AHCA’s Parkinson: COVID-19 ‘Almost a Perfect Killing Machine’ for Elderly

The leader of the nation’s largest organization of post-acute and long-term care facilities didn’t mince words about the dangers of the novel coronavirus during a nationally televised interview. The mortality rate for the 84-and-older population that makes up the vast majority of nursing home residents is well north of 15%, American Health Care Association (AHCA) […]

‘CMS Loves That’: Moderate Therapy Shifts, Bureaucratic Reality Could Slow PDPM Changes

Despite steady reports of increasing reimbursements under the new Medicare payment model for nursing homes, at least one industry leader believes that the federal government will be happy with the early returns — and that any changes are fairly far down the road. Skilled nursing operators have not gone overboard with the strategy changes that […]

Verma Strikes Back on MFAR: Worries Over Billions in Medicaid Cuts ‘Alarmist’ and ‘Overblown’

The head of the Centers for Medicare & Medicaid Services (CMS) on Wednesday issued a strong defense of a proposed rule that nursing home advocates claim would place up to $50 billion in Medicaid reimbursements in immediate jeopardy, framing the move as a necessary step toward reducing fraud and waste. The Medicaid Fiscal Accountability Regulation […]

‘Pendulum Swung Too Far’: Therapists Raise Concerns Over Layoffs, Clinical Changes Under PDPM

It’s four months into the Patient-Driven Payment Model (PDPM), and despite some industry analysts pointing to early gains for nursing homes, many occupational, speech, and physical therapy advocates continue to criticize layoffs and changes to resident care patterns. On the operational side, the initial PDPM returns have been positive: For instance, 67% of nursing homes […]

Winners Still Outnumber Losers in Latest PDPM Analysis, But Length of Stay Trends Could Erase Rate Gains

The latest analysis of the new Medicare payment model for nursing homes again shows more operators scoring gains than suffering losses, but the change from the previous system may not be quite as straightforward — particularly as fee-for-service Medicare continues to lose ground to other payment sources. A little more than 67% of skilled nursing […]

Tips for Early PDPM Success: Demand More Data from Hospitals, Market Higher-Acuity Services

The early returns for the new Medicare nursing home payment model have been positive, but providers aren’t seeing gains by sitting back and watching the changes. Several key strategies for success have emerged in the Patient-Driven Payment Model’s first four months, with a particular focus on data — as well as clearly communicating the availability […]

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. […]