In an April 2024 Update, the Centers for Medicare & Medicaid Services (CMS) describes a risk-based survey (RBS) that it is testing to provide shorter, “more focused” surveys for “consistently higher-quality facilities.” CMS does not describe the … [Read more...] about CMS Must Preserve Standard Surveys for All Nursing Facilities
Skilled Nursing Facility
CMS Proposes Major Changes to Civil Money Penalties for Nursing Homes
As part of the annual update to Medicare Part A payments to skilled nursing facilities, the Centers for Medicare & Medicaid Services (CMS) proposes significant changes to the civil money penalty (CMP) system for nursing homes. The Center for … [Read more...] about CMS Proposes Major Changes to Civil Money Penalties for Nursing Homes
MedPAC Report Undermines Nursing Home Industry Claims
In its March 2024 policy report, the Medicare Payment Advisory Commission (MedPAC), the independent government agency that advises Congress on Medicare policy, recommends a reduction of 3% in payments to skilled nursing facilities in the traditional … [Read more...] about MedPAC Report Undermines Nursing Home Industry Claims
Reports: Nursing Facilities’ “Financial Shenanigans” Divert Reimbursement to Private Gain, Jeopardizing Resident Care
In March 2024, two lengthy investigative pieces exposed the complex and often hidden ownership practices that increasingly dominate nursing facilities, evade meaningful public scrutiny and enforcement, and result in grossly poor care for … [Read more...] about Reports: Nursing Facilities’ “Financial Shenanigans” Divert Reimbursement to Private Gain, Jeopardizing Resident Care
A Model for Nursing Home Enforcement
Acting New Jersey Comptroller Kevin Walsh issued three reports identifying the worst-performing nursing facilities in the state and the millions of dollars these facilities receive in Medicaid funding, despite the poor care they provide to residents … [Read more...] about A Model for Nursing Home Enforcement
Nursing Homes Hide Profits
Nursing homes claim to lose money every year, but they stay in business and don’t close or file for bankruptcy. How is that possible? It’s possible because industry claims aren’t true. Nursing homes hide 62.9% of profits by paying inflated prices to … [Read more...] about Nursing Homes Hide Profits
New From the House Ways & Means Committee: No Nursing Home Staffing Standards Ever
On March 6, 2024, the House Ways and Means Committee passed a bill, H.R. 7513, “Protecting America’s Seniors’ Access to Care Act,” that prohibits the Secretary of Health and Human Services from promulgating any nursing home staffing standards, now or … [Read more...] about New From the House Ways & Means Committee: No Nursing Home Staffing Standards Ever
Two Courts Reject Nursing Home Industry Challenges to New York Law Requiring Minimum Spending on Care and Caps on Profit
In 2021, New York enacted a state law requiring facilities to spend 70% of their revenue on resident care, including 40% of resident-facing care, and limiting profits to 5%. The law has not been implemented.The nursing home industry filed two … [Read more...] about Two Courts Reject Nursing Home Industry Challenges to New York Law Requiring Minimum Spending on Care and Caps on Profit
Know Jimmo | Skilled Nursing Facility Policy
Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility ServicesSection 30Coverage of nursing care and/or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement … [Read more...] about Know Jimmo | Skilled Nursing Facility Policy
CMS Must Strengthen Federal Criteria for Certifying Nursing Homes for Medicare and Medicaid Reimbursement
One of the best predictors of quality is past performance. If an operator provides poor care in its facilities, it is likely to provide poor care in any additional facilities that it may purchase or operate. As a result, one of the most effective … [Read more...] about CMS Must Strengthen Federal Criteria for Certifying Nursing Homes for Medicare and Medicaid Reimbursement