‘Rays of Sunshine’: Nursing Home Staffing Shortages Loom Large in Hospital Discharge Crisis, but Solutions Exist

The crisis involving patients languishing at hospitals awaiting discharge into appropriate post-acute care settings has shown little signs of abating. The root causes of these discharge delays are manifold, but chief among them are workforce shortages at nursing homes. According to experts at a webinar hosted by ATI, the discharge crisis is amplified by a […]

TEAM Model: Hospitals in the Driver’s Seat, Nursing Homes as ‘Collaborators’ in Latest Bundled Payment Initiative

The Centers for Medicare & Medicaid Services’ (CMS) in April released a bundled payment model that is the culmination of the best aspects from such past models, all to align with the agency’s efforts to get all Medicare Fee-for-Service beneficiaries involved in value-based care by 2030. The Transforming Episode Accountability Model, or TEAM, is considered […]

Medicare Advantage Growth Could Normalize, but Nursing Home Leaders Call for Rate Floor and Other Changes

While Medicare Advantage (MA) has grown steadily in the last several years, leaders in the nursing home sector speculate whether increased federal regulation – and perhaps even more importantly, changes in the consumer experience – will slow its growth. This would come as a welcome development to many nursing home leaders, who have been struggling […]

CMS Value-Based Purchasing Proposals Draw Nursing Home Pushback, But ‘Stability is Welcome’

The Centers for Medicare & Medicaid Services’ (CMS) recently proposed Value-Based Purchasing Program updates include staffing provisions that are being met with provider concern, although other updates should be well received once the dust settles. Among recommended changes, CMS is proposing allowing SNFs to review and correct Payroll-Based Journal (PBJ) data beginning with the fiscal […]

‘Gobbled Up’: CMS Medicare Increase for Nursing Homes Fails to Price in Dire Economic Environment, Costly Regulation

The federal government’s proposed Medicare payment increase for 2025 is not sitting well with the nursing home sector, with financial experts and operators raising concerns that the bump fails to compensate for inflation-induced operating costs – and a staffing proposal anticipated to cost in the billions each year. For some experts, the Centers for Medicare […]

‘Elephant in the Room’: Medicare Advantage a Huge Factor in CCRC Decision Making Around Nursing Home Services

Soaring costs associated with skilled nursing – and problematic payer sources – are making it harder for continuing care retirement communities (CCRCs) to provide such labor intensive post-acute care. CCRCs have to ask themselves some hard questions when it comes to what services they can reasonably offer, and if it’s worth it to keep open […]

In Positive Move for Nursing Homes, CMS’ Prior Auth Rule Cracks Down Further on Medicare Advantage Plans

Piece by piece, nursing home operators are seeing stricter government oversight of Medicare Advantage (MA) plans, a welcome relief given that partnerships with such managed care plans have become a huge source of administrative burden for providers in the sector, especially as workforce shortages persist. Most recently, the Centers for Medicare & Medicaid Services (CMS) […]

Inside the CMS Policies That Could Improve Care, Payments for Dual-Eligible Nursing Home Residents

Given that a vast majority of long-stay nursing home residents are dual eligible for Medicare and Medicaid, residents and facilities alike can reap financial benefits while improving quality of care and reducing administrative burdens if federal and state policies better enabled a value-based care model that integrated the experiences of dual eligibles. This is the […]

When Disparities and Differences in Resources Abound, Medicaid Acts as Stopgap

The need for Medicaid as stopgap coverage for long-term care is more apparent when looking at differences in race, gender and ethnicity, and rural versus urban status of the residents. This is according to an analysis conducted by ATI Advisory, which identified the impact of disparities and differences in resources – finances, insurance and social […]

Insights on Exposing, Resolving Chronic Underfunding of Nursing Homes

As nursing homes grapple with a tough economic and labor environment – which has forced closures and created access issues – patient and nursing home advocates underscored the emotional toll of care, calling upon the federal and state governments to do more to address new and emerging generational challenges to care. Anne Tumlinson, founder of […]

While More is Needed, Operators are ‘Generally Pleased’ With 4% Increase in SNF Final Rule

Nursing home operators had a mixed reaction to the Centers for Medicare & Medicaid Services (CMS) final payment rule for 2024. While some operators said that they were generally appreciative of the 4% increase in Medicare reimbursement, they are also calling for more help and understanding from federal agencies in tackling the workforce crisis – […]

Skilled Nursing Vs. Home Health: Referral Trends Shift Due to Acuity, Staffing Shortages, Regulation

After years in which Medicare policy and Covid-19 drove more hospital referrals to home health, skilled nursing facilities recently have seen referrals surge, thanks to a variety of factors. Referral trends through January 2023 showed a jump in patients sent to the nursing home while at the same time rejection rates for home health agency […]

Congress, States, CMS Urged to Ensure Nursing Facility Medicaid Rates Cover Care Costs

A Congressional advisory body on Wednesday put forth recommendations for closer assessment of nursing facility Medicaid payments, including whether they are sufficient to cover costs of care. The proposals could allow for a finer tuning of Medicaid rates and therefore could benefit the sector, as long as they do not put greater administrative costs and […]

CMS Data Shows SNFs a ‘Good Landing Spot’ For Less Acute Patients, Emboldens Calls for Ending 3-Day Stay Rule

As nursing home advocates continue to push for ending the 3-day hospital stay requirement, a recently released federal agency report on the use of these waivers by accountable care organizations (ACOs) showcases some of the benefits that they have brought to patients and providers. Use of waivers by ACOs for a 3-day stay did not […]

Skilled Nursing Operators Protest ‘Insane Amount’ of Administration Needed as Medicare Advantage Expands

As the federal government pushes to get more beneficiaries on managed care, nursing home providers say the administrative burden associated with such clients is “extraordinary.” That’s according to Kim Majick, chief development officer at Carespring Health Care Management. A heavier administrative lift is set against a backdrop of dire staffing shortages, along with staffing minimum […]