Rising Tide of Audits: Brace Yourself for Increased Scrutiny on Skilled Nursing Providers in 2024

In 2023, regulators re-instituted audits of facilities for inappropriate diagnoses of schizophrenia (justification for anti-psychotic use), plus a five-claim audit of every nursing home. The purpose of the audit was to address a long-standing concern that inappropriate coding was driving higher Medicare reimbursement under PDPM, despite documentation in patient records, not substantiating the level of care … Read more

Friday Feature: Healthcare Economics Update

TGIF! A report I get and enjoy comes from Altarum (a non-profit consulting organization) looking at various economic data elements with regard to healthcare spending across a number of metrics (percent of GDP, time series growth, etc.). Granted, the report is a bit “wonky” but given what I do for a living, “wonky” is kind … Read more

Record Bankruptcies in Health Care in 2023

As the economy continued to struggle through a high inflationary cycle with restrictive Federal Reserve policy in-place to curb inflation, providers struggled to stay afloat in the turbulent economic waters. Significant financial headwinds in 2023 have only modestly abated at the start of 2024. Labor supply issues (shortages) of direct care staff (other disciplines as well) … Read more

Conference Board Report/C-Suite Outook for 2024: Concerns Ahead

The Conference Board, a renowned non-profit research organization, has recently released a comprehensive report that sheds light on the business outlook and concerns of CEOs for the year 2024. This study offers valuable insights into the minds of top executives, highlighting their attention towards the economy and organizational talent. In this post, I’ll delve into … Read more

Senior Living Occupancy Trends: Positive Fourth Quarter Data | National Investment Center

Fourth quarter data is out from the National Investment Center regarding senior living/senior care occupancies and the trend remains positive. See the NIC summary here: 4Q23-NIC-MAP-Market-Fundamentals-PDF Senior Housing occupancy, 4th quarter, came in at 85.1%, up 80 basis points from the 3rd quarter. Nursing home/SNF occupancy rose to 83.1%, up 70 basis points. Assisted Living … Read more

Fitch 2024 Oulook: Life Plan (CCRC) Communities, Non-Profit Hospitals – Deteriorating

The Fitch Ratings Public Finance outlook dropped earlier this week and not surprising, their outlook for Life Plan Communities and Non-Profit Hospitals/Health Systems remains negative or in their terms, “deteriorating”. Their forecast is for deteriorating credit conditions in these two sectors due primarily to labor and cost pressures (insufficient supply of labor at higher comp levels … Read more

Final Independent Contractor Rule: Implications for Health Care

This morning, the Department of Labor issued a final rule interpreting who is and who is not, an independent contractor v. an employee. Contract work in health care has boomed since the pandemic, though even pre-pandemic, the use of contractors (physicians, nurses, therapists, etc.) was on the increase. The final rule is available here: 2024-00067 The … Read more

SNF Closure Risks Increasing

Two articles in my email caught my attention to start the week. Both have to do with SNF closure risks, one regarding rural facilities and the other regarding staffing challenges. Interesting enough, both cross the same issues for closure, approached however, somewhat differently. I’ve written about this subject for years now yet, attention has only become acute … Read more

Friday Feature: The Economic Impact in Aging Countries

TGIF! The U.S. is aging. Its median age is 37.7, just behind China’s median age of 37.9. Comparatively, the U.S. would be considered young in relationship to Japan where the median age is 48.4. While it is true that the Japanese have a longer life expectancy than the average American (84.6 years vs. 77.29 years), … Read more

Wednesday Feature: Dying Broke

Happy First Hump Day of 2024! Short weeks aren’t really deserving of a Hump Day, but it is officially a Wednesday that is not a holiday in a workweek (though I’m sure many are still off from the Christmas/New Year’s season). Thus, no matter deserved or not, it is my first Wednesday Feature and therefore, … Read more