Skilled Nursing Facilities Outperform Home Health on Readmission Rates: Study

Despite the increasing preference among payers and hospital partners to discharge residents to home health agencies, brick-and-mortar skilled nursing facilities are superior at reducing hospital readmissions — with one key caveat. After controlling for a variety of factors, residents sent from a hospital to the care of a home health agency had a 5.6-percentage-point higher […]

Hager: Shift from SNFs to Home Has Run Course, Therapy Costs to Drop 10% to 15% Under PDPM

Large-scale efforts to shift post-acute residents from skilled nursing facilities to the home health space have largely “run their course,” Genesis HealthCare (NYSE: GEN) CEO George Hager said Tuesday, while also predicting serious cost savings under the new Medicare payment model. Though industry leaders have long worried about payers’ growing preference for the lower-cost home […]

Trump Budget Plan Would Cut $845B from Medicare, $241B from Medicaid

The White House on Monday released a budget proposal that would substantially slash Medicare and Medicaid spending over the next decade. In part by adopting a site-neutral payment model for post-acute care under Medicare and converting the Medicaid system to block grants, the federal government would end up gutting more than $1 trillion from the […]

Nurses May Need to Shoulder Documentation Burdens Under PDPM

Once the new Medicare payment model takes effect, frontline nurses may prove vital to securing the proper reimbursements for skilled nursing services. The Patient-Driven Payment Model (PDPM) will place increasing pressure on nursing facilities to justify each resident’s need for Medicare-reimbursed skilled care, Zimmet Healthcare Services Group president Marc Zimmet said during a recent industry […]

Providers Can’t Fall for Therapy Myths When Preparing for PDPM

As skilled nursing facilities and rehabilitation providers across the U.S. prepare for the changes to Medicare payments coming in October, they have to make sure they don’t get sidetracked by a slew of misconceptions about what’s coming. That’s according to a Tuesday webinar by clinical management software provider Optima Healthcare Solutions, held in conjunction with […]

CMS to Crack Down on Staffing, Separate Short- and Long-Term Stays in SNF Star Rating Overhaul

The Centers for Medicare & Medicaid Services (CMS) on Tuesday announced stricter standards for its consumer-facing nursing home ratings, including a lower threshold for staffing penalties and new separate ratings for short-term and long-term stays. Starting April 24, CMS will automatically hand out one-star staffing ratings to buildings that have four or more days in […]

Diakonos, Leo Brown Mix Post-Acute with Private Pay at New $15M Skilled Nursing Facility

In an era of tight finances and legal caps on the number of beds, new skilled nursing developments are few and far between — with most of the action in recent years focused on higher-end, post-acute rehab facilities. The Diakonos Group’s latest development, a $15 million skilled nursing facility in Tulsa, Okla. with a total […]

Vanguard Healthcare Settles Medicare, Medicaid Fraud Claims for $18 Million

A Tennessee-based skilled nursing provider this week agreed to pay the federal government $18 million in order to resolve claims of Medicare and Medicaid fraud. Vanguard Healthcare, LLC of Brentwood, Tenn. — along with several of its affiliated firms — reached the deal with the Department of Justice, which accused the provider of providing “grossly […]

Facilities Thriving Under Current Model Poised to Take Biggest Hits Under PDPM

As skilled nursing providers prepare for a new Medicare reimbursement system, those with solid revenues under the current model may be in for the most severe declines going forward. Operators that have mastered the current Resource Utilization Group (RUG) system tend to be those projected to see reimbursement declines under the new Patient-Driven Payment Model, […]

What Hospitals Want: How SNFs Can Break into New Payment Partnerships

Skilled nursing facility operators frequently hear about how forging hospital partnerships is essential to their success under new payment models, but the intricacies of those interactions can often be difficult to navigate. Speaking at the National Investment Center for Seniors Housing & Care (NIC) spring conference in San Diego last week, the leader of one […]

Paul Ryan: Medicare Advantage is the Future of Medicare, and Medicaid Reform Will Return

Public-private partnerships will form the basis of comprehensive Medicare reform as the baby boom population ages, former Speaker of the House Paul Ryan predicted Thursday morning in remarks at a major skilled nursing and senior housing industry conference. “I believe the future for Medicare is in the Medicare Advantage type of space,” Ryan, a Wisconsin […]

OIG Finds $84 Million in Improper Skilled Nursing Facility Payments

The federal government improperly paid skilled nursing facilities more than $84 million for services that did not meet Medicare’s three-day hospital stay requirement, according to a report released Wednesday by the Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG). Medicare beneficiaries must stay in a hospital for three consecutive calendar […]

Spending Growth for Skilled Nursing Facilities to Lag Behind Home Health Care

Total spending on nursing care facilities will grow by 5.4% through 2027, according to a new analysis from the Centers for Medicare & Medicaid Services (CMS) — but that figure still lags behind the rate increase for home health agencies. Overall spending on medical care at skilled nursing facilities and continuing care retirement communities (CCRCs) […]

Genesis Exec: Skilled Nursing Industry Has No Choice But to Embrace New Models

It’s an existential problem that many providers face in the skilled nursing industry: New payment models demand substantial operational changes, but the current fee-for-service reality determines how they can pay and plan for those shifts. This frustrating dichotomy was on full display during a panel discussion on Institutional Special Needs Plans (I-SNPs) and other new […]

Why Short-Term Rehab Alone Might Not Sustain Skilled Nursing

A consulting firm that offers services across the health care spectrum sees opportunity for growth in skilled nursing, though the leader of its SNF practice believes that the industry must expand beyond short-term rehab to survive. The Wayne, Penn.-based McBee plans to look at both hires and potential acquisitions as it tries to bolster its […]

As PDPM Nears, Providers Can’t Rely on Sunny CMS Projections to Succeed

As the implementation date draws nearer for the overhaul of the Medicare reimbursement system, some providers have found comfort in government projections about their revenue under the new model. But that comfort might be misplaced, according to a webinar held Wednesday by Minneapolis.-based consulting and management firm Health Dimensions Group. The Centers for Medicare & […]

CMS Hints at ‘Calling Out’ Nursing Homes Over Quality Problems

A Centers for Medicare & Medicaid Services (CMS) official last week suggested that the public would benefit from more information about resident safety at nursing homes — including the explicit identification of bad actors. Writing in response to a November study about the correlation between Nursing Home Compare star ratings and safety, CMS chief medical […]