AHCA: CMS Already Has Authority to Simplify Three-Day Stay Rule for Nursing Home Coverage

The leading national trade group representing for-profit skilled nursing facilities this week called on the federal government to streamline its policy on Medicare eligibility for nursing home care, arguing that officials already have the legal authority to do so. American Health Care Association president and CEO Mark Parkinson formally asked Centers for Medicare & Medicaid […]

Verma: CMS Should Reduce Survey Frequency for Top Nursing Homes, Look Beyond Monetary Penalties

The leader of the Centers for Medicare & Medicaid Services (CMS) on Wednesday continued her public push for greater nursing home oversight, promising that the agency will use data to target states with suspiciously low rates of citations — while also expressing a desire to reduce survey frequencies for top performers. CMS administrator Seema Verma […]

OIG Calls on New York to Crack Down on Nursing Home Safety

The federal government’s top health care watchdog has called on state officials in New York to beef up enforcement of nursing home safety rules after uncovering multiple violations in a recent audit. The Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG) this month released a report accusing the Empire State […]

Skilled Nursing Providers Could See Slight Changes in Value-Based Purchasing Penalties, Bonuses After CMS Error

Skilled nursing operators may notice some small changes to their final bonuses or penalties under a key value-based payment initiative after federal officials acknowledged a slight error in their calculations. The Centers for Medicare & Medicaid Services (CMS) on Thursday announced that it incorrectly calculated its scores for the SNF Value-Based Purchasing (VBP) initiative, according […]

‘Under Siege’ for Years, SNFs Face Uphill Battle for Respect Under New Payment Models

Though skilled nursing facilities have experienced significant pain under the structures of alternative payment models such as accountable care organizations (ACOs), they still have the opportunity to show value. But it’s something of an uphill road, according to Harvard Medical School professor and Medicare Payment Advisory Commission (MedPAC) member David Grabowski. “I absolutely think that […]

Lawsuit Over Three-Day Stay Rule for Medicare SNF Coverage Begins as Verma Promises: ‘We’re Listening’

A class-action lawsuit challenging the Medicare eligibility rules for skilled nursing coverage will finally get its day in court this week — shortly after the administrator in charge of the program publicly questioned the status quo. The trial over the lawsuit, first filed in 2011, began Monday in a Hartford federal courtroom, according to an […]

Genesis Exec: ACOs May Work Better Than I-SNPs for Skilled Nursing Facilities

Skilled nursing providers, seeking more control over their own destiny and the premium dollar, have been driving the growth of a specific subtype of Medicare Advantage plan designed for the care of patients in the institutional setting. But Jason Feuerman, senior vice president for strategic development and managed care at nationwide operator Genesis HealthCare (NYSE: […]

CMS Finalizes $851M Pay Bump for Nursing Homes, Rolls Out PDPM Clarifications

The federal government on Tuesday finalized a predicted funding increase for nursing homes, while also formalizing changes to several key quality programs — with an eye toward clarifying some parts of the new Medicare payment model for skilled nursing facilities. Under the terms of the 2020 final rule for Medicare skilled nursing facilities, the Centers […]

Abuse Reporting and Owner Background Checks Loom Large in Elder Justice Hearing

Background checks for staff and better reporting for nursing home abuse loomed large in a U.S. Senate Committee on Finance hearing held Tuesday, with consumer advocates and industry representatives confirming the findings of a new report that revealed oversight gaps by the Centers for Medicare & Medicaid Services (CMS) around nursing home abuse. The report, […]

CMS Rule Allows – But Could Discourage – Arbitration Agreements in Skilled Nursing Facilities

The Centers for Medicare & Medicaid Services (CMS) has overturned an Obama-era ban on the use of pre-dispute, binding arbitration agreements by skilled nursing facilities. But providers might still think twice about using these agreements, due to certain consumer protection provisions in CMS’ final rule. In fact, the protections for SNF residents and their families […]

Legislators React to SNF Arbitration Ban Reversal: ‘New Rule Does Not Put Patients First’

The Centers for Medicare & Medicaid Services overturned a ban on skilled nursing operators using pre-dispute arbitration agreements with their residents in a final rule issued July 16, and a range of lawmakers reacted throughout the week. The ban on arbitration agreements in long-term care was implemented by the Obama administration in 2016, to strong […]

New Investigation Puts Skyline Healthcare Back in the Spotlight

A new investigation has put Skyline Healthcare back in the national spotlight. An investigative report by NBC News published Friday examined the rise and fall of Skyline Healthcare, the skilled nursing company that collapsed in dramatic fashion over several months. The Wood Ridge, N.J.-based Skyline at its height owned or operated more than 100 skilled […]

CMS Releases New Skilled Nursing Affiliate Data for ACOs as More Take on Risk

The Centers for Medicare & Medicaid Services’ (CMS) overhaul of the Medicare Shared Savings Program is paying off in the form of greater accountability and more risk-taking, CMS administrator Seema Verma wrote in a blog post published Wednesday in Health Affairs. The post came as part of an announcement about accountable care organization (ACO) participation […]

CMS’s Regulatory Delay: What’s In, What’s Out, and Why Nursing Homes Could ‘Substantially’ Reduce Costs

Skilled nursing facilities could see relief from regulatory burdens if a proposed rule from the Centers for Medicare & Medicaid Services (CMS) takes effect, and according to the agency, it could lead to millions in savings. Specifically, the rule would overhaul multiple requirements and delay the implementation of regulations related to the Quality Assurance and […]

Verma: CMS ‘Doubling Down’ on Nursing Home Safety Oversight

The Centers for Medicare & Medicaid Services (CMS) this week issued yet another new proposal aimed at overhauling federal oversight of nursing homes, and the agency’s chief reaffirmed her dedication to the issue. “The Trump administration is empowering residents and their caregivers with information about nursing home safety and quality, and we’re doubling down on […]

CMS Finalizes Reversal of Arbitration Ban in Nursing Homes, Proposes Partial Phase 3 RoP Delay

The federal government on Tuesday finalized a rule that allows skilled nursing operators to use arbitration agreements with their residents, while also proposing a new rule to reduce paperwork burdens that would delay certain aspects of the Requirements of Participation. The Centers for Medicare & Medicaid Services (CMS) struck something of a compromise with the […]

Proposed Mandatory Payment Model for Dialysis Could Have Skilled Nursing Promise

The federal government on Wednesday unveiled a new proposed payment model for certain kidney-related conditions, and several providers in the space say it could have serious potential for skilled nursing operators. Under the proposed End-Stage Renal Disease (ESRD) Treatment Choices (ETC) model, Medicare would expand coverage of care for kidney diseases and offer financial incentives […]

As PDPM Looms, Providers Must Balance Desire to Boost Payments with Audit Dangers

Under the Patient-Driven Payment Model (PDPM), reimbursement for Medicare Part A patients in skilled nursing facilities will be driven by patient condition, rather than by therapy minutes provided to that patient. It’s a change that the industry has hailed as an opportunity to receive financial credit for the care that they’re already providing, but they […]