The Centers for Medicare & Medicaid Services’s (CMS) proposed annual update to Medicare Part A reimbursement for skilled nursing facilities, published at 88 Federal Register 21316 (Apr. 10, 2023), includes a number of significant changes to … [Read more...] about CMS Proposes Updates to Medicare Part A Reimbursement for Skilled Nursing Facilities
Weekly Alert
Inspector General Audit: Care Compare Did Not Accurately Report Deficiencies at Two-Thirds of Nursing Facilities
Using a random sample of 100 nursing facilities, identified as of August 2020, the HHS Office of Inspector General (OIG) reports in CMS Did Not Accurately Report on Care Compare One or More Deficiencies Related to Health, Fire Safety, and Emergency … [Read more...] about Inspector General Audit: Care Compare Did Not Accurately Report Deficiencies at Two-Thirds of Nursing Facilities
Investigation Finds Some California Nursing Facilities Experienced “Substantial Increase” in Profits
Although nursing home admission and occupancy rates declined in California nursing facilities between 2019 and 2020, a clinical investigation of data from 828 nursing facilities in 2019 and 887 nursing facilities in 2020 finds that “Some but not all … [Read more...] about Investigation Finds Some California Nursing Facilities Experienced “Substantial Increase” in Profits
Is the Nursing Home Industry Irrevocably Changed?
The nursing home industry, as we know it today, is diminished and may be disappearing. Starting before the pandemic, nursing home utilization was declining. Plante Moran, an accounting and business consulting firm, reports a 32% decline in … [Read more...] about Is the Nursing Home Industry Irrevocably Changed?
Federal District Court Denies Nursing Home Chain’s Motion to Dismiss Federal Government’s “Worthless Services” Case
In June 2022, the Department of Justice sued American Health Foundation, Inc., subsidiaries, and three nursing facilities (Cheltenham Nursing and Rehabilitation Center in Pennsylvania, The Sanctuary at Wilmington Place in Ohio, and Samaritan Care … [Read more...] about Federal District Court Denies Nursing Home Chain’s Motion to Dismiss Federal Government’s “Worthless Services” Case
New Article: Private Equity and Nursing Homes
In “Private Equity and Nursing Home Care: What Policies Can Be Adopted to Address the Growing Problems,” published in The Gerontological Society of America’s Public Policy & Aging Report, Charlene Harrington and Center for Medicare Advocacy … [Read more...] about New Article: Private Equity and Nursing Homes
CMS Issues Final Medicare Advantage Payment Rates for 2024 and Final Rule Addressing Prior Authorization, Marketing, and Other Issues
The Center for Medicare Advocacy has long-highlighted concerns relating to Medicare Advantage (MA) overpayments, as well as access to care issues, including MA plans’ widespread and inappropriate use of prior authorization and on-going denials. … [Read more...] about CMS Issues Final Medicare Advantage Payment Rates for 2024 and Final Rule Addressing Prior Authorization, Marketing, and Other Issues
Federal Court Dismisses Home Health Aide Lawsuit
On April 5, 2023, a federal court in D.C. dismissed a lawsuit filed by the Center for Medicare Advocacy on behalf of beneficiaries with chronic, disabling conditions who cannot access the home health aide services they require. By law, Medicare’s … [Read more...] about Federal Court Dismisses Home Health Aide Lawsuit
Medicaid and Nursing Homes: Don’t Believe Owners and Operators That All Medicaid Rates Are Too Low
Owners and operators of nursing homes, and their trade associations, invariably argue that Medicaid rates are too low. They claim that Medicaid rates must be increased if the Centers for Medicare & Medicaid Services (CMS) imposes mandatory nurse … [Read more...] about Medicaid and Nursing Homes: Don’t Believe Owners and Operators That All Medicaid Rates Are Too Low
Elder Justice “No Harm” Newsletter | Volume 5, Issue 1 Now Available
In the Elder Justice Newsletter, we highlight citations, including deficiencies related to abuse, neglect, and substandard care, that have been identified as not causing any resident harm. The goal of this brief newsletter is to shed light on … [Read more...] about Elder Justice “No Harm” Newsletter | Volume 5, Issue 1 Now Available