CMS to Merge Nursing Home Compare into Single, Cross-Continuum Database

The federal government on Thursday announced a major shake-up to its consumer-facing database of skilled nursing facility quality information, revealing plans to merge Nursing Home Compare into a more comprehensive website that features data about care sites across the continuum. Sometime later this year, the Centers for Medicare & Medicaid Services (CMS) will combine all […]

CMS Chief Medical Officer to Leave for Role With Insurance Giant Humana

The chief medical officer at the Centers for Medicare & Medicaid Services (CMS) will be leaving the agency next month to take a new position with health insurance heavyweight Humana (NYSE: HUM). Modern Healthcare first reported the news Thursday. CMS confirmed to Modern Healthcare that Goodrich, who has also served as director of the Quality […]

Proposed Medicaid Rule Would Mean Billions in Cuts, Waves of Nursing Home Closures

With skilled nursing facilities in multiple states facing significant shortfalls in their Medicaid reimbursement, supplemental payment programs used to bolster rates have become a lifeline. This is especially true for Texas and Indiana, both of which employ programs designed to get SNFs a higher rate for Medicaid services through varying mechanisms. Both states are motivated […]

Verma: Overhaul Led to Significant Growth in ACOs Taking on Risk, But Verdict Out on Spending

A federal overhaul to the Medicare Shared Savings Program (MSSP), implemented late in 2018, has led to an increase in the number of accountable care organizations (ACOs) taking on downside risk. The redesign of the program, dubbed “Pathways to Success,” generally required new ACOs to take accountability for spending increases after two years; previously ACOs […]

CMS Taps Anthem Vet Smith for Top Innovation, Value-Based Care Posts

The federal government on Monday announced the appointment of Brad Smith, a health care and insurance industry veteran, as the next head of the Center for Medicare & Medicaid Innovation (CMMI). Smith, previously the chief operating officer at insurance giant Anthem’s diversified business group, will additionally serve as senior advisor for value-based transformation to Department […]

As Providers Warn of ‘Broad Negative Impact,’ CMS Extends Comment Period on Medicaid Supplement Crackdown

The federal government extended the deadline for providers — both acute and post-acute — to comment on a proposed rule that would crack down on supplemental payment programs under Medicaid. The new deadline is February 1, pushed back about two weeks from the original end date of January 17. The Centers for Medicare & Medicaid […]

CMS to Remove Section G from Minimum Data Set in Fiscal 2021

The federal government in late December released draft updates to a key set of paperwork for nursing home staff, revealing a potential change ahead for 2020 and beyond. The Minimum Data Set (MDS) will no longer include Section G, the Centers for Medicare & Medicaid Services (CMS) announced in late December. “Please note that Section […]

Federal Lawmakers Resurrect Nursing Home Arbitration Ban with Proposed Bill

Two Congressional representatives introduced a bill on Thursday that would ban nursing homes from requiring — or even asking — residents to enter into mandatory, pre-dispute, binding arbitration agreements. The Fairness in Nursing Home Arbitration Act, introduced by Democratic Reps. Linda Sánchez of California and Jan Schakowsky of Illinois, has support from a range of […]

CMS Penalties Fund Program Designed to Reduce Readmissions, Improve Skilled Nursing Outcomes

Thirty nursing homes in the state of Washington will benefit from a federal program that injects penalty recoveries back into initiatives that boost nursing home quality — and the ramifications of the funding could go well beyond the facilities in that one state. The grant, totaling more than $644,000, comes from the Centers for Medicare […]

CMS to Have ‘Limited’ Survey Capacity for New Nursing Home Requirements of Participation

Confusion continues to reign over the final set of new requirements for Medicare- and Medicaid-certified nursing homes, as the federal government disclosed that it will have very little ability to enforce the rules until the middle of next year. The third and last update to the Requirements of Participation (RoPs) is set to take effect […]

Some Medicare Contractors Holding Up Claim Payments Amid the Shift to PDPM

Some of the private insurance companies that process Medicare claims on behalf of the federal government are holding up claims for skilled nursing facilities after the implementation of the Patient-Driven Payment Model (PDPM) in October. But it’s not clear how widespread that is, BKD director John Harned and senior managing consultant Sherri Robbins said on […]

As Medicare Advantage Plans Slowly Migrate from RUG to PDPM, Providers Must Avoid Lost Payments

Most Medicare Advantage (MA) plans that used the old Medicare system for calculating reimbursement for skilled nursing facilities are moving to the new system along with the federal government — at least if the early weeks of the Patient-Driven Payment Model (PDPM) are anything to go by. That said, details on contracts and changes are […]

CMS Could Soon Crack Down on States’ Medicaid Payment-Boosting Programs for Nursing Homes

In multiple states, supplemental programs help skilled nursing facilities offset the low reimbursement for their services from Medicaid. But the federal government is starting to take a closer look at the programs, with an eye to increasing transparency, Andrea Maresca, senior vice president at the consulting firm Thorn Run Partners, said during a presentation on […]

As Phase 3 Looms, Many Skilled Nursing Facilities Lack Key Required Staff

A new survey found that though antibiotic stewardship has increased at skilled nursing facilities across the country, there are still gaps with regard to the infection preventionist (IP) position -— even though that position is a key part of Phase 3 of the Requirements of Participation (RoPs) for SNFs, taking effect at the end of […]

Less Than 5% of Nursing Homes Receive Abuse Icon — But Financial Impacts Could Be Coming

As the federal government predicted, just under 5% of the nation’s nursing facilities received a new abuse warning icon on the consumer-facing Nursing Home Compare website — but the early data also reveals significant regional variations that could have an impact on valuations and bottom lines moving forward. Out of 15,262 total facilities, just 760 […]

Verma: New Abuse Warning Icon ‘Isn’t Really Going to Impact Very Many Nursing Homes’

Despite widespread anger in the skilled nursing industry, a controversial new warning icon for facilities with previous reports of abuse and neglect will affect only a relatively small proportion of properties, Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma told lawmakers in Washington on Wednesday. Testifying before the House Committee on Energy & […]