CMS Offers Fix to Medicare Advantage Denials

An issue that has been tied to AI (artificial intelligence) and specifically, to Medicare Advantage plans, involves coverage denials. I wrote about this in a post earlier this year at https://rhislop3.com/2023/05/01/medicare-advantage-part-d-final-rule/ Coverage denials have been a fairly hot topic around Medicare Advantage plans. The core of the issue is that Medicare Advantage plans are required … Read more

Wednesday Feature: A Bit of Economic Nostalgia

Happy Hump Day! I was going back through some historic stuff and I landed in 2010. The year 2010 was, after further review, eerily similar to right now, economically speaking. Sadly, not much has changed in terms of health policy and the economic state of healthcare. In 2010, the economy was choppy, recovering or trying … Read more

3rd Quarter Senior Housing Update

Senior Housing has had a long, slow grind toward recovery, post-pandemic. Fitch classified the Life Plan component as “deteriorating”. Among the many challenges the industry sectors (Independent, Assisted, Life Plan) faced, access to capital and access and maintenance of dependable and qualified labor are the two most challenging. COVID shaved occupancies rather substantially. Pre-pandemic, as … Read more

Friday Feature: Senior Living Investment Outlook

TGIF! On a calendar year basis, we are into the home stretch for 2023. It’s generally about now that I start looking at how 2024 is shaping up. What trends are there to watch? What do markets look like now, socially and economically? What does policy and politics tell us about the year to come? … Read more

SNF Staffing, Mandates, and More

Seema Verma, former CMS head, spoke out yesterday regarding the proposed staffing mandate (hours and type of staff, per resident per day) proposed rule, indicating her opinion that the approach was flawed. A recap article on her comments is here: https://www.mcknights.com/news/former-cms-chief-verma-regulators-over-their-skis-with-staffing-mandate/?utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_MLT_DAILYUPDATE_110223&hmEmail=IjP1GPaY%2BJ2uvsLxTJ79bVeRWY7ycbnr&sha256email=aa4cb7c695037c31a216b9562788596b6fcd012145d566f31440b6fcd139c8a9 Regular readers know that I have covered various topics on healthcare staffing, particularly as … Read more

MedPAC and Medicare Advantage

In yesterday’s post, Mish-Mash Monday, in the section about the House Budget Committee’s Health Care Task Force, I offered some commentary regarding MedPAC (Medicare Payment Advisory Commission) and Medicare Advantage plans. I also included a letter from the senior living trade association LeadingAge to the Congressional task force that references MedPAC’s concerns regarding Medicare Advantage … Read more

Friday Feature: Important COVID Criminal Case Dismissed

Ten days ago, I wrote a post about COVID litigation and how it was not only mounting but also morphing in terms of scope. Cases were predominantly focused on responsibility for infections at the senior living end such as, my ‘family member’ caught COVID at XYZ Manor and died, so therefore XYZ Manor is responsible … Read more

Boomers and Senior Living: What to Expect

There is a constant discussion within the senior housing/senior living industry about the impact Baby Boomers will have on the industry. Their numbers (boomers) are huge (hence the name, “boomers”). The Baby Boom generation name is reflective of the post-WWII period of 1946 to 1964. During this period, families grew rapidly having two or more … Read more

Sr. Living M&A Update – Third Quarter

This topic fits a line from the old police serials of my younger days. These are the favorites I watched religiously like Adam-12, the Rookies, The FBI, etc. The line, generally at a crime scene: Move on folks, nothing to see here. That line fits today’s topic. The mid-year report illustrated softness in activity principally … Read more

Real Estate Sales Report – News Worsens for CCRCs/Life Plan Communities

With occupancy rebounding to pre-pandemic levels and demand remaining strong, CCRCs/Life Plan Communities continue to face economic headwinds from capitalizing on improving market conditions. Capital costs continue to rise making borrowing money a challenge or alternatively, perhaps adding additional debt service costs if existing debt is variable. Accessing capital is nearly imperative for most CCRCs/Life … Read more