Senior Living Capital Outlook 2025

Since the pandemic (COVID), capital investment in senior living has been disjointed (to say the least). The pandemic constrained demand and as the economy rebounded from periods of lockdowns, supply shortages, work reductions, etc., inflation snuck in. In turn, to battle inflation, the Federal Reserve steadily raised interest rates. The rise in rates changed the … Read more

Federal Assisted Living Regulatory Initiative

Last week via a member news release from Leading Age Minnesota, the specter of federalized Assisted Living regulation popped up. Per this release, legislation enabling federal assisted living regulation of some form is anticipated to be proposed by U.S. Senator Mark Kelly (D-AZ) prior to the year’s end. The primary outcome of what Senator Kelly … Read more

CMS Issues Updates on Immediate Jeopardy

Back in 2019, CMS issued revisions to Appendix Q of the State Operations Manual pertaining to Immediate Jeopardy considerations (on the part of surveyors) and ultimately, citation decisions.  This guidance was relevant for all provider and supplier types participating in Medicare (hospitals, home health, SNFs, etc.). In late October, CMS issued guidance on penalties. What … Read more

Being a More Effective Executive: A Checklist

Across my multiple decade career, I have spent a great deal of my work life mentoring and coaching executives and boards on developing effective habits and systems. As I have done a fair amount of turnaround work, building a high performing organization was as much about creating effective leaders and leadership habits as it was … Read more

Friday Feature: Four Topics to Watch

It has been a busy week and next week is a holiday week (Thanksgiving) so of course, a shortened news and work week. That said, there is a lot going on right now and for followers and readers, I thought sharing my top four topics to watch made sense. Tort Reform: Back in February, the Georgia … Read more

CMS Reinforces Hospice Regulatory, Fraud Focus

Yesterday, CMS dropped a memo to state survey agencies titled, “Ensuring Consistency in the Hospice Survey Process to Identify Quality of Care Concerns and Potential Fraud Referrals”. The memo is available here: qso-25-06-hospice According to CMS, the memorandum aims to bolster current mechanisms for detecting instances where a hospice provider’s failure to adhere to the … Read more

SNF Survey and Certification Update

When the 2025 Final SNF PPS Rule was released, the focus was on Medicare rate increases.  This is typically known as the “headline”. But as readers and followers here know, there is always a regulatory tidbit or two that can be even more significant in terms of operations, particularly as more and more Medicare patient … Read more

Litigation Breaks on CMS Staffing Mandate

As anticipated, litigation has started via various sources, in Federal courts, challenging CMS’ SNF “staffing mandate”. For specifics on the mandate and actual text, go here: https://rhislop3.com/2024/04/23/cms-final-snf-staffing-rule/ A big impetus behind the legal challenges to CMS mandate is the recent Supreme Court ruling known as the Chevron decision https://rhislop3.com/2024/07/01/scotus-chevron-decision-a-win-for-healthcare/ The decision overturns a longstanding doctrine … Read more

Touching Base with 2024’s Outlook

Back in December of 2023 (late), I wrote a post with my 2024 Outlook. I dusted off the “old” crystal ball and peering deeply, I offered a few prognostications.  The post is available here: https://rhislop3.com/2023/12/27/wednesday-feature-outlook-for-2024/ Below are the predictions along with a quick review of how close, or not, I was at the time.  I’ll … Read more

Federal Judge Key Ruling on False Claims Act

On September 30, US District Judge Kathryn Kimball Mizelle from the Middle District of Florida ruled in a landmark decision that the qui tam provision of the federal False Claims Act (FCA) is unconstitutional. This ruling could have significant impact on whistleblower (Qui Tam) actions filed against healthcare providers, particularly home health and hospice (most … Read more