Some physician groups have decided to join the accountable care organization (ACO) REACH programs to better serve high needs groups given that the nursing home sector is gravitating toward value-based care – the trend being especially true if patients are already aligned with an ACO through their primary care provider. Theoria Medical, for one, made […]
The nursing home business is in a contraction phase, with continued increased labor costs, revenue draining government initiatives including but not limited to the minimum staffing proposal, and managed care diverting patients away from the space. Operators must balance census and labor with innovative ideas to stay afloat, says Kent Rodgers, President and CEO of […]
Nursing homes could receive a hardship exemption for the minimum staffing proposal – but the devil is in the details here – and looks like qualifying for it is going to be tough. Facilities will need to meet four criteria for an exemption, but it’s unclear how operators will prove some aspects of the criteria […]
As advocacy efforts to oppose the federal government’s proposed staffing mandate continue, the National Association for Licensed Practical Nurses (NALPN) is lending its voice towards the withdrawal of the mandate by sharing a joint letter it sent to the federal agency. The role of licensed practical nurses (LPNs) has been chopped off from the proposal, […]
As the Centers for Medicare & Medicaid Services (CMS) looks into more oversight for Medicare Advantage (MA), some progressive lawmakers are urging caution over Medicaid Advantage plans – long lamented among those in the nursing home industry – over deceptive advertising and high rates of denial for services. Members of Congress discussed pitfalls of Medicare […]
More than two months after the Centers for Medicare & Medicaid Services (CMS) announced its minimum staffing proposal for the skilled nursing industry, commentary from stakeholders came to a close Monday with a staggering 40,000-plus comments received. Reviewing the hefty load of comments on the proposal may take as long as a year, according to […]
The Centers for Medicare & Medicaid Services (CMS) aims to further advance its overall value-based care strategy with the finalized 20224 Medicare Physician Fee Schedule (PFS) – adding ways for medically complex, high-cost beneficiaries like those in nursing homes to participate in Medicare Shared Savings Programs (MSSPs). Additionally, CMS therapy assistants can be more generally […]
As the comment period for the federal government’s staffing proposal winds down, advocates for both nursing homes and residents alike are looking at ways to reach a middle ground. Among these advocates for measured change are members of the Moving Forward Coalition – an organization formed in April 2022 following the National Academies of Sciences, […]
The Centers for Medicare & Medicaid Services (CMS) should not implement the proposed nursing home staffing mandate for numerous reasons, including that “numerical staffing staffing thresholds are not consistent with the modern clinical practice.” That’s according to the American Hospital Association (AHA), which commented on the proposed mandate on behalf of its nearly 5,000 member […]
More guidance is available on how to conduct mood interview changes, with the Centers for Medicare & Medicaid Services (CMS) updating the Resident Assessment Instrument (RAI) manual to reflect key changes in the new Minimum Data Set (MDS). Notably, if a resident refuses or is unwilling to participate in the interview, assessors need to go […]
Nearly 100 members of the U.S. House of Representatives are urging the Centers for Medicare & Medicaid Services (CMS) to reconsider the proposed federal nursing home staffing mandate. The lawmakers on Friday sent a letter to CMS describing their concerns with the mandate. “Finalizing this proposal would result in limited access to care for seniors, […]
Only 6% of real estate investment trust (REIT) assets are in compliance with the federal minimum staffing proposal for nursing homes, compared to the industry average of 19%. This difference is due at least in part to less nonprofit representation in REITs, BMO Capital Markets analysts said in a note on Thursday. The BMO analysts […]
More than a month after the announcement of the federal minimum staffing proposal, an official with Centers for Medicare & Medicaid Services (CMS) reinforced the agency’s commitment to the rule and urged providers and other stakeholders to continue submitting comments on the matter by Nov. 6. Dr. Dora Hughes, acting CMS Chief Medical Officer and […]
The recently proposed federal nursing home staffing mandate includes the requirement that all facilities have a registered nurse on staff around the clock, every day of the week. Operators are taking some early steps to prepare for this requirement even as they rally against this aspect of the mandate, arguing that 24/7 RN staffing will […]
Nursing home operators expressed frustration with Minimum Data Set (MDS) changes effective Oct. 1, with many concerned that they will be out of compliance with completion and submission requirements because of error codes. Errors are stemming from software vendors, and providers are unable to submit MDS data with proper coding information, nursing home operators said […]
More than a week after updates to the Minimum Data Set (MDS) went into effect, each section change seems to be emphasizing focus on the resident’s voice, which along with substantial coding changes – four years in the making – will require time to incorporate, experts said. Kevin Cezat, director of clinical excellence for Therapy […]
As managed care plans continue to reshape the skilled nursing landscape, operators must navigate the complexities of managing patients under managed healthcare programs, including maintaining patient census levels, adapting to industry-specific policies, and addressing issues related to case managers’ involvement. As Medicare Advantage continues to penetrate the nursing home market, leaders have said that MA […]
Nursing home staff’s trust in their leaders and federal health care agencies eroded during the worst of the pandemic – and the rebuild will be slow going. Industry executives and advocacy leaders, who said that the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) have been unable […]
Ahead of the upcoming Minimum Data Set (MDS) changes on Oct. 1, the preparation of clinicians is mixed and may have a lot to do with company size and regional market, along with resources to stay apprised of reimbursement updates. Many clinicians feel stressed and overwhelmed by the adjustments, with some playing catchup to the […]
At least 5% of the nation’s nursing homes had private equity ownership in 2022, according to a new report issued by the Government Accountability Office (GAO), which also noted “limitations” in the federal government’s data on nursing home ownership. The congressional watchdog based its analysis on a review of the Centers for Medicaid & Medicare […]
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