Top and Bottom States for Nursing Home Sector Dealmaking in 2025: A Regional Breakdown

Sufficient reimbursement, less regulation and adequate staffing are all attractive features for dealmaking, impacting operator decisions on which states and regions offer the path of least resistance when it comes to expanding their footprint. It may boil down to price per bed and the ease of the change of ownership (CHOW) process when determining desirability […]

Even With Extension, Nursing Homes Concerned CMS Medicare Revalidation Will Be Burdensome, Confusing, Pull Resources Away from the Bedside

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 […]

Nursing Homes Cautiously Optimistic Post-Election, Reflecting on ‘Industry Friendly’ CMS Under Previous Trump Admin

Finance and operator voices alike are cautiously optimistic about prospects for the nursing home sector as the Trump administration prepares to enter the White House in January, alongside a Republican majority in the U.S. Senate that has historically been sympathetic to nursing home issues. When it comes to the federal minimum staffing mandate, Cascadia Healthcare’s […]

SCOTUS Decision Sets Stage for Nursing Homes to Challenge Civil Monetary Penalties but Such Litigation Is Likely Too Costly

The U.S. Supreme Court’s June decision regarding civil monetary penalties (CMPs), which allows defendants the right to present their case to a federal jury when a federal agency is seeking financial penalties, may seem like a win for nursing homes at first glance. However, many providers are unlikely to pursue this path. The CMP decision […]

Cascadia, Diversicare CEOs: The Greater ‘War’ Is Over Rooting Out Nursing Home Labor Problems, Not Just the Staffing Mandate

The timing and feasibility of the federal staffing mandate continue to haunt nursing home operators and communities, particularly those in rural areas, where providers across the health care continuum are competing to find clinical staff. Take for example, the case of a nursing home owned by Diversicare Healthcare Services in Yorktown, Texas, which is one […]

‘Can’t Be On Your Game’: Inside Nursing Home Staff Turnover’s Domino Effect on Surveys and Acquisitions of Distressed Facilities

An ongoing depletion of knowledgeable nursing staff at nursing homes, such as the Minimum Data Set (MDS) coordinators, is leading to errors and confusion with facility surveys and ratings. This, in turn, is impacting operations and the ability to acquire and improve distressed facilities. A high turnover among those close to the survey process is […]

Chevron Fallout Could Create ‘Regulatory Flux’ for Nursing Home Sector

While hopeful that the Supreme Court’s recent Chevron decision will undermine the federal staffing mandate and lead to a more rational regulatory environment, leaders in the nursing home sector also are warning that the ruling could create a period of uncertainty and tumult. Steve LaForte, director of corporate affairs and general counsel for Idaho-based Cascadia […]

‘The Poor Get Poorer’: Why State Relationships, Collaboration with CMS Is Needed to Mitigate Nursing Home Survey Risk

In an era when surveys – and delay in surveys – have been the cause for much stress among nursing home operators, a sometimes undervalued and overlooked strategy to minimize survey risk involves operators developing strong relationships with their state survey agencies. That’s certainly an easier task compared to getting approval from national agencies like […]

Cascadia and Brickyard Execs: Cybersecurity Shaky, Insurance Premiums Sky High as Nursing Home Risks Abound

As regulatory, operational and legal risks abound for nursing home operators, strong relationships with commercial insurance carriers and brokers continue to be key in countering costs. Operators facing higher insurance premiums and greater administrative burdens have turned to using strong commercial insurance risk management companies as well as data-driven solutions that factor in the new […]

‘A Very Large Task’: CMS’ Facility Assessment Arduous For Some Nursing Homes Amid Cost Pressures, Staffing Shortages

The new facility assessment requirements that federal agencies are expecting will guide decisions on staffing levels are also garnering concerns about potential administrative and financial burdens, particularly for smaller-sized nursing home chains. The Centers for Medicare & Medicaid Services (CMS) modified the existing requirements in late June, issuing expanded guidance to include metrics that are […]

Nursing Home Operators Optimistic About CMS Survey Testing, But Devil Lies in the Details

Potential changes to the nursing home survey process being mulled over by federal authorities – and aimed at standardization across states – have many operators feeling optimistic for the years ahead, especially given that regional differences in implementation can lead to extra administrative burdens and survey backlogs. Toward the end of 2023, the Centers for […]

DOL’s Final Rule on Worker Classification To Increase Legal Woes, Administrative Burdens for Nursing Homes

Many skilled nursing operators will need to reclassify their existing relationships with independent contractors and rethink future ones in the wake of a final rule issued by the Department of Labor (DOL) on Tuesday. The DOL’s new rule revises guidance on how to determine who is an employee and who is an independent contractor under […]

Inside the Balancing Act of Personal Technology Use Among Nursing Home Staff

Managing personal technology devices is a common concern among staff at businesses across the nation, and nursing homes are no exception. While policies for personal technology use at nursing home organizations run the gamut – from completely restricting cell phone use to limited use to even encouraging use among employees – nursing homes have had […]

Minimizing Risk for Nursing Home Operators Means Fostering Culture, Enabling Robust Compliance

As operators mull problems on staying up to date with new or upcoming rules, legal and compliance executives believe that the federal government’s staffing proposal and focus on healthcare fraud prosecution are among the top challenges facing the sector. Speaking at Skilled Nursing News’ Risk Summit, leaders from Cascadia Healthcare and American Senior Communities, discussed […]

Expect ‘Skeletons’: With Mom-and-Pops at Breaking Point, Nursing Home Chains Hone Acquisition Practices

While financial pressures have created challenges and precipitated closures for smaller mom-and-pop nursing homes, the trend has also meant opportunities for those looking to acquire and add scale. Operators who have recently acquired mom-and-pop or small facilities say the most important consideration when expanding a portfolio with mom-and-pops is getting to know the culture of […]

The Delicate Dance of Temp Agency Regulation: 1099 Worker Classification, Wage Caps at Issue in Tight Labor Market

As government entities and organizations in the nursing home space are scrambling for policy changes to regulate staffing agencies, they seem to be prioritizing legislation that addresses price gouging while worker classification also remains on the table. The Protecting the Right to Organize Act (PRO Act) introduced in Congress in 2021 and currently being examined […]

Success Stories, Medicare Advantage Trends Drive I-SNP Growth in Nursing Home Sector

With the end of the public health emergency, industry stakeholders said the development of Institutional Special Needs Plans (I-SNPs) are of more interest to skilled nursing operators than ever before. Mark Price, Chief Executive Officer of Curana Health, said the interest level in I-SNPs has significantly increased in the past few months. “With the end […]

PDPM is a Start, But Rising Acuity at Nursing Homes Demands Building New Payment Models for Adequate Reimbursement 

As acuity continues to rise among nursing home residents, providers say reimbursement needs to change too – and not just the dollar amount. Incentives should be based on quality of care, and the industry will need to build out specific reimbursement models to match expanded acuity specialities, especially as value-based care becomes more and more […]