The nursing home sector in 2026 will be defined by rapid change, leaders said, as payment constraints, workforce shortages and rising expectations from the public and government entities converge. All the while, operators brace for Medicaid uncertainty and Medicare Advantage growth. Shortened retroactive eligibility periods and potential state-level cuts to Medicaid programs may further contribute […]
The skilled nursing sector experienced a turbulent and transformative 2025, shaped by sweeping deregulation efforts, intensifying financial and policy pressures as well as volatile reimbursement dynamics. Meanwhile, rising M&A activity and renewed scrutiny of private equity ownership dominated markets and financial chatter. At the beginning of the year, the Trump administration’s approach to deregulation was […]
The Centers for Medicare and Medicaid Services (CMS) is set to indefinitely suspend its mandatory off-cycle skilled nursing facility provider enrollment validation, which had a deadline of Jan. 1, 2026. Associations including the American Health Care Association and National Centers for Assisted Living (AHCA/NCAL) have long asked for relief from the revalidation process, given the […]
The federal government shutdown that began on Oct. 1 is likely to cause minimal disruption to nursing home operations, but surveyors will be adhering to contingency plans and providers are concerned about reduced telehealth access. “Seniors, their loved ones, and their caregivers can rest easy that their long term and postacute care will be minimally […]
Physiatry is becoming a cornerstone of skilled nursing care in the midst of a push toward value-based reimbursement in Medicare and Medicaid. Its integration into care teams has helped improve outcomes while reducing costly hospitalizations, industry leaders said. The rise of patient acuity has been a huge driver in the evolution of physiatry in nursing […]
Proposed Medicaid cuts are spurring widespread concern among nursing home providers, as reductions would severely impact care quality, staffing, and facility operations. Activity on the Hill and a new report puts the spotlight on potential impact to stakeholders. About 92% of providers are concerned about further Medicaid cuts, according to a May report from the […]
Nursing home stakeholders remain cautiously optimistic regarding Medicare Advantage plan audits announced by the Centers for Medicare and Medicaid Services (CMS) last month, but many hope the agency will extend the same scrutiny to prior authorizations, AI usage and internal coverage criteria. Operators are unlikely to face reimbursement cuts as a result of the audits, […]
The current nursing home market has its share of positives and negatives midway through 2025, with operators enjoying Medicare and Medicaid reimbursement increases as well as a decline in facility supply, creating higher competition among buyers. Buyers are being more aggressive in the acquisition process, he said, with fewer facilities available. Brokerage firms are seeing […]
Cost-cutting measures in nursing homes, particularly food budgets, have been a concerning underlying issue in the industry, with more than a quarter of facilities in the country spending under $10 per day on food per resident. An investigative report by NJ Advance Media, in collaboration with Rutgers University and data experts at SNFdata Resources of […]
Congress may cut Medicaid provider taxes for nursing homes as a part of budget reconciliation, significantly impacting the sector as many providers rely on this avenue of reimbursement for crucial services and resident resources. These taxes are a key funding tool: providers pay a fee, matched by federal dollars, to support state Medicaid programs. But […]
The Centers for Medicare & Medicaid Services (CMS) has delayed nursing home survey changes for another month, with implementation now to begin April 28 rather than March 24. Associations and providers alike are glad they’re being given more time to prepare, educate and test procedures. CMS said the delay “allows ample time” for both surveyors […]
Just days ago officials with the newly formed Department of Government Efficiency (DOGE) were granted access to agency systems and technology at the Centers for Medicare & Medicaid Services (CMS), but it’s unclear how the department plans to use such findings, or what sort of impact it would have on nursing homes. Nursing home associations […]
Days after the Trump administration issued an executive order to freeze federal aid, it has been rescinded. The order affected Medicaid funding, with at least 20 states on Tuesday unable to draw funds. More than six out of 10 nursing home residents rely on Medicaid to cover their daily care; it’s a critical safety net […]
The newly installed Trump administration late Tuesday prompted federal health agencies, including the Centers for Medicare & Medicaid Services (CMS), to pause external communications through Feb. 1. That includes regular scientific reports, updates to websites and health advisories – communication that those in the nursing home industry regularly rely upon. Nursing home associations including the […]
While 2025 remains a bit uncertain due to the federal staffing mandate and a new White House administration, leaders in the nursing home industry plan to continue working toward improving quality of care, addressing workforce challenges and advocating for fair regulation and reimbursements. Clif Porter, president and CEO of the American Health Care Association/National Center […]
The American Health Care Association, LeadingAge and other nursing home stakeholders involved in the lawsuit against the federal minimum staffing mandate filed their final argument against the rule late on Friday, asking a federal judge to deny the federal agency’s cross-motion for summary judgement. Given that a judgement is expected early in the new year, […]
The nursing home industry has been on a wild ride this past year, with major regulation up in the air and a flip in the White House leaving operators unsure of whether they should applaud or brace for impact. Rhetoric surrounding the federal minimum staffing mandate has changed drastically throughout the year, with leaders condemning […]
Federal agencies are honing in on ownership transparency and corporate-level compliance, most recently with the Office of Inspector General (OIG) citing concerns about certain practices that allow nursing homes to hide profits. OIG’s latest guidance focuses on the practice of “tunneling,” which refers to the misrepresentation or concealment of profitability in payments to related parties, […]
Surveyors will be evaluating for compliance in new ways, as a result of nursing home survey changes for 2025. While significant, these changes reflect federal initiatives that associations and operators have been seeing for some time now. Nursing home providers are parsing through recent, significant changes to the survey process and trying to grasp the […]
Uncertainty surrounding the information required for the new nursing home Medicare revalidation process has led to high levels of concern, particularly among for-profit operators, who view it as yet another punitive measure. Following letters from nursing home advocates about the rushed timing of the off-cycle revalidations, the Centers for Medicare & Medicaid Services (CMS) has […]
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