Post Acute Care Strategy That Holds Up
A strong post acute care strategy aligns referrals, reimbursement, data, and risk so operators can compete under Medicare pressure and tighter scrutiny.
SNF
Medicare Reform Analysis Update
The real Medicare reimbursement reform analysis starts with a hard truth: this is no longer a debate about payment mechanics. It is a debate about who absorbs risk, which care settings remain financially viable, and whether federal policy can restrain spending without destabilizing access. For operators in post-acute care, senior living, home health, hospice, and … Read more
VOHRA Wound Care Faces Medicare Fraud Claim
The U.S. Department of Justice (DOJ) filed a False Claims Act lawsuit on April 4, 2025, against Vohra Wound Physicians Management LLC, Dr. Ameet Vohra, and VHS Holdings, P.A., in the U.S. District Court for the Southern District of Florida (Case No. 25-cv-21570). The complaint alleges that since December 2017, Vohra engaged in a nationwide … Read more
Oxford Valley Health v. Nursa Update
This case caught my attention back in March as it raises issues that I commonly hear about namely, staffing agency costs and possible abuses in terms of actual time worked v. time billed by the agency. My March post is available here: https://rhislop3.com/2024/03/28/skilled-nursing-operator-takes-legal-action-against-staffing-platform-for-alleged-overbilling/ Nursa, an electronic staffing application company based in Utah, filed a lawsuit … 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
Nursing Assistants = Supply Shortage
Nursing assistants are anticipated to experience the largest projected shortfall among all healthcare occupations analyzed, with an expected national shortage exceeding 73,000 assistants by 2028. This projection is based on a report by Mercer, which also predicts a nationwide deficit of over 100,000 healthcare workers by the same year. The demand for nursing assistants is … Read more
Final 2025 SNF Rule – Rate Increase, More Fines
Under the Final 2025 (PPS) rule released last Wednesday, nursing homes are set to receive a 4.2% pay increase in Medicare Part A. Additionally, the facilities will encounter a stricter fines system, with civil monetary penalties being applicable in more situations. The Final Rule is available here: SNF Final Rule 2025 In April I wrote … Read more
The Ensign Group Inc. Case Study: Nursing Home Chains Analysis
In the midst of the Covid-19 pandemic, nursing homes across the United States faced daunting challenges. One such example is The Ensign Group Inc., the second largest for-profit chain in the country. A descriptive case study delves into the financial and quality metrics of this publicly traded U.S. nursing home chain during the age of … Read more
Arbitration Agreements: AZ Atty. General Seeks to End Secrecy Provisions
Arizona’s Attorney General, Kris Mayes, is challenging a major nursing home operator in the state with a new legal initiative aimed at ending the concealment of elder abuse and neglect. In March 2022, a resident with dementia was found face-down at Sun West Choice Health and Rehab. He had a massive bedsore − a telltale … Read more
Defend Your Long-Term Care Facility Against Litigation with Expert Data Analysis
My firm has a unique practice concentration in the area of complex litigation. Our expertise is principally on the defense side of claims. Our team assists long-term care providers in leveraging intricate data to safeguard against legal disputes and adverse public opinion. We help clients discover methods to analyze and utilize data from government, consumers, … Read more