Wednesday Feature: Massachusetts Nursing Home Residents Set to Transition to Community Living with $1 Billion Settlement

Happy Hump Day! Last week, the Lieutenant Governor of Massachusetts, Kim Driscoll, announced the settlement of a class action lawsuit filed against the state by six disabled nursing home residents. The suit was filed in 2022 alleging that the state underfunded community-based care options, trapping them in nursing homes despite their wishes to return to … Read more

CMS Final SNF Staffing Rule Released

Late yesterday, CMS released the draft of the Final Rule consistently defined as the “staffing mandate rule”. Earlier in the day, I wrote a post about the final staffing rule and the final Medicaid access rule. At the time, CMS had only notified everyone about the final rule(s) contents via a press release. The actual … Read more

Regulation Monday: SNF Staffing Mandate and Medicaid Access Rule

Just announced this morning, CMS has finalized two hotly debated proposed rules into final rules. The final rules involve the SNF staffing mandate proposed last year and the Medicaid Access Rule, requiring 80% of payments for Medicaid HCBS programs go to compensation for direct care workers. The Medicaid Rule follows the original proposed rule while … Read more

Challenges Persist in Staffing for U.S. Life Plan Communities and Skilled Nursing Facilities

Monday, Fitch Ratings dropped a Non-Rating Commentary about staffing challenges in Life Plan and SNF organizations. Per the release, “Though growing for some time, payrolls for U.S. life plan communities (LPCs) and skilled nursing facilities (SNFs) are still well off the pace needed to reach a full post-pandemic recovery.” Bureau of Labor Statistics (BLS) data … Read more

Wednesday Feature: Budget Stuff…Cubed

Happy Hump Day! Busy day so far but wanted to sneak this post in, wrapping up the last two days of posts on budget (federal, Medicare) stuff. This being the third day and post on budgets (and last for a while, I promise), the title fits – cubed. https://rhislop3.com/2024/04/15/monday-budget-day/ https://rhislop3.com/2024/04/16/medpac-report-to-congress-a-wrap-with-monday/ What follows is a different … Read more

MedPAC Report to Congress: A Wrap with Monday?

Yesterday I wrote a post on President Biden’s healthcare budget. Today, I thought a quick visit back to March and MedPAC’s Annual Report to Congress on payment and program adequacy would be a good “wrapper” – for now. Every year, MedPAC (the Medicare Payment Advisory Commission) reports to the Congress in March on the Medicare … Read more

Monday = Budget Day

As much as politics consumes the news, little on policy is included. Most days, the political stuff such as trials, Congressional hearings, back and forth tabloid (almost) stuff is front and center, missing is the “meat”. Reminds me of the 80’s Wendy’s commercial titled, “Where’s the beef?” https://www.youtube.com/watch?v=riH5EsGcmTw While I know that the national election, … Read more

The Dark Side of the Economy

On Monday, a good portion of the U.S. saw all or portions of a total eclipse. If you were in the “zone of totality”, you saw a heck of a show and witnessed the side-effects of day turning to dark and the weather turning noticeably colder. Cool stuff. Unfortunately, within the past week or so, … Read more

Medicare, DOJ, Fraud and the Eclipse?

Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more

CMS Releases 2025 PPS Proposed Rule for SNFs

It’s that time of year again where CMS begins to drop various rule proposals for updates to provider groups under PPS. From Hospitals, to SNFs, to Home Health and Hospice, each industry segment will see a proposed series of rate and programmatic (rule) updates from CMS. This is normal and it occurs at about the … Read more