CMS to Offer Advance Medicare Payments to Providers as COVID-19 Relief

The federal government on Saturday announced a plan to offer advance Medicare fee-for-service payments, as well as accelerated reimbursements, to all Medicare Part A and B providers. Under the terms of the emergency action, most providers who bill under Medicare Parts A and B can request up to 100% of their Medicare payment for a […]

Stimulus Lifts 2% Medicare Rate Cut, But Nursing Homes Largely Left Out — While Other Settings See Relief

The Senate’s landmark $2 trillion coronavirus stimulus package contains a temporary 2% bump on Medicare fee-for-service reimbursements across the board, but aside from increased funding for the federal government’s infection-control crackdown, skilled nursing facilities were largely left out of the post-acute relief. The bill, which the Senate passed by a vote of 96-0 on Wednesday […]

Coronavirus Stimulus Bill Includes $200M for CMS Infection-Control Efforts at Nursing Homes, $100B in Health Grants

The $2 trillion coronavirus stimulus bill that was approved late Wednesday in the Senate includes $200 million in funding for a federal push to bolster infection-control efforts in the nation’s nursing homes. The Centers for Medicare & Medicaid Services (CMS) has placed infection control at the center of its emergency nursing home inspection protocols, suspending […]

CMS to Enforce Tougher Survey Guidelines in Wake of COVID-19 Deaths at Kirkland Nursing Home

The federal government on Monday announced the release of an updated survey tool for nursing home inspectors, with an even stricter focus on infection-control policies — derived directly from lessons learned at a facility in Washington state that served as the epicenter of the first COVID-19 outbreak in the United States. The Centers for Medicare […]

CMS Waives Quality Reporting Requirements for Nursing Homes, Delays New MDS

The federal government on Sunday waived several key quality reporting requirements for skilled nursing facilities, framing the move as a way for operators to focus more on patients and less on paperwork during the coronavirus crisis. The deadlines for submitting fourth-quarter 2019 data under the Skilled Nursing Facility Quality Reporting Program (QRP) and the Value-Based […]

CMS Bans Most Visits to Nursing Homes, Waives Three-Day Stay Rule in Coronavirus Battle

The federal government late Friday formally issued new guidance prohibiting all non-essential visits to nursing homes, while also waiving the three-day hospital stay requirement for subsequent Medicare skilled nursing coverage, as officials look to blunt the effects of the novel coronavirus on elderly Americans. The strict ban allows exceptions for families to visit loved ones […]

CMS Releases Updated Visitation, Citation Guidance for Nursing Homes Amid Coronavirus Spread

UPDATE, Saturday, March 14: Since this article was published, the federal government has implemented stricter guidance for nursing home visits, effectively banning all non-essential visitors with very limited exceptions. Read about the most up-to-date guidance here. The federal government late Monday released an updated set of guidelines for nursing home operators amid the growing spread […]

DOJ Forms Nursing Home Task Force, Promises Criminal and Civil Penalties for Owners and Operators

The Department of Justice this week announced the creation of a specialized task force targeting “grossly substandard care” in nursing homes, with both criminal and civil penalties on the table for owners and operators. About 30 individual facilities across nine states are already under investigation, the DOJ revealed in announcing its new National Nursing Home […]

CMS Confirms Some PDPM Claim-Processing Errors, Promises Fix by October

The federal government on Thursday acknowledged some errors in processing Medicare claims under the new payment system for nursing homes, promising to make a full correction by the start of its next fiscal year. The main issue has to do with the sequence of initial claim filings for Patient-Driven Payment Model (PDPM) reimbursements, the Centers […]

Rise of Data Could Bring More False Claims Act Cases, CMS Scrutiny to Skilled Nursing

Attend any conference geared toward long-term and post-acute health care operators, and you’ll hear a common thread: Data is king. In a landscape defined by value-based payment models such as Medicare Advantage plans and accountable care organizations (ACOs), investing in data analytics has become almost a prerequisite for success. If a given operator can prove […]

Matros: ‘We All Knew PDPM Wasn’t Going to Be Revenue-Neutral,’ Doesn’t Expect CMS Clawback

Sabra Health Care REIT Inc. (Nasdaq: SBRA) is optimistic about how the new Medicare reimbursement for skilled nursing facilities will play out among its operators – even if the new Patient-Driven Payment Model (PDPM) doesn’t quite have the results the federal government expected. Specifically, the Irvine, Calif.-based real estate investment trust (REIT) is seeing PDPM […]

I-SNPs vs. ACOs: Balancing the Skilled Nursing Risks, Rewards of Two Hot Payment Models

As the skilled nursing industry struggles to adapt to a new Medicare payment landscape, in-house Medicare Advantage plans have emerged as one of the hottest topics among leaders — while the space’s publicly traded behemoth has thrown its full support behind the separate accountable care organization (ACO) model. There may not be one set answer […]

CMS Proposes Three-Year Extension, Additional Outpatient Coverage for CJR Bundled Payment Model

The federal government on Thursday issued a proposed rule that would extend the Comprehensive Care for Joint Replacement (CJR) bundled-payment model for an additional three years — while also expanding its reach to include outpatient procedures. Initially set to expire on December 31, CJR would remain active through the end of 2023 if the Centers […]

Verma Touts Low SNF Provider Terminations, Wants to Give Operators Chance to ‘Turn Things Around’

The head of the Centers for Medicare & Medicaid Services (CMS) touted the agency’s changes around enforcement of quality and safety standards in a blog post published on Tuesday, as part of a series on its five-part strategy to improve care in nursing homes across the country. The strategy’s components include: strengthening oversight, enhancing enforcement, […]

Lawmakers: Medicaid Supplement Crackdown Would Constrict Nursing Home Supply

A group of 27 U.S. representatives asked the Centers for Medicare & Medicaid Services (CMS) to rethink a proposal restricting Medicaid supplemental payments — claiming enforcement will lead to decreased services and fewer available nursing home beds. The controversial proposed rule, the Medicaid Fiscal Accountability Regulation (MFAR), would bring tighter regulations to state-based Medicaid supplemental […]

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 […]

White House: Site-Neutral Payment System for Post-Acute Care Would Save Medicare $100B

The Trump administration’s proposed fiscal 2021 budget, released Monday, put a price tag on a long-floated plan to unify Medicare reimbursements for post-acute services under a single, site-agnostic system: more than $101 billion over a decade. “The budget prioritizes use of the trust funds to pay for seniors’ healthcare and incentivizes quality and efficiency in […]

Bipartisan Group of 99 Lawmakers Calls on CMS to Rethink 8% Therapy Payment Cut

A group of 99 U.S. representatives, consisting of both Republicans and Democrats, this week asked the Centers for Medicare & Medicaid Services (CMS) for more information about a rule that could have a major impact on nursing home residents who receive therapy services. Under the 2020 Physician Fee Schedule (PFS) final rule, CMS implemented a […]