote care for nursing home residents. Retroactive to March 6, Medicare can pay for virtual consultations provided through telehealth platforms across the country, including those conducted in a patient’s […]

Verma: CMS to Soon Ban All Nursing Home Visits ‘With a Few Exceptions’ Amid Coronavirus Fears [Updated]

UPDATE, Saturday, March 14: CMS formally issued its guidance late Friday, enacting a ban on most non-essential visits to nursing homes and also waiving the three-day stay rule for Medicare skilled nursing coverage. The federal government will soon issue guidance directing nursing home operators to ban the vast majority of visitors amid the spread of […]

Skilled Nursing Telehealth Bill Gets New Life Amid Coronavirus [Updated]

Telemedicine is drawing national attention from lawmakers as officials look to safeguard health care workers and patients — while nursing homes anxiously monitor infection-control policies to protect vulnerable residents from the global pandemic of the coronavirus. Expanded Medicare coverage of telehealth services was included in the recent $8.3 billion emergency bill, offering national aid in […]

How Focused Post Acute Balances Urban and Rural Markets to Thrive Amid Medicaid, Labor Stress

A skilled nursing operator or investor could be forgiven for running toward the exits when presented with the opportunity to take over buildings in rural West Texas. Between persistently low Medicaid rates in the Lone Star State and the general operational difficulties that rural buildings face in markets across the country, the combination may not […]

CMS: No Timeline for Resuming Non-Emergency Surveys for Nursing Homes Amid Coronavirus

After the Centers for Medicare & Medicaid Services (CMS) announced an immediate crackdown on nursing home compliance in the wake of the coronavirus, the agency laid out new expectations for updated inspections and surveys — with no exact timeline for resuming non-emergency surveys in sight. Although containing and preventing the coronavirus is the agency’s current […]

Medicare Advantage Plans Attracting Lower-Income Seniors — While Saving Them $1,600 Per Year

Medicare Advantage plans have long been a thorn in skilled nursing facilities’ sides, with lower-per day rates and increased pressure to reduce lengths of stay than traditional fee-for-service Medicare. But a new report shines a light on why seniors are increasingly choosing the plans in the first place, reinforcing recent calls to embrace working with […]

Diversicare ‘A Very Different Company’ After Kentucky Exit, Touts 7.5% Medicare Rate Boost

Despite a net loss for the quarter, skilled nursing operator Diversicare Healthcare Services (OTCQX: DVCR) touted its performance at the end of 2019, pointing to a 7.5% Medicare rate boost and generally positive performance under the new Patient-Driven Payment Model (PDPM). “With our portfolio changes behind us after the Kentucky exit and the implementation of the new […]

CMS to ‘Immediately’ Refocus Nursing Home Inspections on Infection Control Amid Coronavirus

In the wake of an outbreak of the novel coronavirus at a Washington nursing home, the Centers for Medicare & Medicaid Services (CMS) will immediately refocus inspections of skilled nursing facilities on compliance with the agency’s infection control policies — and suspend all non-emergency survey work, the agency announced on Wednesday. “We obviously are looking […]

DOJ Forms Nursing Home Task Force, Promises Criminal and Civil Penalties for Owners and Operators

The Department of Justice this week announced the creation of a specialized task force targeting “grossly substandard care” in nursing homes, with both criminal and civil penalties on the table for owners and operators. About 30 individual facilities across nine states are already under investigation, the DOJ revealed in announcing its new National Nursing Home […]

Skilled Nursing Operators Can Find Success Under the ‘Quite Similar’ PDPM and I-SNP Models

The Patient-Driven Payment Model (PDPM) overhauled the way skilled nursing facilities are paid for their services to Medicare fee-for-service patients when it took effect last year – removing therapy as a driver of reimbursement and putting an emphasis on patient conditions. That gives it more than a passing resemblance to a lightning rod in the […]

CMS Confirms Some PDPM Claim-Processing Errors, Promises Fix by October

The federal government on Thursday acknowledged some errors in processing Medicare claims under the new payment system for nursing homes, promising to make a full correction by the start of its next fiscal year. The main issue has to do with the sequence of initial claim filings for Patient-Driven Payment Model (PDPM) reimbursements, the Centers […]

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 […]