How CMS Can Improve Visibility on Nursing Home REIT, Private Equity Ownership

Even as the Biden administration strives to crack down on confusing ownership structures in the nursing home industry, it appears there are gaps in federal data collection and limited visibility into ownership. Only one-third of private equity (PE) and fewer than one-fifth of real estate investment trust (REIT) investments in the nursing home space are […]

States Where Nursing Homes Used the Most Agency Nursing Staff in 2022

Vermont, New York and Maryland led the nation in terms of the share of nursing homes utilizing agency nursing staff in 2022. That’s according to a Health Affairs report published Wednesday. The study authors compared free-standing nursing homes’ usage of agency staff in the years leading up to Covid-19 with usage of agency staff during […]

Why Immigrant CNAs Are Crucial as the Nursing Home Space Faces A Staffing Mandate, Quality Measures

Given that nursing homes increased their reliance on immigrant certified nursing assistants (CNAs) with positive outcomes for care quality during the pandemic, researchers in the space are reiterating the need for a policy change to get more immigrant CNAs into skilled nursing.  The most effective policy solution that could help nursing homes get more immigrant […]

Nursing Home and CCRC Spending Grew 5.6% to $191.3B in 2022 – After Dropping 7.8% in 2021

Nursing homes and continuing care retirement communities (CCRCs) made up $191.3 billion of national health expenditures in 2022, an increase from $181.1 billion in 2021, reaching levels close to the onset of the Covid-19 pandemic. Pre-pandemic, such expenditures sat between $162 billion and $174.1 billion between 2016 and 2019, according to a survey published by […]

Why CMS Staffing Mandate Could Jumpstart Union Efforts in Nursing Homes

Nursing home and labor leaders believe more labor organizing will happen in conjunction with the forthcoming federal staffing minimum mandate, as the sector has historically seen a low proportion of workers covered by union contracts. Having a federal standard in place could begin collective bargaining efforts, or maybe remove this sticking point in labor negotiations, […]

Dementia Patient Suffering Tied to SNFs Where They Are Not Dominant Population

Nursing home residents with Alzhiemer’s disease and related dementias, when not the majority of a facility population, may not be receiving the specialized care they need. In fact, only skilled nursing facilities that had a population with over 90% of residents with Alzheimer’s and other related dementias seemed to have better care. This is according […]

Vaccination Disparities Among Nursing Home Workers: Night Shift, Part-time Status, Race and Age Linked to Lower Rates

Night-shift staff may have lower testing rates and vaccination rates compared to day-shift staff, according to a new study from Health Affairs. The researchers also noted generational and racial disparities in testing and vaccinations. Employees who were younger, Black, worked part time as LPNs, CNAs, CMAs, or as other direct care aides, had the lowest […]

REIT Ownership of Nursing Homes Linked to Changes in Clinical Staffing Patterns 

Real estate investment trust (REIT) investment in nursing homes has been linked to an increase in some clinical staff hours per resident day – specifically a 2.15% and 1.55% percent bump in licensed practical nurse (LPNs) and certified nursing assistant (CNAs) hours, respectively. Registered nurse (RN) hours, on the other hand, decreased 6.25% in the […]

New Analysis Sheds Light on Covid Excess Mortality for Nursing Homes Vs. HCBS

Covid-19 mortality rates for younger residents in nursing homes were comparable to those in Medicaid home and community-based services (HCBS) from March 2020 through December 2020 – specifically HCBS recipients and nursing home residents 65 and younger. That’s according to a study published in Health Affairs, among the first to provide multi-state data on mortality […]

Spending on Nursing Care Facility, CCRC Services Dropped 8% Nationally in 2021

Total expenditures for nursing care facilities and continuing care retirement communities (CCRCs) fell by 7.9% between 2020 and 2021. Going back to 1970, these expenditures had only ever increased each year, according to data released Wednesday. The decline last year can be attributed in large part to the pullback in federal relief programs related to […]

Skilled Nursing Game Changer: Calls for Innovation in HUD Financing Gain Momentum

Lenders, operators, industry lobbying organizations and consumer advocates all agree that an expansion of skilled nursing financing programs through the Department of Housing and Urban Development (HUD) could be a game-changer in driving much-needed innovation. Building on suggestions from the National Academy of Sciences, Engineering, and Medicine (NASEM), the authors of a recent Health Affairs […]

Why HUD Financing Has Potential to Propel the Nursing Home Industry Forward

Loans and other types of financing through the Department of Housing and Urban Development (HUD) may be key to incentivizing operators to seek innovation, such as scaling the small home model in a meaningful way – but the program isn’t quite at that point yet. The National Academy of Sciences, Engineering, and Medicine (NASEM) report […]

The Future of Labor Activism in Nursing Homes

Despite the nursing home industry being in the grips of a staffing crisis – with more leverage in the hands of direct care workers – unionization in the space hasn’t taken off across the country like many were expecting. Instead, national unionization in the sector slowly increased from just under 10% in 2010 to 16.8% […]

Hospitals in Areas With More SNF Beds Found to Have Lower Readmission Rates

Some healthy competition may be good for nursing home providers. At least that’s what Kevin Griffith, assistant professor in the Department of Health Policy at Vanderbilt University Medical Center and an investigator at the Partnered Evidence-based Policy Resource Center, found when looking at hospital discharge patterns. In a study published in Health Affairs this month, […]

How Nursing Homes Could Benefit From Having a Seat at the Table in Community-Wide Disaster Planning

After more than 200,000 nursing home residents and staff died in U.S. nursing homes over the course of Covid, disaster planning has taken on new meaning for the sector. For Michael Wasserman, a geriatrician and the former CEO of California nursing home giant Rockport Healthcare Services and University of Chicago Professor R. Tamara Konetzka that […]

Experiment Over: Future of Nursing Home 3-Day Stay Waiver in Doubt Post-PHE

While the Centers for Medicare & Medicaid Services (CMS) has been winding down certain waivers tied to the public health emergency (PHE), the agency has been noticeably silent about what could be the most impactful of the pandemic-related waivers – suspension of the three-day stay requirement. Industry leaders aren’t holding out much hope that the […]

Industry-Wide Unionization Could Have Led to 8,000 Fewer Nursing Home Resident Deaths

Labor unions may play an important role in improving workplace safety, especially for nursing homes in the context of the COVID-19 pandemic. In fact, having unionized workers in nursing homes has been associated with lower resident COVID-19 mortality, in addition to  lower worker COVID-19 infection rates, a study published in Health Affairs this month suggests.  […]

National Nursing Home Spending Could Reach $273B by 2030

Nursing homes and continuing care retirement communities (CCRCs) will ultimately experience an increase in expenditures from $174.2 billion in 2019 to $273 billion in 2030 – a fluctuation along that timeline reflects a drop in federal financial support and eventual moderation compared to what the industry received during the height of the pandemic in 2020. […]

Streamlined Value Incentive Program Matches CMS Desire to Consolidate Value-Based Care

The Medicare Payment Advisory Commission (MedPAC)’s value incentive program (VIP) seeks to standardize the many value-based purchasing programs that are available to different care settings, including skilled nursing. In its most recent report on Medicare payment policy, MedPAC devoted a chapter to the design of a VIP for post-acute care (PAC) in order to highlight […]

National Nursing Home Spending Reaches $196.8 Billion in 2020

Nursing homes were among the main health care providers to drive spending growth in 2020, along with hospitals and physicians, contributing to a 9.7% increase to reach $4.1 trillion. The acceleration in spending was caused by a 36% increase in federal expenditures, according to a report published by peer-reviewed journal Health Affairs, in response to […]