Washington, D.C.<\/strong> — A major new analysis is sounding the alarm: as many as 10 million Americans could lose Medicaid coverage within two years, and the fallout for nursing homes could be severe.<\/p> Researchers at the Urban Institute, with support from the Robert Wood Johnson Foundation, published findings this week estimating that between 4.9 million and 10.1 million people would lose Medicaid access by 2028 under work requirements included in H.R. 1 — the so-called “One Big Beautiful Bill” passed by the House last year. The range depends heavily on how aggressively states choose to implement the new rules.<\/p> For…
Author: Mordy Y
New York, New York — Most Americans know they’ll probably need long-term care someday. Far fewer have done anything about it. A New York Times analysis published Friday laid out a stark financial reality: a private room in a nursing home now runs around $130,000 a year. Assisted living averages just over $74,000 annually. Even non-medical care at home — a home health aide a few hours a day — runs roughly $80,000 per year. And nearly none of it is covered by Medicare. The Coverage Gap Most Families Don’t See Coming Medicare pays for short-term skilled nursing care after…
Washington, D.C. — Two House Democrats introduced sweeping new legislation this week demanding mandatory minimum nurse staffing levels at every nursing home in the country — a direct response to the Trump administration’s decision earlier this year to scrap federal staffing requirements that had been years in the making. Representatives Jan Schakowsky of Illinois and Lloyd Doggett of Texas filed the Safe Staffing Saves Lives Act, which would require nursing homes to provide at least 4.1 hours of direct care per resident each day. It would also mandate that a registered nurse be on duty 24 hours a day, seven…
Brooklyn, New York — A nursing home company with a history of fraud settlements and Medicaid diversion allegations has quietly offloaded three of its flagship Brooklyn facilities for a combined $296 million — including a record-breaking $161.5 million sale that stands as the largest real estate transaction ever recorded in Borough Park. The seller is Centers Health Care, the tri-state nursing home network owned by Kenneth Rozenberg and Daryl Hagler. The buyer is Emerald Group, a Lakewood, New Jersey-based healthcare company linked to Shmuel A. Serle. Huntington National Bank provided nearly $240 million to finance the purchase. A $161.5 Million…
North Miami Beach, Florida — A Miami-Dade County jury handed down one of the largest nursing home neglect verdicts in the county’s history this February, awarding a Florida family $14.7 million after their 82-year-old father died from severe pressure wounds while in the care of Krystal Bay Nursing and Rehabilitation. The verdict was a win on paper. Whether the Brakes family ever sees a dollar is another matter entirely. Horace Brakes Jr. had lived at the North Miami Beach facility for two years. His children say they raised concerns about his care repeatedly during that time. On one visit, a…
Lincoln, Nebraska — Nebraska is pushing to become the only state in the country to eliminate retroactive Medicaid coverage entirely — and if it goes through, nursing home residents and their families could be caught in the financial wreckage. The state’s Department of Health and Human Services is seeking a five-year federal waiver to set retroactive Medicaid coverage to zero months, effective October 1. Under current federal law, Medicaid will pay for up to three months of care before a patient even submits an application — a safeguard that exists precisely because emergencies don’t wait for paperwork. Nebraska’s proposal would end…
Washington, D.C. — As the federal government accelerates its push to move Medicare away from fee-for-service payment, skilled nursing facilities are largely being left behind. More than 90% of the nation’s nursing homes have no pathway into accountable care organization programs, according to the American Health Care Association and National Centers for Assisted Living — and industry leaders say that’s a problem CMS can no longer afford to ignore. Nisha Hammel, AHCA/NCAL’s vice president of reimbursement policy and population health, put it plainly: the current ACO models were never built for long-term care. They were designed with community-based populations in…
Harrisburg, Pennsylvania — Pennsylvania’s nursing homes have spent two decades absorbing a quiet penalty built into the state’s Medicaid system. For every dollar they spend caring for a Medicaid patient, they get 80 cents back. And unless the state legislature acts before June 30, that gap is about to get even wider. Operators across the state are now pressing lawmakers to reform the mechanism responsible — a tool called the budget adjustment factor, which the state uses to spread limited Medicaid funds across all nursing facilities when the budget doesn’t fully cover what they’re owed. How the Adjustment Factor Works…
Oakland, Maryland — Two residents died. Dozens more were hurt. And for months, the people in charge kept getting paid by Medicaid. Now they’re settling. Maryland Attorney General Anthony G. Brown announced this week that the state secured a $250,000 settlement with the owners of the Dennett Rehab Center, a nursing home in Oakland that state investigators say delivered consistently substandard care to hundreds of Medicaid residents. The deal also requires the facility to operate under a three-year corporate monitoring agreement — giving state officials ongoing access to its books, medical records, and staff. The Case Behind the Settlement The…
Washington, D.C. — The fax machine’s days in American healthcare are numbered — and for nursing homes, that clock is now ticking. The Centers for Medicare & Medicaid Services finalized a sweeping rule this week requiring HIPAA-covered entities, including skilled nursing facilities, to adopt standardized electronic systems for submitting claims-related documentation. The rule, published Friday, takes effect May 26, 2026, with full compliance required by May 2028. The move eliminates one of healthcare’s most persistent bottlenecks: the billions of faxed pages and paper mailings that flow between providers and insurers every year. CMS estimates the industry exchanges roughly 9 billion…
