Wednesday Feature: It’s the Economy, Stupid

The title may jog memories for some readers. During the 1992 election cycle, advisor to then candidate Bill Clinton, James Carville, (running against George H.W. Bush) used the phrase for campaign workers as a charge to focus on. He wanted people to pay attention to the economic issues (inflation) affecting how people were feeling about … Read more

Outlook for Single Site CCRCs/Life Plan Communities

As economic conditions continue to create headwinds for senior living, I thought this post was timely. Bottom-line: I’m seeing lots of single site and even a number of multi-site, small scale organizations struggling. Depending on their markets and their debt load plus cash position, surviving as independents could be a real challenge over the upcoming … Read more

Friday Feature: Quality and the Revenue Connection (2019 version)

I’ve written a lot over the years about understanding the unique connection between quality care and the systems to support its delivery, and revenue. Arguably, the most successful provider organizations understand that impeccable quality of care (delivery, outcomes, patient satisfaction) begets high occupancy (referrals) and preferential payer mix (quality mix). Of course, the inverse relationship … Read more

SNF Performance Update – Occupancy, etc.

No other segment of senior living/senior care got rocked as much by the pandemic as skilled nursing. Frankly, the industry had challenges from labor shortages and lagging reimbursement entering the pandemic (2020). The pandemic didn’t just accentuate these issues, it blew them up in terms of magnitude (impact) while adding supply chain issues, inflation, and … Read more

CMS Releases Rule on SNF Staffing Mandate

Surprise! Surprise! Surprise! This morning, CMS dropped a proposed rule for a staffing mandate for SNFs. On Wednesday, I wrote about the delays (staffing mandate) and the information from a CMS contracted study completed by Abt and Associates. That post is here: https://wp.me/ptUlY-LM The consensus around the staffing mandate issue is that CMS was bogged … Read more

SNFs (and others), a (not good) Staffing Litigation Trend to Watch

It seems like I have been writing a lot on staffing issues these past few months, and I have. Staffing along with the current economy, are a Hydra today (two headed serpent), negatively impacting provider financial conditions and patient care in many forms (access, outcomes, care coordination, etc.). A few months ago, I wrote a … Read more

Wednesday Feature: CMS SNF Staffing Mandate Stalled? The Abt Report on Feasibility…

Happy Hump Day! Another Wednesday with news too heavy to ignore. I’ll try to return to some levity and light in future Wednesday features. For a number of years, CMS has been playing with developing a staffing level mandate.  The first CMS study from 20 years ago recommended a 4.1 hours per day benchmark.  Recently, … Read more

SNF Final Rule 2024 – Update

Back a few weeks ago I did a post summarizing the 2024 Final PPS Rule for Skilled Nursing Facilities. Recall, these rules come out yearly, updating payment rates and other provisions impacting payment and some, impacting policy. Typically, the initial or proposed rule starts in spring and then after comments, etc., becomes final during the … Read more

Politics and Health Policy

Last week, the 2024 Presidential campaign season kicked into full swing with the first candidate debate. Arguably, momentum has been building ahead of the debate, especially in Iowa, during the State Fair, where candidates roamed, gave speeches, and pressed the flesh. I was there one day and enjoyed seeing Tim Scott and few other notables, … Read more

Friday Feature: CMS Updates RAI Manual for SNFs

As foretold in the SNF PPS Final Rule, CMS was going to fine tune the MDS/RAI manual prior to October 1 when the new 2024 Fiscal Year starts. Generally, data such as this update comes much closer, sometimes even after the October 1 implementation date. Providers get a break for a change.  Initial proposed changes … Read more