Customer service, staff wellbeing, and tackling low reimbursement rates are some of the top priorities for nursing home operators as they prepare for the future. And educating and supporting care teams is especially important in order to strategize with the quality measures that will be implemented in the coming years, as these will have an […]

Negotiating power with Medicare Advantage (MA) plans may become easier as nursing homes explore participation in bundled payment options such as the Transforming Episode Accountability Model (TEAM), which enables following patients through an entire episode of care. It’s a lever available to participants and collaborators to forge new contracting strategies with their MA plan and […]

Meticulous documentation is the name of the game for nursing home operators looking to keep up with Minimum Data Set (MDS) changes and maintaining a good rating in the Five-Star Quality Rating System. This is especially because inaccurate or insufficient data could affect a facility for at least a year in the future. Leaders in […]

Reimbursement issues at nursing homes are pushing operators to adapt their payment models to increase reliance on Institutional Special Needs Plans (I-SNPs) and Accountable Care Organizations (ACOs). But while these models aim to enhance care quality even as they control costs, they also bring on unique challenges, including requiring extra oversight with discharges and related […]

Despite operational and financial headwinds affecting the nursing home sector currently, a transitional care program and physiatry partnership has been able to cut readmission rates from 29% to 9% among a group of facilities. OSF HealthCare, a 17-hospital system in Illinois and Michigan, partnered with physiatry and care coordination management group Puzzle Healthcare to deliver […]

Amid plans to launch the largest provider-owned institutional special needs plan (I-SNP) in the U.S., Brickyard Healthcare is also making sure it surpasses certain other challenges facing the sector. Along with this endeavor, eliminating agency use, preparing for managed Medicaid in Indiana, and being ready to face the staffing mandate, have all been top of […]

Texas-based Touchstone Communities hasn’t been slowing down this year, with the operator busy acquiring and building properties. On top of brick-and-mortar updates, Touchstone also partnered with Longevity Health in January to offer institutional special needs plans (I-SNPs) to its residents. It’s very thoughtful, controlled growth aimed at diversification of assets, said Leslie Cunningham Campbell, COO […]

Managed care’s growth across all health care settings, including nursing homes, has pushed reimbursement rates lower, and operators are implementing strategies to counter the situation.  For starters, operators expressed the need to be well equipped for negotiating better rates with managed care organizations (MAOs). And, coming armed with cost of care data to the negotiating […]

Operational and financial challenges can make it difficult for nursing homes and other health care facilities to transition to the federal government’s Value-Based Program (VBP), which ties payment to quality and outcomes. An editorial published in JAMA Internal Medicine Monday expresses the need for more data and improved measurement of outcomes, better methods of financial […]

The Centers for Medicare & Medicaid Services’ (CMS) in April released a bundled payment model that is the culmination of the best aspects from such past models, all to align with the agency’s efforts to get all Medicare Fee-for-Service beneficiaries involved in value-based care by 2030. The Transforming Episode Accountability Model, or TEAM, is considered […]

If there’s no additional funding for the minimum staffing rule, well over 5% of existing facilities will close, depending on how successfully operators can pivot to meet the standard. The rates of closure may even reach 10% to 15%, depending on the market, cautioned sector leaders attending the LTC100 conference this week. Steve Nee, CEO […]

The Centers for Medicare & Medicaid Services (CMS) is testing out a payment model that would cover all costs associated with an episode of care, including a skilled nursing stay, but it appears that select hospitals would be in the driver’s seat if approved. Certain surgical procedures will fall under the new model and include […]

The Centers for Medicare & Medicaid Services (CMS) on Friday issued its draft Minimum Data Set (MDS) — earlier than the federal agency’s typical timeline and with less sweeping changes compared to past years. Changes, effective Oct. 1, include an update to the list of state RAI coordinators, MDS automation coordinators, CMS locations and contacts, […]

The costs of long-term care in every setting, including nursing homes, is considered out of reach for most seniors, averaging more than $100 per day nationwide. This is coupled with the fact that the majority of older adults with very low incomes will need such services and have the fewest resources to pay for them. […]

As patient preference continues to shift away from nursing homes, public attention is increasingly on alternate modes of skilled nursing care as well, including continuing care retirement communities (CCRCs). Newsweek, for one, came out with a ranking of such communities in partnership with global market and consumer data firm Statista. The companies expect rankings to […]

Some physician groups have decided to join the accountable care organization (ACO) REACH programs to better serve high needs groups given that the nursing home sector is gravitating toward value-based care – the trend being especially true if patients are already aligned with an ACO through their primary care provider. Theoria Medical, for one, made […]

The Centers for Medicare & Medicaid Services (CMS) aims to further advance its overall value-based care strategy with the finalized 20224 Medicare Physician Fee Schedule (PFS) – adding ways for medically complex, high-cost beneficiaries like those in nursing homes to participate in Medicare Shared Savings Programs (MSSPs). Additionally, CMS therapy assistants can be more generally […]

The way physicians and nursing home organizations work together must improve, especially with value-based care continuing to grow in prominence among all care settings. More specifically, C-suite executives, nursing staff and other leaders – from both the physician group side and nursing home operator end – must have a close partnership and aligned business strategies […]

The latest proposed changes to the REACH accountable care organization (ACO) may make it even easier for skilled nursing facilities to be a part of an ACO program – and there may be implications for quality of care, industry leaders said. A broadened criteria and an attractive high needs population track is expected to be […]

The rise of managed care plans among nursing home beneficiaries has meant that nursing home providers have had to make tough choices to balance the pros and cons of such plans to reap profits. And, despite a proven track record of handling higher acuity, many providers may not think to use this to their advantage […]