Leaving Money on the Table: Nursing Home Appraisals, if Adopted by Legislators, Could Bolster Medicaid Reimbursement

As so many in the nursing home space focus on Medicaid reimbursement, others are taking a closer look at improving rate setting methodology and how it can be optimized for facilities. Medicaid rates are in part influenced by fair rental value, which is determined after experienced housing experts perform an in-depth market valuation on the […]

In Suing Ohio Medicaid Department, Nursing Home Associations Allege Facilities Were ‘Significantly Shortchanged’

Nursing home associations in Ohio have sued the state Department of Medicaid last week over a Medicaid rate that does not match what’s needed to meet quality incentives. Ohio’s rebasing process splits Medicaid funding into two categories, with 60% based on meeting certain quality incentives and 40% reserved for the “base rate,” or a calculation […]

Why the Medicaid Battle is Leading to More Quality-Based Nursing Home Payments

In the midst of lagging Medicaid reimbursements, more nursing providers are pushing states to launch quality incentive programs that are designed to enhance care and reward high-performing long-term care providers. Twenty-four states already have them in place, and the latest to join this trend is Pennsylvania. And to that end, nursing home providers in Pennsylvania […]

Closing the Medicaid Gap Is Just the First Step, as Nursing Homes Fight for Predictable Reimbursement

Nursing homes and the state associations that represent them continue to put pressure on legislators to match Medicaid rates with rising costs, and change how often rebasing occurs to give operators a more even playing field. In a lot of cases, Medicaid increases helped lessen the gap between costs and stagnant rates. But, legislators still […]

How Medicaid Waivers Have Affected Nursing Home Utilization – And Why the Staffing Proposal May Further This Trend

One of the unintended consequences of the minimum staffing proposal may mean less utilization of nursing homes as residents are shifted to other means of care – a trend spurred by an expanded use of Medicaid waivers. Policymakers may opt for these as a safety net for access issues among seniors, especially in rural settings, […]

State Budget Aims to Boost Funding for Nursing Homes in Ohio – Including for Private Rooms 

Nursing homes in Ohio may see a significant boost in state investment from Medicaid and Coronavirus relief funds thanks to a budget proposal expected to pass the House on Thursday. The House framework includes major changes to the governor’s proposed budget including giving Medicaid dollars to put residents in private rooms, and an amendment that […]

Nursing Home Staff Vaccine Rates Promising Ahead of CMS Deadline, But Boosters May Be a ‘Step Too Far’

As the Centers for Medicare & Medicaid Services (CMS) vaccine mandate deadline looms this week, nursing homes across the country have stepped up to get their staff vaccinated in time – while still lagging on booster numbers. Nearly 85% of nursing home staff per facility are vaccinated, according to CMS data, and 87.3% of residents […]

Ohio Legislature Greenlights $300M for Nursing Homes, Includes No Agency Pay Provision

Direct care workers in Ohio will receive $300 million in appropriated federal pandemic relief funding, with both legislative bodies passing the bill this week. The Ohio Senate and House greenlit the nursing home funding on Wednesday and Thursday respectively, as part of $4.18 billion in pandemic relief dollars. The majority of funds are earmarked for […]

By Targeting Skilled Nursing Ownership Transfers, States Look to Prevent More Skyline-Style Implosions

The swift expansion and equally rapid flameout of one skilled nursing provider left its mark on several states in the form of sudden state takeovers, drawn-out receiverships, and several closures. That company — Skyline Healthcare — may also leave a more lasting legacy in the form of stricter vetting of new operators in multiple states. […]