Harrisburg, Pennsylvania — The SEIU Healthcare Pennsylvania Health and Welfare Plan, the union-trustee fund that covers thousands of nursing home workers across the state, told contributing employers in a May 28 letter that it is in a financial emergency and is dumping its self-insured model in favor of a fully insured Highmark Blue Cross package starting August 1. Employer contribution rates are jumping at the same time, and workers are about to see a benefit package that looks nothing like what they had before. The notice, signed by the plan’s contract administrator, 90 Degree Benefits, did not soften the language.…
Author: Mordy Y
Baltimore, Maryland — A portfolio of 18 nursing homes operated by CommuniCare is changing hands in a $500 million deal that ranks as one of the largest eldercare sales in Maryland in the past decade. According to industry reports, the buyer is a group of family trusts led by Jack Shelby, a businessman who already owns nursing homes in Florida and Texas. Ten of the Maryland properties sit in the Greater Baltimore area. The rest are spread across the Washington, D.C. suburbs, Western Maryland, and the state’s Eastern Shore. The Maryland Health Care Commission cleared the transaction back in March.…
Murfreesboro, Tennessee — National Health Investors is signaling it may not be done trimming its skilled nursing portfolio, even after agreeing to a $560 million sale of facilities to one of its existing operating partners. The real estate investment trust said it remains open to additional offers above that pending deal, according to industry reports. The move suggests NHI is still reshaping how much exposure it wants to keep in skilled nursing, a sector that has drawn renewed investor interest but still carries heavy reimbursement and operating risk. NHI said its skilled nursing holdings stood at 65 facilities with 8,565…
Washington, District of Columbia — CMS is rolling out a digital prior authorization push that could reshape how nursing homes move residents through Medicare Advantage and other plan approval bottlenecks, with federal officials projecting the broader effort could save the health system as much as $15 billion over the next decade. The plan centers on faster electronic exchange of prior authorization requests and decisions, a process providers have long argued is too slow, too manual and too easy to weaponize against post-acute care. For nursing homes, that matters most at the point of admission and during transitions in care, when…
Murfreesboro, Arkansas — Arkansas regulators have revoked the license of a small-town nursing home and stripped its administrator of her own credentials, after investigators said she was diverting resident funds into her personal bank account and ignoring abuse-reporting rules. The Office of Long-Term Care, part of the state’s Division of Provider Services and Quality Assurance, pulled Sandra Barnett’s administrator license on May 20. Days later, the agency moved to shut down her facility, Murfreesboro Rehab and Nursing, citing what officials described as severe and repeated misconduct. Residents had already been moved out by the time the formal closure notice landed.…
Washington, D.C. — A group of Senate Democrats is pushing to dismantle one of the federal government’s most controversial Medicare experiments, and the fight could reshape how prior authorization plays out in skilled nursing facilities for years to come. Sens. Ron Wyden of Oregon, Maria Cantwell of Washington, Richard Blumenthal of Connecticut, and Kirsten Gillibrand of New York filed a resolution on Wednesday to roll back the Wasteful and Inappropriate Service Reduction model, better known as WISeR. Twenty senators have signed on so far, according to industry reports. The model, launched earlier this year in six states, lets the federal…
Washington, D.C. — The federal government is putting artificial intelligence to work on a stack of overlooked state audits, and the consequences could ripple straight into nursing home Medicaid funding. The Department of Health and Human Services on Thursday launched a new program called the Audit Enforcement and Risk Oversight initiative — AERO — that uses AI to comb through at least five years of audits filed by states, local governments, nonprofits and other federal grant recipients. If those reviews surface unresolved problems, HHS says it can hold back payments, freeze future awards, or terminate grants outright. For skilled nursing…
Washington, D.C. — The Trump administration moved Wednesday to rein in the supplemental Medicaid payments that have quietly become a financial lifeline for nursing homes, hospitals, and academic medical centers across the country. The proposed rule from the Centers for Medicare & Medicaid Services would cap state-directed payments — a funding mechanism that lets states route extra dollars to providers through Medicaid managed care plans. CMS says the change could save the federal government $510 billion if finalized. For nursing home operators already absorbing a $1 trillion wave of Medicaid cuts from last summer’s “One Big Beautiful Bill,” the new…
CMS wants nursing homes to report quality data on every resident, not just Medicare. The proposed all-payer expansion of the SNF Quality Reporting Program comes with an $88M annual cost estimate that providers say is far too low.
Albany, New York — New York Attorney General Letitia James says a pediatric skilled nursing facility in Albany will pay $1.3 million after state and federal investigators found years of resident neglect, chronic understaffing, and false certifications tied to Medicaid billing. The settlement, announced Tuesday, resolves allegations against St. Margaret’s Center, a not-for-profit facility that serves chronically ill and disabled children along with other residents insured by Medicaid. Investigators said the facility certified from 2018 through 2023 that it was meeting state and federal nursing home standards while failing to provide the level of care those standards require. Officials said…
