2021 Will See ‘Many Facilities Fail’ Without Federal, State Help

Nursing home and senior living providers in the not-for-profit sector are facing significant strains from the surge in COVID-19 nationwide. Leading into the Thanksgiving holiday, operators are pleading with those in the community to refrain from gathering amid challenges both operational and financial. “Nursing homes really are at the brink,” Deke Cateau, the CEO of […]

New Medicare Claims Analysis Reveals Depths of COVID-19’s ‘Double Whammy’ Effect on SNFs

When elective surgeries were halted or suspended in spring in an attempt to preserve hospital capacity, the number of patients leaving the hospital setting dropped significantly — and the number of patients leaving that setting for skilled nursing fell by nearly half as well. A new analysis of all Medicare fee-for-service claims data from January […]

Curve Health Sees Value-Based Progress at Nursing Homes — Even If It’s Still Technically Fee-for-Service

The federal government has talked a big game about shifting toward value-based payments for Medicare and Medicaid providers, but fee-for-service reimbursements have remained a primary force governing operations in the post-acute and long-term care sector. COVID-19 has subtly shifted that dynamic, however — especially in the field of telemedicine, which has seen skyrocketing adoption rates […]

Invesque to Cut Symphony Exposure in Half, Reports No Bridgemoor Revenue as Post-Acute COVID Strains Mount

Invesque Inc. (TSE: IVQ.U) this week reported significant COVID-19 strains on a pair of its post-acute care tenants, with the skilled nursing landlord taking steps to reduce its exposure to Symphony Care Network and reporting no revenue from Bridgemoor Transitional Care. The real estate investment firm will either sell or transition operations at half of […]

CMS, Medicare to Cover COVID-19 Antibody Drug in Nursing Homes

The federal government this week announced that Medicare will cover a recently approved antibody treatment for COVID-19 in a range of settings, including nursing homes. The Food and Drug Administration on Monday cleared on an emergency basis the use of bamlanivimab — a monoclonial antibody infusion — for adults with mild to moderate cases of COVID-19. […]

Verma: COVID-19 Shows LTC ‘Relies Too Heavily on Nursing Homes’

The nation’s top Medicare and Medicaid official this week called on states to boost their home- and community-based services for the elderly, arguing that the impact of COVID-19 on nursing homes has exposed a key flaw in the overall system. “The COVID-19 crisis has shone a harsh light on the human costs of a long-term […]

Verma Pushes Back on Criticism of CMS Response to Life Care COVID Outbreak: ‘Our Inspection Was Critical’

The nation’s top Medicare official took to Twitter to respond to a mainstream news report critical of the federal government’s handling of the first major COVID-19 outbreak at a skilled nursing facility. “60 Minutes” this past Sunday profiled that outbreak — which devastated a Life Care Centers of America facility in the Seattle suburb of […]

HHS Relaxes Rules for Using Provider Relief Funds to Cover Lost Revenue

The federal government this week amended its rules for how providers can use coronavirus relief funding, specifically removing limitations around covering lost revenues not directly related to COVID-19. The Department of Health and Human Services (HHS) announced the change in the wake of criticism from providers and some lawmakers. “In response to concerns raised, HHS […]

SNN Survey: Most Providers Will Survive into 2021, But Capital Providers Remain Worried About Census

A recent Skilled Nursing News survey of nursing home operators found cautious optimism about the near-term future of the space, with a majority seeing a clear path to the future even without additional government support. At the same time, operators have largely been pouring that federal largesse — including CARES Act grants, Payroll Protection Program […]

CMS ‘Quiet’ on PDPM-Related Enforcement Even as Rates Rise, But Managed Care More Prone to Denials

The Patient-Driven Payment Model (PDPM), the overhaul to Medicare reimbursement for skilled nursing facilities that took effect in October of 2019, has proven its worth as a mechanism for paying for nursing care during a global pandemic. It has, however, been “anything but revenue-neutral,” at least in terms of how much money the government is […]

Cold Storage, Medicaid Coverage: Inside the Walgreens, CVS Vaccination Deal for Nursing Homes

The federal government last week tapped a pair of retail pharmacy giants to distribute an eventual COVID-19 vaccine to nursing home residents across the country, and while there remain significant questions about the logistics of distributing an as-yet-unapproved vaccine, officials have continued to position the plan as the only workable solution to a massive public […]

Medicare Advantage Growth Outpaced Traditional Medicare, 60% to 5%, Over Six Years

Medicare Advantage (MA) has seen dramatic enrollment growth over the past six years, significantly outpacing traditional Medicare, according to a report commissioned by the Better Medicare Alliance released October 15. The report, prepared by the actuarial firm Milliman, examined the growth in enrollment in MA and the similarities and differences between enrollees in that program […]

CMS to Relax Medicare Billing Rules to Speed COVID-19 Vaccine Distribution in Nursing Homes

The federal government on Friday announced its intention to relax restrictions around billing Medicare for immunization in nursing homes, with the stated goal of speeding the eventual distribution of a COVID-19 vaccine. Skilled nursing facilities are typically required to bill Medicare directly for immunizations under the terms of the Social Security Act, even if the […]

Verma: Alternative Payment Model Performance ‘Deeply Concerning,’ More Mandatory Programs Ahead

The nation’s top Medicare official this week expressed serious disappointment in the performance of alternative Medicare payment models, citing key design flaws and promising more mandatory programs to come. The Centers for Medicare & Medicaid Services (CMS) recently completed an analysis of several early attempts at value-based payment structures, with administrator Seema Verma disappointed in […]

Genesis’s LTC ACO Pulls in $18.8M in Shared Savings for 2019

LTC ACO, the accountable care organization (ACO) launched by Genesis HealthCare (NYSE: GEN), brought in $18.8 million for the nursing home operator under the Medicare Shared Savings Program (MSSP) during the 2019 program year. The ACO achieved sufficient Medicare fee-for-service savings among its 5,800 beneficiaries to trigger the payment, which translates to $17 million in […]