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5 days ago | 
skillednursingnews.com | Amy Stulick
While Medicare Advantage claim denials represent 17% of initial claim submissions, including those submitted by nursing home providers, about 57% of these denials are ultimately overturned. However, MA claim denials result in a 7% net reduction in provider MA revenue, due to the dollar-weighted share of claim denials that were not overturned, according to a study published in Health Affairs this month.
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6 days ago | 
skillednursingnews.com | Amy Stulick
CareTrust REIT (NYSE: CTRE) acquired 10 nursing homes in the Pacific Northwest for $146 million, the real estate investment trust announced on Monday. The 10 facilities are spread across Idaho, Oregon and Washington, and comprise 911 licensed beds. The deal was completed through a joint venture agreement between CareTrust and an unnamed large third-party health care real estate owner.
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1 week ago | 
skillednursingnews.com | Amy Stulick
Aligning diagnosis codes on the Minimum Data Set (MDS) with claim forms used to bill Medicare and Medicaid can’t be understated, especially considering annual revenue losses of $25,000 to $30,000 per nursing home as a result of incorrect coding.
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1 week ago | 
skillednursingnews.com | Amy Stulick
Palm Health Partners’ Paul Walczak on Wednesday was pardoned by President Donald Trump, weeks after Walczak’s mother Elizabeth Fago attended a $1 million-per-person fundraiser at Mar-a-Lago. The Florida-based nursing home executive failed to pay more than $10 million in taxes, instead using the withheld taxes to enrich himself, according to an April statement from the U.S. Department of Justice (DOJ).
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1 week ago | 
skillednursingnews.com | Amy Stulick
The nursing home sector is undergoing a significant transformation in real time, driven by a recognition that the traditional, reactive model is no longer sustainable. Changes in occupancy patterns, increasing patient acuity, evolving workforce dynamics, and shifting payment structures are all contributing to this redefinition, according to Austin Steele, chief strategy officer for Indiana-based operator Journey.
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2 weeks ago | 
skillednursingnews.com | Amy Stulick
Legislation to streamline and improve outdated prior authorization processes for Medicare Advantage (MA) was reintroduced this week. The Improving Seniors’ Timely Access to Care Act would require MA plans to adopt an electronic prior auth system with standardized transactions, and improve transparency around MA prior auth use and requirements. It’s the third time this legislation was put forth in Congress.
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2 weeks ago | 
skillednursingnews.com | Amy Stulick
The UnitedHealth Group (Nasdaq: UNH) allegedly paid bonuses to nursing homes in order to reduce hospital transfers of residents under its Medicare Advantage (MA) plans, according to an investigation conducted by The Guardian. The investigation revealed these cost-cutting practices saved the company millions, but endangered patient health; this included delayed or denied emergency hospital care.
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2 weeks ago | 
skillednursingnews.com | Amy Stulick
Easily preventable and overlooked compliance issues in nursing homes often start in the kitchen and resident rooms, but there is another surprising source: Amazon deliveries. All the while, the category of infection prevention and control continues to lead in number of citations. and surveyors often see multiple failure points when it comes to person-centered care, too, including inconsistent practices tripping up staff and a failure to recognize resident preferences.
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2 weeks ago | 
skillednursingnews.com | Amy Stulick
Greystone provided $40.5 million in bridge financing to Kalesta Healthcare Group for the acquisition of two nursing homes in California. Meanwhile, Dwight Capital and its real estate investment trust affiliate closed on $521 million in financing for Q1.
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2 weeks ago | 
skillednursingnews.com | Amy Stulick
Some state legislatures are taking a closer look at the sustainability of long-term care, with their eye on a rapidly aging population and an increased need for such services in the coming years. In Pennsylvania, nursing home associations testified on reimbursement during a legislative hearing this spring as the state discussed its 2025-26 budget.
