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 […]

A big question that operators must ask themselves when considering involvement in an institutional special needs plan, or I-SNP, is ultimately wrapped up in how much money is being made on the Medicare Part B therapy side, some say. It might not make financial sense to sign up for an I-SNP if a SNF operator […]

Nursing home operators participating in a value-based purchasing program (VBP) might be able to derive greater benefits in coming years from higher scores based on new measures, as the federal government seeks to reward organizations who prioritize health equity, among other factors. Joel Van Eaton, EVP of post-acute care regulatory affairs and education at Broad […]

The Centers for Medicare & Medicaid Services (CMS) this week updated the SNF Quality Reporting Program (QRP), with changes to specifications used to calculate quality measures effective on Oct. 1. In terms of measures slated for removal from QRP, CMS doesn’t address how these gaps will impact requirements for reporting in its latest update, Jessie […]

Following the Biden Administration’s bid this week to reduce the price of certain drugs – many of which are commonly used in nursing homes – experts are cautioning that the changes may negatively impact the bottomline of organizations in the sector. As Medicare Part D price negotiations for these drugs come into focus this week, […]

General staffing metrics used to assess quality of care hold less weight these days and need to be updated, experts say, because the entire skilled nursing industry is struggling to build and retain its workforce. These quality measures need to be presented through the lens of the pandemic and the staffing crisis, SNF leaders say. […]

Clinical staff in nursing homes can successfully improve care and reduce hospitalizations by virtually monitoring patients, according to a study on novel nurse-driven virtual care models released Tuesday. The qualitative study of remote monitoring models has implications for addressing staffing challenges at nursing homes without compromising patient care.  The Regenstrief Institute in Indianapolis implemented a […]

Value-based care program (VBP) measures proposed by the Centers for Medicare & Medicaid Services (CMS) have long loomed over skilled nursing operators, and now it seems more are finally on their way for 2026. Staffing-related measures, rehospitalization, discharge and infection prevention are all areas of focus for CMS’ proposed and finalized measures alike. Moreover, proposals […]

As rising acuity and reimbursement challenges stymy nursing home workforce growth, third party contracts have been increasingly responsible for providing daily services. Whether its providing resident-facing clinical work, including use of third party doctors, supplying medical equipment or rendering back office services that focus more on ensuring proper documentation for reimbursement, third parties are increasingly […]

As acuity rises in the long-term and post-acute care settings, nursing homes and hospitals are in greater competition for nurses. Nurses may have in the past preferred to work in the traditional hospital setting for the chance to apply their clinical skills in more sophisticated ways, and for higher salaries. But an increase of residents […]

Trilogy Health Services today announced plans to expand into Wisconsin starting with two facilities, bringing its roster of campuses to nearly 130 across five states. The newly acquired properties – Sun Prairie Senior Living and Waunakee Valley Senior Living – both offer post-acute health care services. Both also offer assisted living, and Waunakee has an […]

Preparations for Minimum Data Set (MDS) changes vary from state to state, raising questions about how Medicaid reimbursements will be determined as the clock ticks down to the Oct. 1 start date. The key issue is the removal of Section G, which is used to measure the functional status of residents, from the nursing home […]

The Centers for Medicare & Medicaid Services (CMS) has decided to take action on transitions in care – specifically Medicare Advantage (MA) plans diverting care to home health instead of skilled nursing – after years of skilled nursing industry and consumer feedback. CMS last month took steps to address the trend with a proposed rule […]

Lenders, operators, industry lobbying organizations and consumer advocates all agree that an expansion of skilled nursing financing programs through the Department of Housing and Urban Development (HUD) could be a game-changer in driving much-needed innovation. Building on suggestions from the National Academy of Sciences, Engineering, and Medicine (NASEM), the authors of a recent Health Affairs […]

Loans and other types of financing through the Department of Housing and Urban Development (HUD) may be key to incentivizing operators to seek innovation, such as scaling the small home model in a meaningful way – but the program isn’t quite at that point yet. The National Academy of Sciences, Engineering, and Medicine (NASEM) report […]

Leaders in the skilled nursing space have increasingly seen value in creating a primary care strategy, with some intending to become part of a risk-based model as part of that strategy — especially as acuity continues to be high among residents. Operators looking to shift to such a strategy need a clear vision of how […]