OIG Initiatives for SNFs

On the heels of a report released in January of this year, the Office of Inspector General for the Department of Health and Human Services has created a series of regulatory reviews/quality initiatives for SNFs. The report focuses on the SNF experience during COVID and what, in the opinion of the OIG analysts, regulatory interventions … Read more

Owner’s Rep – What It Is, When and How to Use One

Healthcare has a great deal of complexity in terms of care delivery and clinical needs. Today, and going forward, equal complexity exists on the business and operations front. Large provider organizations and systems are likely to have the capacity and capability to acquire and internalize, expertise within the organizational structure. Smaller, single site or regional … Read more

Friday Feature: Occam’s Razor and Management

When I have coached/mentored executives and senior management, I am always initially surprised by how much these folk want to complicate things. Healthcare is notorious for bureaucracy and to a large extent, folks that have worked only in healthcare have been socialized that complex regulations and rules and then, organizational systems for compliance wrapped with … Read more

Merge/Affiliation Strategy Update – Checklist

A recent federal funds rate cut by the Federal Reserve of 50 bps has created a bit of optimism in the M&A and capital development arena for senior living and senior housing. The expectation of more Fed rate cuts going forward undergirds the optimism BUT…Overall economic conditions remain sketchy including inflation which, ticked a notch higher … Read more

SNFs Get Ready – Claims Audits Start Soon!

Recently, CMS announced that its Medicare Audit Contractors (MACS) would soon commence (June 5) a five-claim audit process for every nursing home in the nation participating in the Medicare program. The reviews are set to occur on a rolling basis whereby each MAC in its region, will begin by pulling five Medicare claims from each … Read more

Friday Feature: SNFs Still Make Sense

For some recent years, enhanced by the pandemic, the role of SNFs in the post-acute/senior living industry has tarnished. Residents and families often view the SNF as a “negative place” to reside, even if for short-term recuperation. Clinical staff take a dim view of the care complexity such that the SNF is a downgraded clinical … Read more

Home Health and Assisted Living: Compliance and Litigation Tips to Note

A growth, if you will, opportunity for many Assisted Living facilities is caring for a more clinically complex resident or resident group. The clinical complexity is very much tied to additional medical and physical frailty, necessitating access at times to skilled nursing and therapies. Most Assisted Living facilities, especially those not affiliated with a national … Read more

Senior Housing and the Real Estate Market – Status

While we are seeing incremental occupancy gains in senior housing, the increases are slow but steady. Is there a leveling-off point upcoming? Perhaps. Regardless, even with the recent history of gains, there is a reason to be a bit skeptical for some product types to continue to improve. My skepticism rests at the Independent Living … Read more

Insight: CEO Turnover

During the pandemic and continuing somewhat through current, healthcare turnover has been on the rise. Nursing turnover (from direct care) and retirements exploded by mid-pandemic. Burnout was high as was job dissatisfaction. What became evident is the linkage between staff turnover and staffing difficulties along with COVID policy, and CEO turnover. While 2021 turnover was … Read more

Senior Housing/Senior Living Debt Review

Senior housing in the form of CCRCs, Independent Living and Assisted Living (including memory care) is a large user of debt financing. While equity has become more prevalent via increasing private equity interests in senior living, operators, especially non-profits, continue to rely heavily on bank and bond financing. Private equity and venture capital investment trends … Read more