Nearly 100 House Members Ratchet Up Pressure on CMS to Scrap Nursing Home Staffing Mandate 

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, […]

Nursing Home Leaders Support House Bill To Defeat CMS’ ‘Cookie-Cutter’ Minimum Staffing Proposal

A Congressional bill that aims to defeat the Biden Administration’s minimum staffing proposal began making rounds last week, and nursing home executives, including clinical team members attending the industry’s largest annual gathering in Denver, hailed it as a welcome development. If passed, the bill could keep the Centers for Medicare & Medicaid Services (CMS) from […]

‘Not All the Same’: LeadingAge’s Sloan Careful to Distinguish Nonprofit Nursing Homes in Response to Biden

In a response to President Joe Biden’s editorial in USA Today, LeadingAge CEO Katie Smith Sloan penned her own opinion piece in the publication to tell the industry’s side of the story, as the nursing home space reels from the federal staffing minimum announcement last week. Notably, Sloan expanded on the story of nonprofits in […]

While More is Needed, Operators are ‘Generally Pleased’ With 4% Increase in SNF Final Rule

Nursing home operators had a mixed reaction to the Centers for Medicare & Medicaid Services (CMS) final payment rule for 2024. While some operators said that they were generally appreciative of the 4% increase in Medicare reimbursement, they are also calling for more help and understanding from federal agencies in tackling the workforce crisis – […]

[UPDATED] CMS’ 2024 SNF Final Rule Seen as Insufficient for Payment Rates While Advancing Unfair Measures

The Centers for Medicare & Medicaid Services (CMS) issued a final rule Monday that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System for fiscal year 2024. The federal agency estimates that the aggregate impact of the payment policies in the latest rule would result in […]

‘Whole System Is Broken’: Nursing Home Operators in National Coalition Say Long-Term Care Will Need a Generation to Fix

In the aftermath of issuing a series of action plans, the Moving Forward Nursing Home Quality Coalition – a national coalition of 120 nursing home stakeholders – held a meeting Wednesday to share more details about the action plans to improve quality in nursing homes, with providers present saying that the coalition’s work is a […]

‘Astronomical’ Medicare Advantage Denials, Pre-Auth Issues Cause Outcry from Nursing Homes

The Medicare Advantage preauthorization process and denials of care are a growing concern across the continuum, and nursing home operators and advocates — as well as federal lawmakers — are pushing more urgently for change. Such concerns are not new, and already some action has been taken: the Centers for Medicare & Medicaid Services (CMS) […]

Payment Perspectives: Nicole Fallon, Vice President of Integrated Services & Managed Care, LeadingAge

As VP of integrated services and managed care for national nonprofit aging services provider association LeadingAge, Nicole Fallon is at the helm of policy-making and advocacy efforts related to the health care payment landscape. Having worked previously for both insurance and consulting organizations, Fallon brings a wealth of knowledge to her role in exploring emerging […]

As CMS’s Proposed Rule Comment Period Ends, Rate Increase, Quality and Value-Based Measures Questioned

The Centers for Medicare & Medicaid Services’ (CMS) comment period on the SNF proposed rule ended with only 74 comments posted from skilled nursing stakeholders Monday. For perspective, last year’s comment period garnered about 4,700 comments. The drastic decline in comments reflects a sense of appeasement with the new rulings. Providers in 2022 faced a […]

PDPM is a Start, But Rising Acuity at Nursing Homes Demands Building New Payment Models for Adequate Reimbursement 

As acuity continues to rise among nursing home residents, providers say reimbursement needs to change too – and not just the dollar amount. Incentives should be based on quality of care, and the industry will need to build out specific reimbursement models to match expanded acuity specialities, especially as value-based care becomes more and more […]

‘A Black Box’: Advocates Decry Opaqueness of Medicare Advantage Denials as Senators Seek Clarity on Process

As a Senate subcommittee continues to seek additional information on Medicare Advantage care denials through May, nursing home advocacy groups have issued detailed recommendations that underline lack of transparency, administrative burdens and low reimbursements associated with MA plans. The Senate Homeland Security & Government Affairs Permanent Subcommittee on Investigations held a hearing on Wednesday that […]

‘Access Crisis Unfolding’: Nursing Home Operators, Advocates Warn of Dire Effects from Biden’s Order on Staffing

President Joe Biden’s executive order that aims to implement minimum staffing standards and tie Medicare payments to staff retention drew frustration from nursing home industry operators and advocates, who said that the well meaning directives would likely compound the staffing crisis and lead to closures unless policies are aimed at resolving its root causes, and […]

CMS Data Shows SNFs a ‘Good Landing Spot’ For Less Acute Patients, Emboldens Calls for Ending 3-Day Stay Rule

As nursing home advocates continue to push for ending the 3-day hospital stay requirement, a recently released federal agency report on the use of these waivers by accountable care organizations (ACOs) showcases some of the benefits that they have brought to patients and providers. Use of waivers by ACOs for a 3-day stay did not […]

CMS Finds Deepening Backlog in Nursing Home Inspections – 4,500-Plus Facilities Are Overdue

As the nursing home industry continues to recover from the last several years of the pandemic, annual inspections have fallen by the wayside. According to federal data from mid-February, about 4,500 of the nation’s 15,000 nursing homes were overdue for an inspection. More than 1,500 of those facilities were last inspected before the public health […]

‘We Need to Start Today’: Nursing Home Providers Strive to Implement Workforce Tech Amid Challenges

As staffing remains one of the leading areas of trouble for nursing homes, operators have turned to technology tools that have improved both retention and recruitment of workers in the last year. But while operators, advocates and even insurance providers associated with the skilled nursing sector applaud the implementation of staffing-related technology, doing so is […]

Nursing Home Advocates Ramp Up Calls to End 3-Day Stay Amid Senate Hearings 

As Senators began hearings on the challenges facing the health care sector Thursday, nursing home advocacy groups redoubled their calls to lawmakers to end the three-day hospital stay requirement for the skilled nursing industry, noting difficulties facing the sector, especially amid staffing shortages. LeadingAge, which represents more than 5,000 nonprofit aging services providers, sent letters […]

CMS Proposes Rule Requiring More Nursing Home Ownership Transparency, Including REIT and Private Equity Disclosures

The Centers for Medicare & Medicaid Services (CMS) announced Monday a proposed rule to require nursing homes to disclose more information regarding their ownership and management, including information related to assets held by real estate investment trusts (REITs) and private equity firms. Nursing homes will be expected to disclose this information as part of the […]