Analysis finds over 25% of nursing homes cited for serious deficiencies in recent inspection cycle, with infection control and medication errors among most common violations.
Author: Ahuva S
CMS finalizes 2.4% payment increase for skilled nursing facilities in fiscal year 2027, providing modest relief amid ongoing cost pressures.
Skilled nursing facility margins showed notable improvement in 2025 according to new data from CLA, though analysts warn that financial challenges lie ahead for the sector. The 2025 report, based on approximately 11,700 cost reports for fiscal years ended 2024, reveals a rebound in profitability after years of pandemic-related stress. The analysis from CLA shows that skilled nursing facilities have begun to recover from the severe financial pressures of the COVID-19 era. Occupancy rates have stabilized and many operators have implemented cost-control measures that are now bearing fruit. However, the report cautions that a ‘shock’ may be coming. Industry experts…
Baltimore, Maryland — Nursing homes across the country woke up this week to an unwelcome surprise: their quality ratings dropped, even though nothing about their care actually changed. The Centers for Medicare & Medicaid Services quietly raised the threshold requirements for its Quality Measure star ratings, effective immediately. Facilities now need significantly more points to earn the same star ratings they held just days ago — a move experts say will push many providers down a full star. According to the new CMS standards released this week, nursing homes need 38 additional points to achieve a 5-star QM rating, 33…
Dallas, Texas — Nurse practitioners are taking on a bigger role inside nursing homes as operators face tougher surveys, sicker residents and growing pressure to prevent avoidable hospital trips. Industry leaders say the shift is no longer theoretical. In many buildings, NPs now serve as the clinician families see most often, while also helping facilities manage quality programs, survey readiness and day-to-day care decisions. At Texas-based Cantex Continuing Care Network, the company employs 24 nurse practitioners and registered nurses across its skilled nursing, hospice, home health and pharmacy operations. CEO Robin Underhill said the role has expanded well beyond traditional…
Washington, D.C. — The U.S. Department of Health and Human Services has deferred more than $1 billion in federal Medicaid payments to California and Minnesota, a move that nursing home operators fear could ripple through the sector and tighten already strained budgets. Approximately $867.5 million in payments to California and $199 million to Minnesota are now on hold, according to an HHS statement issued Tuesday. The agency said focused financial reviews found claims in both states that require additional documentation before federal matching funds are released. Nursing homes in both states stand to feel the impact. California directed $981.4 million…
The Centers for Medicare and Medicaid Services is rolling out a major overhaul of how it inspects nursing homes, and the changes could reshape daily life for operators across the country. Starting in September, CMS will launch a nationwide Risk-Based Survey process that streamlines inspections for high-performing facilities while directing more resources toward homes with weaker track records. The agency announced the move Thursday, framing it as a way to modernize oversight amid years of budget strain. The problem isn’t new. Federal funding for state survey agencies has stayed flat for a decade even as complaint investigations have jumped more…
Washington, D.C. — Nursing homes could be in for a rare regulatory win this summer. The Centers for Medicare & Medicaid Services is preparing a proposed deregulation rule that could drop as early as August, and industry groups are already lining up with a long list of what they’d like to see cut. The rule, titled “Cutting Administrative Requirements for Excellence in Patient Care,” is currently under review at the White House Office of Management and Budget. In an OMB filing, CMS said the rule would target “obsolete, outdated, and excessively burdensome regulations that can be eliminated or reformed to…
Pittsburgh, Pennsylvania — Two skilled nursing operators in the Pittsburgh suburbs thought they had a clever argument: the government never actually lost money, so why should they pay $15 million in restitution? A federal appeals court just demolished that logic. The U.S. Court of Appeals for the Third Circuit on Tuesday upheld the convictions of Brighton Rehabilitation and Wellness Center and Mount Lebanon Rehabilitation and Wellness Center, finding that both facilities systematically falsified staffing records to keep Medicare and Medicaid dollars flowing despite chronic understaffing. A federal jury had convicted the operators in December 2023. Trial evidence showed that employees…
Kennebunk, Maine — After emerging from a high-profile bankruptcy, Genesis Healthcare isn’t just trying to stay afloat. The company is rebuilding its entire operating playbook, and early signs suggest the strategy is working. Genesis has rolled out a locally structured “pod model” that groups three to four facilities under a single pod leader, typically an administrator who stays close to the bedside rather than getting pulled into corporate bureaucracy. It’s a deliberate shift away from the top-down management structure that plagued the company before its Chapter 11 filing, and it’s already producing measurable results. According to company executives, early pilot…
