PDPM Could Create Risk-Sharing Opportunities, Headaches for Skilled Nursing

Risk-sharing has loomed large in health care reform efforts over the last decade, and the new Medicare payment model for skilled nursing facilities could open up additional avenues for operators to take control — along with pointed questions from partners along the spectrum. The Patient-Driven Payment Model (PDPM) marks a step toward a long-teased site-neutral […]

Skilled Nursing Dealmakers Could Be Overlooking PDPM’s Potential for ‘Biggest Year’ in Decades

The market will still need to determine whether the new Medicare reimbursement structure for nursing homes will be a net positive or negative for the industry, but at least one insider says buyers and sellers in the space aren’t optimistic enough. Current prices for skilled nursing facilities don’t typically account for the potential of cost […]

CMS Could Release Monthly List of Special Focus Candidates After Senators’ Report

Federal officials could soon begin releasing a previously undisclosed list of underperforming nursing homes targeted for potential inclusion in the Special Focus Facility program, SNN has learned. The Centers for Medicare & Medicaid Services’ (CMS) roster of “candidates” for Special Focus Facility status became public on Monday, when a bipartisan pair of senators released the […]

‘Medicare for All’ Plan Would Expand Coverage for LTC — But Nursing Homes Stay Under Medicaid

Sen. Bernie Sanders this week introduced a bill to create a single-payer health care system for the U.S., a plan that includes long-term care in its scope — but keeps coverage for institutional nursing home care under Medicaid. The legislation would ensure that the so-called “Medicare for All” plan would include benefits for at-home long-term […]

CMMI Could Put Post-Acute Providers Back in Control of Bundled Payments

The leader of the federal government’s center for reimbursement innovation said he is considering bundled payment models where post-acute care providers could take the lead on care — but right now it’s only at the consideration stage. Adam Boehler, who leads the Center for Medicare and Medicaid Innovation (CMMI), said that there has been significant […]

Baby Boomers May Prefer Residential Care Over Home Health: Survey

A new survey of older Baby Boomers goes against some of the common perceptions about what adults in the 60-to-72 age bracket want as they get older — and depending on their circumstances, that could include skilled nursing care. The survey was conducted by LeadingAge, a group which represents non-profit senior living providers, in conjunction […]

Lawmakers Again Take Aim at ‘Observation Stay’ Rules for Medicare SNF Coverage

A bipartisan coalition of federal lawmakers this week took another stab at clarifying the rules regarding a frequently confusing aspect of skilled nursing coverage under Medicare. Under the terms of the proposed legislation, the Improving Access to Medicare Coverage Act of 2019, so-called “observation stays” would count toward the three days of inpatient acute care […]

ICD-10 Coding Will Be Crucial Under PDPM — But SNFs Don’t Need to Become Experts

The Medicare payment model taking effect on October 1 this year represents a sea change for skilled nursing providers in that patient condition, rather than therapy minutes, will drive reimbursement. It also represents a sea change in the mechanics of reimbursement. Under the Patient-Driven Payment Model, ICD-10 codes will form the basis of reimbursements, making […]

Report Revives Potential for Massive Medicaid Cuts Through Block Grants

A plan to fundamentally change the way the federal government funds Medicaid — which could lead to hundreds of billions in cuts — may be back on the table after seemingly dying two years ago. The Trump administration is currently mulling ways to convert Medicaid to a block-grant system, Politico reported late last week, reviving […]

CMS Implements Stricter Nursing Home Staffing Survey Rules for States

The Centers for Medicare & Medicaid Services (CMS) announced Friday that it will use payroll-based journal (PBJ) data to bolster state oversight of nursing homes, effective immediately. Specifically, CMS will use PBJ data to identify and provide state survey agencies with a list of nursing homes that have several days in a quarter without a registered […]

Lessons from Medicare Cuts to Skilled Nursing Go Beyond Winners, Losers

At face value, the statistics look grim: Nearly three-quarters of the nation’s skilled nursing facilities will see pay cuts in 2019 under the government’s value-based purchasing (VBP) program after failing to reach mandated readmission benchmarks. But the numbers themselves don’t tell the full story, according to players in the long-term health care space. Based on […]

CMS Highlights Key Areas of Skilled Nursing Enforcement, Improvement

Improving surveys, clarifying nursing facilities’ reporting requirements, and providing more detail on citations are some of the current top priorities for the Centers for Medicare & Medicaid Services (CMS). Karen Tritz, director of the Division of Nursing Homes in CMS’ Quality and Safety Oversight Group, walked through several policies and their status in a presentation […]

Providers Must Target Rehab Contracts, Cash Flows Now Ahead of PDPM

As skilled nursing providers start preparing for the new Medicare payment model, they need to zero in on how much money they’re making now on the various services they provide. Specifically, they need to brush up on their ICD-10 codes, which will play a key part in the setting of their reimbursement rate, as well […]

NY Times: Lower Census Causing Hundreds of Nursing Homes to Close Each Year

The New York Times covered the issues stemming from declining nursing home occupancy on Friday, detailing how shrinking numbers of residents has led to empty beds and hundreds of closures. Nicholas Castle, a researcher at the University of Pittsburgh, told the Times that 200 to 300 nursing homes close in the United States each year. […]

Skilled Nursing Must Look Past Schools, Government to Solve Workforce Shortage

Staffing shortages in skilled nursing facilities made national headlines last month, but the dearth of workers and registered nurses have been a headache for nursing homes for years now. Some of the fixes can range from bonuses for hard-to-staff shifts to higher-level partnerships with local businesses and governments. But one thing is clear: The problem […]

Uncertainty Surrounds New ‘Arbitrary’ Skilled Nursing Payment Rules

Early reactions to the finalized skilled nursing payment rules from the Centers for Medicare & Medicaid Services (CMS) are in, with one leading provider group issuing a stark warning about the days ahead. “While the skilled nursing profession welcomes a new payment model, we are concerned with the language in this rule about the Patient-Driven […]

RNs Top List of Most In-Demand Jobs Across All Sectors in 2018

A shortage of qualified workers continues to plague the skilled nursing sector, and recent data from job board Monster backs it up. According to a new report from the Weston, Mass.-based online classifieds company, job openings for registered nurses were the most popular type of position posted during the first half of 2018. The health care […]