Rise of Managed Medicaid Could Deepen Skilled Nursing Financial Woes

Increasing numbers of states have begun exploring managed Medicaid programs as a means of achieving savings as their populations age. But unless officials provide crucial oversight, skilled nursing facilities could find themselves under even worse financial pressures. It’s something that states and their legislators need to keep in mind as they weigh options for managing […]

36% of Skilled Nursing Facilities See Star-Rating Declines After CMS Changes Take Effect

Roughly 36% of skilled nursing facilities saw a drop in their overall star ratings after planned changes to the Centers for Medicare & Medicaid Services’ (CMS) Nursing Home Compare system took effect on Wednesday. That’s according to a pair of analyses from the American Health Care Association (AHCA), a trade group representing nursing homes, and […]

AHCA CEO: New Tax Law Raises Financial Pressure on Skilled Nursing Facilities

The Tax Cuts and Jobs Act adds to the financial headwinds already rattling skilled nursing facilities by removing a key deduction without any kind of offsetting mechanism, American Health Care Association (AHCA) president and CEO Mark Parkinson argued in an op-ed published in Bloomberg Tax. Specifically, the tax law limits deductions on loan interest payments […]

‘Medicare for All’ Plan Would Expand Coverage for LTC — But Nursing Homes Stay Under Medicaid

Sen. Bernie Sanders this week introduced a bill to create a single-payer health care system for the U.S., a plan that includes long-term care in its scope — but keeps coverage for institutional nursing home care under Medicaid. The legislation would ensure that the so-called “Medicare for All” plan would include benefits for at-home long-term […]

CMMI Could Put Post-Acute Providers Back in Control of Bundled Payments

The leader of the federal government’s center for reimbursement innovation said he is considering bundled payment models where post-acute care providers could take the lead on care — but right now it’s only at the consideration stage. Adam Boehler, who leads the Center for Medicare and Medicaid Innovation (CMMI), said that there has been significant […]

Lawmakers Again Take Aim at ‘Observation Stay’ Rules for Medicare SNF Coverage

A bipartisan coalition of federal lawmakers this week took another stab at clarifying the rules regarding a frequently confusing aspect of skilled nursing coverage under Medicare. Under the terms of the proposed legislation, the Improving Access to Medicare Coverage Act of 2019, so-called “observation stays” would count toward the three days of inpatient acute care […]

Medicaid Pressures, Worker Shortages Lead to SNF Closure Wave in Wisconsin

Nursing homes in Wisconsin are blaming the state’s low Medicaid reimbursements for a wave of nursing home closures and persistent financial struggles, Wisconsin Public Radio reported earlier this month. Nursing home advocates are asking lawmakers in the state to invest $83.5 million in the next two-year budget as a result, the media organization reported. The […]

ICD-10 Coding Will Be Crucial Under PDPM — But SNFs Don’t Need to Become Experts

The Medicare payment model taking effect on October 1 this year represents a sea change for skilled nursing providers in that patient condition, rather than therapy minutes, will drive reimbursement. It also represents a sea change in the mechanics of reimbursement. Under the Patient-Driven Payment Model, ICD-10 codes will form the basis of reimbursements, making […]

Report Revives Potential for Massive Medicaid Cuts Through Block Grants

A plan to fundamentally change the way the federal government funds Medicaid — which could lead to hundreds of billions in cuts — may be back on the table after seemingly dying two years ago. The Trump administration is currently mulling ways to convert Medicaid to a block-grant system, Politico reported late last week, reviving […]

CMS Implements Stricter Nursing Home Staffing Survey Rules for States

The Centers for Medicare & Medicaid Services (CMS) announced Friday that it will use payroll-based journal (PBJ) data to bolster state oversight of nursing homes, effective immediately. Specifically, CMS will use PBJ data to identify and provide state survey agencies with a list of nursing homes that have several days in a quarter without a registered […]

‘Granny Cams’ Represent Legal Minefield for Skilled Nursing Operators

For families of nursing facility residents, being able to remotely monitor their loved ones can bring peace of mind during a difficult period. But for skilled nursing operators, families installing cameras in sensitive areas can open the door to a variety of legal problems — including the violation of federal wiretapping laws. Only 11 states […]

Top Tips for Skilled Nursing Providers to Win Under the New CMS Rules

The Patient-Driven Payment Model (PDPM) has gobbled up most of the recent headlines in the skilled nursing industry regarding new regulations, but there’s another set of rules that providers shouldn’t forget about. The industry remains in the thick of the new Requirements of Participation, which the Centers for Medicare & Medicaid Services (CMS) will finish […]

In-House Health Plans Provide Path Out of Managed Care Pain for Operators

As the long-term health care industry moves into a value-based payment world, a special type of Medicare Advantage plan could offer skilled nursing providers a path to get ahead. In fact, institutional special needs plans (I-SNPs) could be the future for skilled nursing facilities battered by the changes in reimbursement, the move to value-based models […]

Medicaid Cuts, Regulatory Reform Loom Over Skilled Nursing Ahead of Elections

The skilled nursing industry dodged a bullet in 2017 when comprehensive Medicaid reform failed, but key industry leaders warn that the outcome of the fall elections could revive the $800 billion threat to SNFs’ bottom lines. Should Republicans hold onto their control of Congress in the upcoming midterms, leaders may take another run at Medicaid […]

AHCA Teams with PHI, Launches Long-Term Care Workforce Center

Two of the biggest names in long-term care advocacy have teamed up to create a new online workforce center aimed at curbing persistent staffing pressures at skilled nursing and senior housing facilities. The American Health Care Association (AHCA), in conjunction with the Paraprofessional Healthcare Institute (PHI), on Monday launched the Workforce Resource Center, a website […]