Skilled Nursing Operators Shouldn’t Count on Investors to Share PDPM Optimism

With just two weeks to go before the new payment model for nursing homes takes effect, operators that have prepared for the changes could be expecting a significant boost in their Medicare reimbursements. But providers shouldn’t necessarily expect their investors to share in their optimism over the Patient-Driven Payment Model (PDPM). Over the course of […]

Why Skilled Nursing Operators Can’t Bank on ‘Silver Tsunami’ — or One Good Month Under PDPM — for Relief

As the post-acute and long-term health care industry struggles through shortened lengths of stay and compressed reimbursements, an oasis has lingered just beyond the horizon: the so-called silver tsunami. If operators can wait out the current downturn, the thinking goes, the glut of baby boomers turning 80 and older over the coming years will be […]

AHCA: CMS Already Has Authority to Simplify Three-Day Stay Rule for Nursing Home Coverage

The leading national trade group representing for-profit skilled nursing facilities this week called on the federal government to streamline its policy on Medicare eligibility for nursing home care, arguing that officials already have the legal authority to do so. American Health Care Association president and CEO Mark Parkinson formally asked Centers for Medicare & Medicaid […]

Abuse Reporting and Owner Background Checks Loom Large in Elder Justice Hearing

Background checks for staff and better reporting for nursing home abuse loomed large in a U.S. Senate Committee on Finance hearing held Tuesday, with consumer advocates and industry representatives confirming the findings of a new report that revealed oversight gaps by the Centers for Medicare & Medicaid Services (CMS) around nursing home abuse. The report, […]

Legislators React to SNF Arbitration Ban Reversal: ‘New Rule Does Not Put Patients First’

The Centers for Medicare & Medicaid Services overturned a ban on skilled nursing operators using pre-dispute arbitration agreements with their residents in a final rule issued July 16, and a range of lawmakers reacted throughout the week. The ban on arbitration agreements in long-term care was implemented by the Obama administration in 2016, to strong […]

Rethink Podcast #11: AHCA President and CEO Mark Parkinson

The 11th episode of our podcast, Rethink, is now available! Between the release of a “secret” list of underperforming nursing homes and multiple hearings on Capitol Hill, the skilled nursing industry has found itself under the regulatory and media microscope for most of 2019.And for the most part, Mark Parkinson thinks that’s a good thing.The […]

Parkinson: Releasing ‘Secret’ List Positive for Industry, But Nursing Homes Must Evolve — or Become a Commodity

The release of a so-called “secret” list of nursing homes considered for inclusion in a program for the nation’s worst properties sent shockwaves through the industry early last month — but the man in charge of the for-profit space’s primary trade group says the sunshine is ultimately a good thing for operators. As the skilled […]

OIG Calls on CMS to Crack Down on Abuse in Nursing Homes, Other Settings

The federal government’s top health care watchdog on Wednesday released a new report accusing the Centers for Medicare & Medicaid Services (CMS) of not doing enough to monitor and punish elder abuse in nursing homes and other settings. The Department of Health and Human Services (HHS) determined that CMS could perform detailed analyses of diagnosis […]

CMS Could Release Monthly List of Special Focus Candidates After Senators’ Report

Federal officials could soon begin releasing a previously undisclosed list of underperforming nursing homes targeted for potential inclusion in the Special Focus Facility program, SNN has learned. The Centers for Medicare & Medicaid Services’ (CMS) roster of “candidates” for Special Focus Facility status became public on Monday, when a bipartisan pair of senators released the […]

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 […]