Washington, D.C. — When a nursing home enters a federal enforcement cycle, the medical director can be the difference between a corrective plan and a closure order. Two state regulators say too many of them are missing in action when it counts. Lisa Davies, chief operating officer for the Medical Assistance Plans Division at the Georgia Department of Community Health, and Heather Chamizo, staff services manager for California’s Department of Public Health Center for Health Care Quality, told industry sources the role has changed sharply since 2016, when CMS revised its requirements of participation in Medicare and Medicaid. The job…
Author: Chaya S
Washington, D.C. — A federal proposal that would force nursing homes to run skilled-care assessments on every resident regardless of who’s paying for their stay is drawing sharp pushback from industry experts, who say the agency’s own cost estimate badly understates what operators will actually shoulder. The Centers for Medicare and Medicaid Services is moving to expand the Skilled Nursing Facility Quality Reporting Program, known as the SNF QRP, so that admission and discharge assessments apply across the board — not just to traditional Medicare Part A stays. CMS has pegged the annual burden at roughly $88 million. Industry analysts…
Oakland, Iowa — Hundreds of narcotic painkillers prescribed for residents at a western Iowa nursing home were quietly swapped out for vitamin tablets and over-the-counter antihistamines. The state’s response? A $500 fine — and not even for the theft itself. State inspectors say staff at Oakland Manor, a nursing home in Pottawattamie County, noticed something off during a routine narcotics count on March 4. A registered nurse flagged the discrepancy after another nurse spotted a blister card of oxycodone that had been resealed with medical tape. When staff looked closer, they found the back of the pack had been peeled…
Jefferson City, Missouri — Missouri has abruptly shut off access to a $12 million fund that nursing homes around the state had been using to pay for clinical training, dementia care tools, and compliance technology, leaving roughly 5% of the state’s facilities without resources they’d already started rolling out. The fund in question is Missouri’s share of the federal Civil Money Penalty Reinvestment Program. Penalties paid by nursing homes that violate federal care standards flow back through CMS into a state-administered pot meant to be spent on resident-centered improvements. For years, that money has bankrolled everything from staff competency platforms…
Columbus, Ohio — Ohio Attorney General Dave Yost has charged eight people in a sweeping round of indictments accusing five Medicaid providers of stealing more than half a million dollars from the program — and three others of stealing directly from nursing home residents. The combined alleged Medicaid loss tops $542,000. Yost’s Medicaid Fraud Control Unit secured the indictments in Franklin County, where prosecutors say one defendant alone is responsible for more than $400,000 of the fraud. “Caregivers are meant to protect the vulnerable, not exploit them,” Yost said in announcing the charges. “My office will never tolerate thieves who…
Washington, D.C. — A bipartisan bill introduced in Congress last week would require Medicaid to cover assisted living services for seniors who qualify for nursing facility-level care — a structural shift that could redirect thousands of residents away from traditional nurs and reshape how long-term care is funded in the United States. The legislation, called the Assisted Living Affordability, Choice, Community, Empowerment, Savings and Support Act — or the ACCESS Act — was introduced by Sen. Roger Marshall (R-KS) in the Senate and Rep. Max Miller (R-OH) in the House. Right now, Medicaid is required to cover nursing home care…
CMS is running a new quality data validation program that could quietly cut Medicare payments for thousands of nursing homes — and many facilities don’t even know the clock is already ticking. Roughly 1,500 skilled nursing facilities — about 10% of the nearly 15,300 certified nursing homes that participate in federal reimbursement programs — have been selected for the first rounds of the agency’s new Quality Reporting Program (QRP) audits. The audits, which began with notifications in mid-January 2026, are designed to verify the accuracy of quality measure data that CMS uses to assess facility performance and determine payments. What’s…
Washington, D.C. — The Trump administration has put hospitals and nursing homes on notice: serve sugary drinks or nutrition shakes that don’t meet federal dietary guidelines, and you risk losing your Medicare and Medicaid reimbursements. The directive, pushed by Health and Human Services Secretary Robert F. Kennedy Jr. as part of his Make America Healthy Again initiative, is generating fierce pushback from doctors, dietitians, and even some conservative physicians who say the policy ignores the complex nutritional needs of sick and elderly patients. Kennedy announced the move at a March 30 press event, describing the instructions as “essentially a federal…
Chicago, Illinois — A Cook County jury handed the Adams family what looked like justice: a $12.2 million verdict against a North Side nursing home that let their 79-year-old mother develop infected pressure wounds that eventually killed her. It was the largest nursing home verdict in Illinois history. That was six months ago. The family still hasn’t received a single dollar. The reason comes down to a gap in Illinois law that attorneys say leaves nursing home residents — and their families — with no real recourse when a facility causes serious harm. Licensed nursing homes in Illinois are not…
Lansing, Michigan — State lawmakers got an earful this week about what life looks like inside some of Michigan’s worst nursing homes — and advocates didn’t hold back. At a Senate Oversight Committee hearing, officials from the Michigan Long Term Care Ombudsman Program described residents going weeks without showers, eating burned or meager meals, and lying in beds soaked through from inadequate care. “One resident asked us what they did wrong, because they felt like they were in prison,” said Salli Pung, who directs the ombudsman program. “Another resident said he felt like he was a plant in the corner…
