New Wave of ‘One-Sided’ Managed Care Contracts Could Lead to Payment Strains for Nursing Homes

Some aspects of the nursing home world do not change even during a global pandemic, and that includes the need to manage relationships with multiple payers. Several managed care organizations (MCOs) are now sending in their new contracts to skilled nursing providers as old agreements expire, Chad Bogar, the founder and CEO of the law […]

Former CMS Chief: Feds Must Reimagine Nursing Home Enforcement with Sharper Sticks — and Smarter Carrots

The discussion of how to improve nursing homes, especially in the wake of the still-unfolding COVID-19 tragedy, tends to divide observers into two broad camps: the industry partisans who call for more collaboration from the federal government and better funding, and the sharp critics who insist regulation should primarily — if not exclusively — take […]

CMS to Retire Old Nursing Home Compare Site on December 1

The end is near for the older version of the federal government’s primary consumer-focused nursing home resource. The Centers for Medicare & Medicaid Services (CMS) will formally phase out its eight original Compare tools — including Nursing Home Compare — on December 1 in favor of its new unified Care Compare site. CMS unveiled the […]

OIG to Probe Improper Nursing Home Discharges, Evictions

The federal government’s top health care watchdog last week announced a plan to investigate whether nursing homes are following rules around discharges, specifically citing media reports about improper evictions from facilities. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) added a probe of facility-initiated discharges to its formal work […]

CMS, Medicare to Cover COVID-19 Antibody Drug in Nursing Homes

The federal government this week announced that Medicare will cover a recently approved antibody treatment for COVID-19 in a range of settings, including nursing homes. The Food and Drug Administration on Monday cleared on an emergency basis the use of bamlanivimab — a monoclonial antibody infusion — for adults with mild to moderate cases of COVID-19. […]

Verma: COVID-19 Shows LTC ‘Relies Too Heavily on Nursing Homes’

The nation’s top Medicare and Medicaid official this week called on states to boost their home- and community-based services for the elderly, arguing that the impact of COVID-19 on nursing homes has exposed a key flaw in the overall system. “The COVID-19 crisis has shone a harsh light on the human costs of a long-term […]

Verma Pushes Back on Criticism of CMS Response to Life Care COVID Outbreak: ‘Our Inspection Was Critical’

The nation’s top Medicare official took to Twitter to respond to a mainstream news report critical of the federal government’s handling of the first major COVID-19 outbreak at a skilled nursing facility. “60 Minutes” this past Sunday profiled that outbreak — which devastated a Life Care Centers of America facility in the Seattle suburb of […]

CMS to Relax Medicare Billing Rules to Speed COVID-19 Vaccine Distribution in Nursing Homes

The federal government on Friday announced its intention to relax restrictions around billing Medicare for immunization in nursing homes, with the stated goal of speeding the eventual distribution of a COVID-19 vaccine. Skilled nursing facilities are typically required to bill Medicare directly for immunizations under the terms of the Social Security Act, even if the […]

Verma: Alternative Payment Model Performance ‘Deeply Concerning,’ More Mandatory Programs Ahead

The nation’s top Medicare official this week expressed serious disappointment in the performance of alternative Medicare payment models, citing key design flaws and promising more mandatory programs to come. The Centers for Medicare & Medicaid Services (CMS) recently completed an analysis of several early attempts at value-based payment structures, with administrator Seema Verma disappointed in […]

HHS Warns Against Using Antigen Results for Nursing Home Cohorting, But Sharply Criticizes State Ban

A top U.S. coronavirus testing czar had harsh words for a Nevada directive banning the use of antigen point-of-care COVID-19 tests in skilled nursing facilities during a press call on Friday, calling it “an uninformed and unlawful unilateral prohibition.” But Department of Health and Human Services (HHS) assistant secretary for health Adm. Brett Giroir also […]

CMS Clarifies Quality Reporting Rules After COVID Pause, Nursing Home Compare Frozen Until ’22

The federal government waived several reporting requirements for nursing homes during the COVID-19 pandemic, and while they have since been reinstated, the temporary pause will continue to have ripple effects on public data over the coming years. The Centers for Medicare & Medicaid Services (CMS) this week released an updated tip sheet explaining the agency’s […]

AHCA’s Parkinson: Nursing Homes Must ‘Look in the Mirror’ to Improve Care, Infection Control Post-COVID

While emphasizing that the industry is much better prepared to weather a potential revival of large COVID-19 outbreaks in the fall and winter, a top nursing home leader on Tuesday called on operators to use the hard lessons learned during 2020 to improve from within. “You cannot ignore the fact that probably close to 100,000 […]

Congress Gives Nursing Homes Two-Year Extension on Advance Medicare Repayments

A bill to fund the federal government and avert another shutdown also gave nursing home operators and other health care providers a significant extension on repaying advance Medicare payments offered through a COVID-19 stimulus program. The Senate passed and President Trump last week signed a continuing resolution that included a provision to delay recoupments from […]

CMS Updates Nursing Home Staff Testing Requirements with Eye Toward Rural Providers

The federal government on Tuesday tweaked its methodology for determining required nursing home COVID-19 testing frequencies under, with a specific focus on regions with relatively lower levels of total coronavirus testing information. In response to concerns from governors of rural states, the Centers for Medicare & Medicaid Services (CMS) changed some definitions of its color-coded […]

Citing ‘Over-Reliance’ on Nursing Homes, CMS Releases $165M for Community Transition Programs

The Centers for Medicare & Medicaid Services (CMS) on Wednesday announced $165 million in supplemental funding to states currently operating Money Follows the Person (MFP) demonstration programs, specifically citing COVID-19 as a key reason to encourage the movement of individuals from the nursing home setting into community resources. “The tragic devastation wrought by the coronavirus […]

Senators Excoriate Federal Response to COVID-19 in Nursing Homes, Hint at Future ‘Reckoning’

In an update to a report issued in July, two Democratic senators had sharp words for the federal response to COVID-19 in U.S. nursing homes, arguing that the Trump administration has failed to take sufficient action to protect nursing home residents and workers from the pandemic. They pointed in particular to policy solutions that multiple […]