AI Use by Medicare Advantage Blamed for Increased Denial of Nursing Home Services

Over-reliance on artificial intelligence is compromising post-acute care for nursing home residents on Medicare Advantage plans. This view of the problematic use of algorithms for prior authorizations – and denial based on incorrect assessment of patient needs – is at the center of reporting and analysis published in the health, medicine and life sciences publication, […]

The Future of Labor Activism in Nursing Homes

Despite the nursing home industry being in the grips of a staffing crisis – with more leverage in the hands of direct care workers – unionization in the space hasn’t taken off across the country like many were expecting. Instead, national unionization in the sector slowly increased from just under 10% in 2010 to 16.8% […]

‘Stop Blaming Nursing Homes’: Biden’s Proposed Reforms Garner Mixed Reactions

The Biden administration’s announcement of expansive nursing home reform on Monday elicited varied responses from industry trade groups and advocacy organizations. Groups representing skilled nursing providers expressed particular concern that the reforms would impose stricter expectations without providing the needed resources to meet new mandates related to staffing minimums and other proposed requirements. The reforms, […]

Nursing Home Visitation Policies Tighten in Some States Amid COVID Resurgence

With omicron surging, some states have reimposed stricter nursing home visitation policies to better protect the residents in these communities. Rhode Island, California and New York are among the states to do so. Governor Dan McKee and the Rhode Island Department of Health announced new regulations this week that require visitors at nursing homes and […]

SNFs Seeing More Fines From CMS, But Penalties Are Less Costly

Although the Centers for Medicare & Medicaid Services (CMS) has backed off high-dollar civil monetary penalties (CMPs) in recent years, a trend that was heavily criticized by the AARP Foundation earlier this year, new research indicates that CMPs are picking back up. Fines collected through per-incident penalties increased more than eight-fold from 2016 to 2020 […]

Advocates Push Back on Geography as Driver of Nursing Home Outbreaks — and Detail Drastic Measures for Keeping COVID at Bay

COVID-19 outbreaks in skilled nursing facilities are affected by more than geography, and nursing home operators have tools and actions they can take to mitigate the spread of the virus in their facilities, the Center for Medicare Advocacy (CMA) argued in a report released on Thursday. “Since the start of the pandemic, one of the […]

Scrutiny of HUD-Backed Loans to Nursing Homes Increases Amid COVID-19

A federal lending program for nursing homes and other senior care facilities is once again under the microscope, with Barron’s reporting last week that Washington has backed financing for “dozens of poorly run nursing homes.” The U.S. Department of Housing and Urban Development (HUD)’s Section 232 programSection 232 provides mortgage insurance for long-term care facilities, […]

As CMS Cracks Down on Nursing Home Testing, Questions Remain on Logistics: ‘You Cannot Fine Your Way Out of a Pandemic’

The federal government last week cracked down on COVID-19 testing in nursing homes, with a host of new fines exceeding $8,000 per instance, but some industry leaders — and a prominent geriatrician — have raised concerns about whether providers can meet the new benchmarks, or whether the plan will have the intended effects. “You cannot […]

CMS Cites 2% of Nursing Homes, Fines Less than 1% in Infection Control Push — With Average CMP of $76K

The most recent set of targeted infection control surveys at nursing homes, conducted in the wake of COVID-19 outbreaks, resulted in only a small proportion of deficiency citations for nursing homes, according to a new analysis released Thursday. Just about 2.4% of the 4,175 new surveys reported as of June 24 included nursing homes for […]

Weighing the Promise and Perils of Skilled Nursing Ventilator Care Under PDPM

Among the many unknowns of the new Patient-Driven Payment Model (PDPM) is its effect on the types of patients coming into the skilled nursing facility. But one place to watch resident patterns is around the addition of ventilator services and care to facilities — especially if they haven’t offered those options before. Respiratory therapy — along with […]

Resident Advocate: Nursing Home Fines Must Increase to Improve Care, Prevent Harm

Between a new Medicare payment model and increased scrutiny on nursing home safety from the federal government, 2019 may go down as a watershed year for skilled nursing regulations. But at least one patient advocate says the government — particularly under the Trump administration — hasn’t gone far enough. Toby Edelman, a senior policy attorney […]

In The End, Even The Middle Class Would Feel GOP Cuts To Nursing Home Care

Skilled Nursing News Take: On the same day that Kaiser Health News published this story, American Health Care Association President and CEO Mark Parkinson estimated that the Senate’s health reform bill would ultimately cost individual SNFs $600,000 annually. This KHN story suggests what that might look like—compromising care for people like Alice Jacobs while forcing providers like Dogwood […]