Friday Feature: MedPAC, Single Payment, and the IMPACT Act

The Medicare Payment Advisory Commission (MedPAC) via a report submitted to Congress on Thursday (yesterday) indicated that a single post-acute payment under Medicare is feasible but extensive policy procedural changes would be required to make it workable. The concept is that one uniform payment would apply to post-acute care delivered in home health, skilled nursing, … Read more

Blast from the Past – Duties of Boards: An OIG Perspective

There are nearly 300 articles/posts on this site and from time to time, I’m going to repost an “oldie but a goodie” that is as applicable now as it was when I originally wrote it.  This is from July of 2009.  This follows well with Tuesday’s piece on OIG initiatives and SNFs…https://wp.me/ptUlY-BJ This seemed to … Read more

Supreme Court Decides: Nursing Home Residents/Families Can Sue Public Facilities

This morning, the Supreme Court ruled that residents and their surviving heirs/family members can sue a publicly owned nursing home under the Federal Nursing Home Reform Act. The court upheld a lower court ruling against the Health and Hospital Corporation of Marion County (HHC). This organization operates publicly owned (governmental) SNFs in Indiana. A couple … Read more

Merge/Affiliation Strategy Update – Checklist

A recent federal funds rate cut by the Federal Reserve of 50 bps has created a bit of optimism in the M&A and capital development arena for senior living and senior housing. The expectation of more Fed rate cuts going forward undergirds the optimism BUT…Overall economic conditions remain sketchy including inflation which, ticked a notch higher … Read more

SNFs Get Ready – Claims Audits Start Soon!

Recently, CMS announced that its Medicare Audit Contractors (MACS) would soon commence (June 5) a five-claim audit process for every nursing home in the nation participating in the Medicare program. The reviews are set to occur on a rolling basis whereby each MAC in its region, will begin by pulling five Medicare claims from each … Read more

Friday Feature: SNFs Still Make Sense

For some recent years, enhanced by the pandemic, the role of SNFs in the post-acute/senior living industry has tarnished. Residents and families often view the SNF as a “negative place” to reside, even if for short-term recuperation. Clinical staff take a dim view of the care complexity such that the SNF is a downgraded clinical … Read more

Senior Housing and the Real Estate Market – Status

While we are seeing incremental occupancy gains in senior housing, the increases are slow but steady. Is there a leveling-off point upcoming? Perhaps. Regardless, even with the recent history of gains, there is a reason to be a bit skeptical for some product types to continue to improve. My skepticism rests at the Independent Living … Read more

Insight: CEO Turnover

During the pandemic and continuing somewhat through current, healthcare turnover has been on the rise. Nursing turnover (from direct care) and retirements exploded by mid-pandemic. Burnout was high as was job dissatisfaction. What became evident is the linkage between staff turnover and staffing difficulties along with COVID policy, and CEO turnover. While 2021 turnover was … Read more

Senior Housing/Senior Living Debt Review

Senior housing in the form of CCRCs, Independent Living and Assisted Living (including memory care) is a large user of debt financing. While equity has become more prevalent via increasing private equity interests in senior living, operators, especially non-profits, continue to rely heavily on bank and bond financing. Private equity and venture capital investment trends … Read more

Friday Feature: Three Trends to Watch

TGIF! This Friday, I’m focusing on three trends that I think, will have a major impact on healthcare and senior living for the balance of the year and likely, at least the first half of 2024. These trends are in no particular order. Banking and Credit Struggles: This past week, the Federal Reserve provided some … Read more