How Nursing Homes Can Leverage MDS, PBJ, Other Facility Data to Protect Against Litigation, Lending Issues

In recent years, nursing homes have faced increased scrutiny and litigation, often driven by data that can be misunderstood or misrepresented. To secure themselves, nursing homes must leverage a data strategy, ensuring accurate documentation and clear communication of their data story to legal experts and stakeholders. This approach can mitigate risks, clarify misunderstandings, and showcase […]

CMS Star Rating Process, with Wide State Variation, Sparks Trouble for Consumers and Nursing Homes

Hundreds of nursing homes continue to maintain or display high star ratings despite Immediate Jeopardy incidents in the previous three years, and this can create headaches for both nursing homes and consumers alike. According to a Scripps News analysis released Wednesday, which takes in to account government data from February 2024 of more than 14,000 […]

Medicare Advantage Growth Could Normalize, but Nursing Home Leaders Call for Rate Floor and Other Changes

While Medicare Advantage (MA) has grown steadily in the last several years, leaders in the nursing home sector speculate whether increased federal regulation – and perhaps even more importantly, changes in the consumer experience – will slow its growth. This would come as a welcome development to many nursing home leaders, who have been struggling […]

‘Borderline Useless’ CMS Data Needs an Overhaul, Starting with the Addition of Medicare Advantage to Cost Reports

Conspicuously absent data on Medicare Advantage (MA), along with stagnated data collection overall by government agencies, should give nursing home operators cause for concern especially as this trend has influenced company advocacy and negotiating power when it comes to insurance plans. Having this data and understanding how it’s calculated can help operators “speak the same […]

‘Money Out of Our Pockets’: $274.9M in Nursing Home Revenue Lost For Every Percentage MA Plans Grow

As Medicare Advantage continues to grow in the skilled nursing space, beneficiaries utilizing traditional Fee-For-Service Medicare have declined, and in turn reimbursement has dropped at an alarming rate. For every two beneficiaries that opted for MA, one FFS individual left the program in 2023, the first year the number of FFS beneficiaries declined in every […]

Top Trends That Will Shape the Skilled Nursing Sector in 2024

Margins squeezed by interest rates and inflation, staffing shortages amid a draconian staffing mandate proposal, an invasion of Medicare Advantage and mixed efforts at adapting to Minimum Data Set (MDS) changes are among a litany of the challenges facing the skilled nursing sector at the start of 2024. However, all is not doom and gloom […]

Dealmaking In Nursing Homes: Bubble Will Burst As States Aim for Budget Neutrality During Medicaid Recalibration

In adjusting to new case-mix systems under the Patient Driven Payment Model (PDPM), the changes to reimbursement rates might be more widespread and large-scale than anticipated, posing financing threats to the nursing home sector because lenders are basing loans on rate projections that are expected to be scaled back. The goal of budget neutrality – […]

CMS Clarifies MDS Mood Interview Changes in RAI Manual Updates

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 […]

‘Multidisciplinary’ Resident-Centered Care Is Crucial To Minimizing and Correcting Survey Deficiencies at Nursing Homes

Although survey citation rules can vary from state to state, nursing home operators can implement broad steps to avoid deficiencies if they focus on the often overlooked easy fixes as well as the more complicated overlaps between disparate areas of care – ranging from food safety and mental health documentation to infection control. Certain trends […]

‘We’ve Gotten Lax’: With Covid Surging in Nursing Homes, Calls Rise To Administer Antivirals Early, Revisit Policies and Spaces

Covid cases are beginning to rise again, steadily at first and now with a sharper increase over the past five weeks, especially in large metropolitan areas. Hospitalizations across the country rose by nearly 19% in the last week to 15,067, according to data from the U.S. Centers for Disease Control and Prevention. This is especially […]

Industry Leaders Question Leaked CMS’ Staffing Study Data, Worry About Shortages 

Industry leaders continued to have mixed reactions about the fate of the Biden Administration’s nursing home staffing mandate after the accidental online release of a staffing study commissioned by the Centers for Medicare & Medicaid Services (CMS), with some insiders questioning the leaked study’s data. Industry stakeholders doubted the reliability of the study conducted by […]

Top Skilled Nursing Deficiencies Show Operators Must Avoid Tunnel Vision in Survey Prep

For skilled nursing facility operators, the most common survey deficiencies might not be the ones always at the top-of-mind. In multiple states, a Zimmet Healthcare Services Group (ZHSG) analysis found that food safety and procurement was the primary deficiency, among other areas, like basic infection control and resident rights. “During interviews, the food quality often […]

With CMS Nixing Mandatory Patient Satisfaction Measure, Nursing Homes Remain ‘Behind the Times’

The issue of formally requiring patient surveys for nursing homes, similar to surveys mandated in other segments of health care, has long been a source of debate – one getting stirred up again after federal policy makers decided to nix patient satisfaction measures from the recently issued final prospective payment rule for 2024. The Centers […]

Painful and Getting Worse: Rise of Medicare Advantage Drains Vast Revenue from SNF Sector, Worsens Workforce Instability

The skilled nursing sector is under increasing pain due to the growth of Medicare Advantage, with the industry losing hundreds of millions of dollars while operators also are contending with a host of operational burdens.  This was a message delivered repeatedly Wednesday at the “Roaring Reimbursement” conference held by Zimmet Healthcare Services Group (ZHSG) in […]