The One Big Beautiful Bill Act (OBBBA) has been a “non-issue” for Sabra Health Care REIT (Nasdaq: SBRA) when it comes to dealmaking conversations. The sector also appears to be in a different place now, given the continued decline in supply relative to occupancy, Sabra CEO Rick Matros said Tuesday. The skilled nursing sector’s lobbying […]
The Centers for Medicare & Medicaid Services (CMS) finalized its 2026 Skilled Nursing Facility Prospective Payment System (SNF PPS) rule, approving a net increase of 3.2%, or approximately $1.16 billion in Medicare Part A payments for next year. It’s a jump compared to the proposed 2.8% increase released by CMS in April. For fiscal 2026, […]
With Medicaid already falling short of covering the cost of care in nursing homes, the One Big Beautiful Bill Act (OBBBA) will exacerbate a lot of issues already seen in the sector, driving providers to close, reducing access to services and worsening the workforce shortage. Nursing home association LeadingAge and operator A.G. Rhodes joined Sen. […]
Launching a brand new nursing home business right now is not for the faint of heart. But for those with deep clinical and operational expertise – and a mission to help the industry evolve – it’s worth the struggle. Kimberly Green, founder of Sage Integrated Health, aims to do just that, drawing from more than […]
Officials at the Centers for Medicare and Medicaid Services (CMS) have said they would seek to support changes at the state level to strengthen competition, including addressing uncompetitive certificate of need (CON) laws. While CMS didn’t elaborate at the time, nursing home leaders said incentives to do away with such laws may be likely, despite […]
The Ensign Group (Nasdaq: ENSG) expressed gratitude that the skilled nursing industry was largely protected from direct cuts to Medicaid in the One Big Beautiful Bill Act (OBBBA). Mission Viejo, California-based Ensign plans to use its good working relationships with state legislators and governors’ offices to remind those in power of how important funding for […]
The time is ripe to reconsider an integrated ACO model for dually eligible patients, many of whom need nursing home care. Integration could happen via mandated relationships between Medicare ACOs and state Medicaid agencies, especially for plans serving a high number of dual-eligible beneficiaries. Such a strategy could help the Centers for Medicare and Medicaid […]
Across various states where Genesis operates, the fallout from the nursing home giant’s Chapter 11 bankruptcy has led state lawmakers to scrutinize involvement of private equity firms more closely. In Pennsylvania, where Genesis is headquartered, it has the largest footprint, with 42 of its 175 facilities located in the state. Governor Josh Shapiro, who has […]
Editor’s Note: The following article is based on a webinar that covered several topics that will be under discussion during our upcoming RETHINK conference in Chicago, Aug. 18-20. To learn more about RETHINK and purchase a ticket, please go to: https://skillednursingnews.com/snn-live-event/rethink/ Given that access to capital is easy to find but harder to justify in […]
The Centers for Medicare and Medicaid Services (CMS) is making several updates to the Nursing Home Care Compare tool to improve accuracy and transparency, it stated in a memo Wednesday. The federal agency will begin posting “aggregated” performance data for nursing home chains in a clear, consumer-friendly format. Since 2022, CMS has released ownership data linking […]
A report released Monday by the Office of the Inspector General (OIG) is recommending that the Centers for Medicare and Medicaid Services (CMS) strengthen its oversight of nursing home staffing by enhancing how it uses Payroll-Based Journal (PBJ) data. The OIG is urging the federal agency to flag all nursing homes that provide fewer than […]
Proposed Medicaid cuts are spurring widespread concern among nursing home providers, as reductions would severely impact care quality, staffing, and facility operations. Activity on the Hill and a new report puts the spotlight on potential impact to stakeholders. About 92% of providers are concerned about further Medicaid cuts, according to a May report from the […]
Nursing home stakeholders remain cautiously optimistic regarding Medicare Advantage plan audits announced by the Centers for Medicare and Medicaid Services (CMS) last month, but many hope the agency will extend the same scrutiny to prior authorizations, AI usage and internal coverage criteria. Operators are unlikely to face reimbursement cuts as a result of the audits, […]
While Medicare Advantage claim denials represent 17% of initial claim submissions, including those submitted by nursing home providers, about 57% of these denials are ultimately overturned. However, MA claim denials result in a 7% net reduction in provider MA revenue, due to the dollar-weighted share of claim denials that were not overturned, according to a […]
The federal government is challenging an April ruling that struck down key provisions of the Biden-era nursing home staffing mandate. On Monday, the Department of Health and Human Services (HHS) notified the U.S. District Court for the Northern District of Texas that it is appealing the decision to the Fifth Circuit Court of Appeals. The […]
The Centers for Medicare & Medicaid Services (CMS) on Friday released a draft version of the Minimum Data Set (MDS) with four Section R items removed. In the prospective payment system (PPS) proposed rule for skilled nursing facilities (SNFs), released last month, CMS floated the removal of these MDS items, which assess elements related to […]
Legislation to streamline and improve outdated prior authorization processes for Medicare Advantage (MA) was reintroduced this week. The Improving Seniors’ Timely Access to Care Act would require MA plans to adopt an electronic prior auth system with standardized transactions, and improve transparency around MA prior auth use and requirements. It’s the third time this legislation […]
The current nursing home market has its share of positives and negatives midway through 2025, with operators enjoying Medicare and Medicaid reimbursement increases as well as a decline in facility supply, creating higher competition among buyers. Buyers are being more aggressive in the acquisition process, he said, with fewer facilities available. Brokerage firms are seeing […]
The new direction of the Centers for Medicare and Medicaid Services (CMS) renews focus on harmonizing payments across care settings – a shift that could impact nursing home profits – even as the federal agency’s commitment to advancing value-based care (VBC) remains strong. In a meeting held by the Center for Medicare and Medicaid Innovation […]
Cost-cutting measures in nursing homes, particularly food budgets, have been a concerning underlying issue in the industry, with more than a quarter of facilities in the country spending under $10 per day on food per resident. An investigative report by NJ Advance Media, in collaboration with Rutgers University and data experts at SNFdata Resources of […]
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