Skilled Nursing Operators See Disaster Ahead As CMS Takes Aim at Medicaid-Boosting Provider Taxes

The federal government has proposed a rule governing the use of Medicaid supplemental payments for nursing homes that could have drastic effects on the reimbursement they receive. But the ripples of the rule don’t stop there. They could also overhaul the taxes that providers pay in several states — taxes that in turn contribute to […]

As Providers Warn of ‘Broad Negative Impact,’ CMS Extends Comment Period on Medicaid Supplement Crackdown

The federal government extended the deadline for providers — both acute and post-acute — to comment on a proposed rule that would crack down on supplemental payment programs under Medicaid. The new deadline is February 1, pushed back about two weeks from the original end date of January 17. The Centers for Medicare & Medicaid […]

MedPAC Commissioner: Underfunding Turns Medicaid-Heavy SNFs into ‘7th Circle of Hell’

The Medicare Payment Advisory Commission (MedPAC) once again advised that Medicare’s payments for skilled nursing facilities are too high — but also acknowledged the challenges for providers caused by low Medicaid reimbursement. A presentation by Dr. Carol Carter delivered to MedPAC on December 5 examined Medicare margins for SNFs amid the larger contexts of beneficiary […]

Rapid Medicare Advantage Expansion into Home Health, Senior Living Could Accelerate Pressures on Skilled Nursing

When the Centers for Medicare & Medicaid Services (CMS) moved to allow Medicare Advantage plans to cover more options for care at home, skilled nursing providers could be forgiven for not paying much attention. It’s a move with more immediate impact to home care and home health companies, as well as senior living providers. Medicare […]

Federal Lawmakers Resurrect Nursing Home Arbitration Ban with Proposed Bill

Two Congressional representatives introduced a bill on Thursday that would ban nursing homes from requiring — or even asking — residents to enter into mandatory, pre-dispute, binding arbitration agreements. The Fairness in Nursing Home Arbitration Act, introduced by Democratic Reps. Linda Sánchez of California and Jan Schakowsky of Illinois, has support from a range of […]

I-SNP Case Studies Show Promise in Era Where Fee-for-Service Medicare Looks Unsustainable

Despite the challenges, skilled nursing facilities have succeeded at setting up their own specialty Medicare Advantage plans — and the strategy represents a key potential weapon amid the rise of alternative payment models. Institutional Special Needs Plans (I-SNPs) remain a small part of the overall Medicare Advantage landscape, according to a panel discussion at the […]

Less Than 5% of Nursing Homes Receive Abuse Icon — But Financial Impacts Could Be Coming

As the federal government predicted, just under 5% of the nation’s nursing facilities received a new abuse warning icon on the consumer-facing Nursing Home Compare website — but the early data also reveals significant regional variations that could have an impact on valuations and bottom lines moving forward. Out of 15,262 total facilities, just 760 […]

Verma: New Abuse Warning Icon ‘Isn’t Really Going to Impact Very Many Nursing Homes’

Despite widespread anger in the skilled nursing industry, a controversial new warning icon for facilities with previous reports of abuse and neglect will affect only a relatively small proportion of properties, Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma told lawmakers in Washington on Wednesday. Testifying before the House Committee on Energy & […]

By Targeting Skilled Nursing Ownership Transfers, States Look to Prevent More Skyline-Style Implosions

The swift expansion and equally rapid flameout of one skilled nursing provider left its mark on several states in the form of sudden state takeovers, drawn-out receiverships, and several closures. That company — Skyline Healthcare — may also leave a more lasting legacy in the form of stricter vetting of new operators in multiple states. […]

Providers, CMS Must ‘Band Together’ to Improve Skilled Nursing Care for Behavioral, Mental Health Patients

In a health care landscape full of challenges, staffing consistently ranks as the top concern for skilled nursing facilities. But the second-most prevalent concern is patients and residents who have mental health needs and substance use disorders, according to a top federal official — and there are no easy answers for how SNFs should cope. […]

Therapy Cuts Were ‘Inevitable’ Under PDPM — and Providers Must Prepare for Possible Payment Drops

Reports of therapist layoffs and cuts in therapy hours hit the news within days of the implementation of the new Medicare reimbursement system for skilled nursing facilities, sending shock waves throughout the rehab provider community. But according to one major skilled nursing trade group, the cuts to therapy were baked into the system of the […]

Therapy’s PDPM Paradox: Clinicians Have More Control, But Smaller Rehab Staffs Needed for Now

The new Medicare payment model for nursing homes took effect this week with a bang, as therapists across the nation criticized a wave of staffing reductions in the immediate wake of the October 1 start date. Several companies implemented workforce cuts as the federal government shifted to the Patient-Driven Payment Model (PDPM), which moves incentives […]

It’s Here: Skilled Nursing Providers, Investors Weigh in on PDPM Opportunities, ‘Stumbling Blocks’

The long wait is over: The new Medicare payment system for nursing homes has arrived. October 1 marks the official start of the Patient-Driven Payment Model (PDPM), just about 18 months after the federal government first announced the change in April 2018. Since then, the skilled nursing industry has trained a laser focus on preparations […]

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 […]