Nursing Homes in State Owed Almost $500M in Medicaid Back Payments Due to Managed Care Transition Delays
Indiana nursing homes are awaiting $462 million in Medicaid back payments after the state’s shift to managed care created administrative bottlenecks. The Centers for Medicare & Medicaid Services has not approved Indiana’s 2026 payment methodology, causing two quarterly disbursements to be delayed. The One Big Beautiful Bill Act adds further calculation complexity, while a February 2026 law will move long‑stay residents back to a fee‑for‑service model in 2027. The cash‑flow gap is hitting smaller operators hardest, with 496 facilities still unpaid.
‘It’s Not Logical’: State-Level Nursing Home Staffing Mandates and Policy Pressures Clash With Workforce Gains in 2026
Skilled‑nursing operators reported notable staffing improvements in 2025, driven by reduced agency reliance, stronger hiring pipelines, and paid training programs. Gurwin Healthcare lowered its turnover to 31%, a full 10 points below the industry average, while Journey eliminated most agency...
CareTrust Announces $119M in New Investments, Including Deal Tied to 5 Nursing Homes
CareTrust REIT announced the closing of two new investments totaling $119 million, including a five‑facility skilled‑nursing portfolio in the Midwest and a senior‑housing campus in Southern California. The Midwest assets comprise 506 licensed beds and are financed through a mortgage loan...
Same Services, Sicker Individuals, Less Time: Daily Frustrations with Medicare Advantage as Acuity Rises in Nursing Homes
Medicare Advantage plans are forcing nursing homes to deliver the same level of care to sicker residents in dramatically shorter stays, compressing average skilled‑nursing episodes from about 21 days to as little as 7‑14 days. Methodist Retirement Communities (MRC) reports...
Clock Is Ticking: CMS LEAD Applications Due May 17 for Nursing Homes, but Complexity Demands Careful Review
The Centers for Medicare & Medicaid Services opened applications for its new Long‑Term Enhanced ACO Design (LEAD) model, with a May 17 deadline and a Jan 1 2027 start date. LEAD replaces the outgoing ACO REACH program and promises broader inclusion of high‑needs...
Hospitals Allegedly Retained $500M Meant for Nursing Homes, State Audit Finds
Utah’s state auditor found that hospital‑affiliated entities retained roughly $472 million of the $922 million collected through the Skilled Nursing Facility Upper Payment Limit program, leaving only about $450.5 million for nursing homes. The audit, covering 2016‑2024, says 51 percent of supplemental Medicaid funds...
Nursing Home Oversight: CMS Revises Survey Rules, Strengthens Penalties and Immediate Jeopardy Standards
The Centers for Medicare & Medicaid Services (CMS) issued sweeping revisions to its nursing home survey rules, tightening onsite timelines, clarifying revisit protocols, and expanding civil money penalties. The agency also refined the definition of Immediate Jeopardy to include scenarios...
SNN Parent Company WTWH Acquires HealthLeaders
WTWH Media, the parent of Skilled Nursing News, announced the acquisition of HealthLeaders, a media and events platform for hospital and health‑system executives. The deal broadens WTWH’s health‑care portfolio, linking long‑term‑care and acute‑care audiences. HealthLeaders’ executive community and flagship Exchange...
State Audit Reveals Years of Missed Nursing Home Inspections, Medicaid Eligibility Failures
A Kentucky state audit uncovered a massive backlog of nursing‑home inspections, with 162 of 190 surveys delayed by up to 51 months, far beyond the federal 15‑month limit. The audit also found 358 deceased individuals still listed as Medicaid‑eligible and...
Flu Hospitalizations in Nursing Homes Reduced by Quick, Widespread Preventive Antiviral Treatment
A JAMA Internal Medicine study of 404 influenza outbreaks in U.S. nursing homes found that administering the antiviral oseltamivir to at least 70% of residents within two days sharply reduced 14‑day hospitalizations. The retrospective cohort covered over 35,000 resident observations...
Inside Surviving Nursing Home Audits in the Age of AI
Nursing home providers are facing heightened audit scrutiny as AI and automation tools scan claims for patterns like note cloning, over‑coded services, and vague documentation. Clinical leaders at the PALTC conference emphasized that proactive, precise documentation—clearly linking CPT codes, ICD...
Nursing Homes Fear Being Shortchanged in $1.5B Health Care Funding Split Amid Budget Negotiations
New York is considering a $1.5 billion health‑care funding increase that will be divided between hospitals and nursing homes, but the exact split remains uncertain. Nursing‑home operators are pressing for at least $750 million in Medicaid‑related support, arguing that current rates have...
‘Uphill Battles on Many Fronts’: HDG CEO on Supercharged Nursing Home Payment Pressures, Staffing Challenges
Health Dimensions Group (HDG) CEO Erin Shvetzoff Hennessey warned that skilled nursing facilities (SNFs) are facing "supercharged" payment pressures from Medicaid funding challenges, a drop in private‑pay residents, and managed‑care reimbursement cuts. The financial squeeze coincides with rising resident acuity...
Skilled Nursing Dealbook: Nursing Homes Change Hands in South Carolina, Florida and Mississippi
A New York private‑equity firm bought a 181‑bed skilled nursing facility in South Carolina, planning to lease it to a regional operator. A New Jersey‑based operator acquired a 120‑bed Florida facility and a 100‑bed Mississippi property, both with high occupancy...
A Virtual Lifeline: Nursing Homes Push Telehealth Reform, Highlight Access in Rural Facilities, Say Waivers Create Uncertainty
Telehealth has become essential for rural nursing homes, a fact underscored by the recent government shutdown that exposed reliance on temporary waivers. Operators like Care Initiatives use virtual platforms for psychiatry, therapy, and after‑hours care, while advocacy groups push the...
As CMS Expands ACOs, Nursing Homes Push for More Aligned Model as 90% Are Left Out
CMS is broadening its accountable care organization (ACO) portfolio, but more than 90% of skilled nursing facilities remain excluded. Administrative hurdles and misaligned design keep fewer than 10% of SNFs in existing ACOs. Industry leaders propose a dedicated long‑term‑care ACO...
CMS Leader Talks Risk-Based Surveys, Staffing Campaign, Survey Hot Spots
CMS announced that risk‑based surveys will be expanded to roughly 10% of U.S. skilled nursing facilities, with final criteria slated for release by late summer. Facilities receiving a risk‑based survey can still be escalated to a full recertification if inspectors...
Frontline Honors Award Winner: Jean Verlus, Home Care Registered Nurse, VNS Health
Jean Verlus, a home‑care registered nurse at VNS Health, was named to the Frontline Honors Awards Class of 2025, recognizing his exceptional dedication and patient‑centered care. He recounts his personal journey into nursing, the misconceptions he faced about home care,...
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[UPDATED] OIG Exposes ‘Alarming’ Misuse and Masking of Antipsychotic Drug Use in Nursing Homes
The Office of Inspector General released two reports exposing extensive misuse of antipsychotic drugs in U.S. nursing homes, especially among dementia patients. Facilities frequently prescribed these medications as chemical restraints and deliberately misdiagnosed residents with schizophrenia to evade Medicare quality...
CMPs May Fall Short, Policy Brief Urges CMS to Recalibrate Nursing Home Fines
A Rockefeller Institute policy brief finds that most civil money penalties (CMPs) imposed on nursing homes in 2023 were modest, averaging under 0.5% of net patient revenue despite a total $204 million in fines. The analysis of 3,745 facilities shows that...
‘Considerably’ More Complicated: Nursing Homes Reeling From Estimated $1B in Owed Incentive Payments Face Federal, State Policy Shifts
Ohio nursing homes face an estimated $1 billion in overdue quality incentive payments after the state Supreme Court ruled Medicaid miscalculated rates for three consecutive years. The Ohio Department of Medicaid has yet to complete the required recalculation, leaving the exact...
‘Time of Crisis’: Nursing Home Giant PACS’ CEO on Emerging Stronger From a Federal Investigation
PACS Group reported a $5.29 billion revenue in 2025, marking almost 30% year‑over‑year growth and expanding to 323 facilities in 17 states. CEO Jason Murray said the internal billing investigation is closed, while a federal probe continues without adding new risks....
More LPNs, Fewer RNs: Nursing Home Unionization Reshapes Staffing but Not Quality
Unionization in U.S. nursing homes has altered staffing mixes without affecting overall care quality. Six years after a union vote, facilities added 0.34 LPN hours per resident day (4.2 % increase) while RN hours dropped 0.041 per resident day (9.1 % decline),...
Skilled Nursing Dealbook: Carefam Raises $14.5M For AI-Powered Staffing; Sage Raises $65M to Expand AI-Assisted Care
Care technology firms Carefam and Sage announced significant funding rounds to scale AI-driven solutions in health‑care staffing and senior‑care delivery. Carefam secured $14.5 million, led by Pitango HealthTech, to expand its conversational AI platform that automates hiring, credentialing, and onboarding for...
MA Spending 14% Higher Than FFS Medicare, Including at Nursing Homes, Driven by Coding Intensity and Enrollment Trends
Medicare Advantage (MA) spending is projected to be 14% higher than fee‑for‑service Medicare in 2026, adding roughly $76 billion in excess costs. The gap stems from intensified diagnostic coding, a quality‑bonus program that adds $16 billion, and favorable selection that boosts payments...
Larry H. Miller COO Frasure Says Dealing With MA Burdens and Higher Acuity Has No ‘Short-Term Fix’
Larry H. Miller Senior Health capped 2025 with the $142 million acquisition of the Kissito Healthcare portfolio, adding six Virginia skilled‑nursing facilities and 532 beds. The integration introduced specialty services such as ventilator, tracheostomy and memory‑care units, expanding the company’s clinical...
‘Phone-a-Friend’: On-Call Coaching Model Helps Nursing Homes Improve Care Quality
The Moving Forward Nursing Home Quality Coalition piloted an on‑call coaching model paired with Quality Assurance and Performance Improvement (QAPI) and leadership training in four low‑rated, high‑Medicaid facilities in Michigan. At Fountain Bleu, hospitalizations dropped from 60% to 22% and...
Skilled Nursing Dealbook: NY Nursing Home Sells for $75M; Selectis Selling 2 Facilities to Journey for $15.7M
The skilled‑nursing market saw several high‑profile transactions this week. Excelsior Group acquired the 280‑bed Union Plaza Care Center in Flushing, New York for $75 million, while Selectis Health agreed to sell its two Georgia facilities—Glen Eagle and Eastman Healthcare—totaling 201 beds...
State Lawmakers Weigh Bill to Crack Down on Nursing Home Abuse With Tougher Penalties, More Transparency
Missouri lawmakers are advancing a bill that would increase penalties for nursing‑home abuse to a Class E felony and require facilities to carry at least $1 million in liability insurance. The legislation also mandates the Department of Health and Senior Services to...
Inside PE’s ‘Financial Gamesmanship’: PE-Owned Nursing Homes Face 10 Times Greater Bankruptcy Risk, Higher Mortality
New research from NYU Stern finds private‑equity‑owned nursing homes have 11% higher resident mortality, 4.4% fewer nurses, 25% more hospital complications, and a ten‑fold increase in bankruptcy risk. The study links these outcomes to aggressive debt‑laden buyouts, sale‑leaseback deals and...
‘Code Red’: Chronic Underfunding Is Forcing State’s Nursing Homes to Close, Worsened by Medicaid Cuts, $2B Gap
Health care leaders in Western New York warned that chronic underfunding and looming federal Medicaid cuts are creating a $2 billion budget gap that could force additional nursing homes and hospitals to close. Recent shutdowns of Weinberg Campus, Eastern Niagara Hospital...
‘Important to Balance’: As CMS Reviews Nursing Home Antipsychotic Measure, Agency Comments on Dilemma
The Centers for Medicare & Medicaid Services (CMS) is actively reviewing its antipsychotic quality measure for nursing homes, aiming to distinguish appropriate from inappropriate prescribing. The agency’s latest hybrid method, which blends Minimum Data Set and claims data, has drawn...
Ripple Effects of 5-Star in Nursing Homes, and Why ‘Upstream’ Management Unlocks Higher Ratings
Nursing homes can boost their CMS Five‑Star ratings by adopting an "upstream" management approach that anticipates quality‑measure triggers before they occur. Operators are urged to analyze community trends, validate data, and engage interdisciplinary teams from admission through discharge. Proactive oversight...
Skilled Nursing Dealbook: Welltower-Affiliated Nursing Homes Sell for $82.4M; Multi-State Deal Secures $51.2M in Financing
Hill Valley Healthcare purchased two Virginia skilled‑nursing facilities from a Welltower affiliate for $82.4 million, marking the REIT’s exit from assets originally bought for under $15 million each. Capital Funding Group closed a $51.2 million bridge‑loan to acquire four multi‑state SNFs with 487...
Voices: Laura Geiger, DNP, FNP-BC, NEA-BC, Chief Clinical Officer, Lumina Care
Lumina Care’s Chief Clinical Officer Laura Geiger explains how the company embeds telehealth into skilled‑nursing facilities to extend clinical support from admission through discharge. By establishing standardized, patient‑centered protocols and real‑time EMR integration, Lumina acts as a virtual extension of...
Cost and Trust Drive Post-Acute Care Decisions, Nursing Home Choices – U.S. News Survey
The U.S. News survey of 206 recent discharges found trust to be the dominant factor—93% rated it extremely or very important—slightly outweighing clinical quality. Cost was the top driver when choosing between home health and skilled nursing, yet many respondents...
Frontline Honors Award Winner: Ashley Lott, Certified Nursing Assistant, Litchfield Health & Rehab Center
Ashley Lott, a Certified Nursing Assistant at Litchfield Health & Rehab Center, has been named to the Frontline Honors Awards Class of 2025 by Skilled Nursing News. The award, driven by peer nominations, recognizes frontline workers who deliver exceptional resident...
AHR Lauds Trilogy Gains, Medicare Advantage Rate Momentum for Nursing Homes During Leadership Transition
American Healthcare REIT (AHR) posted a strong Q4 2025, turning a $32.4 million loss into a $10.9 million profit, driven by its Trilogy senior‑care campuses. Trilogy’s same‑store NOI rose 18.4% year‑over‑year and occupancy hit 90.6% in the quarter, while Medicare Advantage rates...
PACS Touts Zero-Deficiency Surveys, High Occupancy and 73% of Facilities Earning Top-Tier Star Ratings
PACS Group reported FY 2025 revenue of $5.29 billion, up 29% year‑over‑year, and net income of $191.5 million, driven by strong occupancy and disciplined acquisitions. Occupancy averaged 89.1% overall and 94.9% at mature facilities, well above the industry average. More than 73%...
Fixing Burnout, Funding and Public Perception in Nursing Homes: AAPACN’s New Blueprint
The American Association of Post‑Acute Care Nursing (AAPACN) unveiled a multi‑year blueprint to tackle nursing‑home workforce burnout, funding volatility, and negative public perception. Its strategy centers on culture change, leadership development, and technology‑driven documentation tools to ease staff burdens. AAPACN...
Dual-Eligible MA Stroke Patients Face Higher Odds of Low-Quality Nursing Home Discharge
A JAMA Network Open study of 44,078 stroke admissions found that dual‑eligible beneficiaries enrolled in Medicare Advantage (MA) were significantly more likely to leave the hospital for low‑quality skilled nursing facilities (SNFs) than their fee‑for‑service (FFS) peers. Roughly 58 % of...
Skilled Nursing Dealbook: 280 Beds Realigned in Ohio as 80-Bed Nebraska Nursing Home Changes Hands
Senwell Senior Investment Advisors completed a multi‑party realignment of more than 280 skilled‑nursing beds across Ohio, moving capacity from overbedded counties to operators targeting high‑demand markets. The transaction involved 12 unnamed sellers and multiple buyers seeking growth or new facility...
State Bill to Standardize Nursing Home Admission Contracts, Limit Role of ‘Assistors’
New Jersey lawmakers introduced a bill requiring the Department of Health to create uniform admission contracts for nursing homes and assisted‑living facilities and to restrict Medicaid "assistors" from providing legal or financial guidance. The legislation also mandates clear notification of...
Higher Medicaid Rates Boost Chances of 4- and 5-Star Ratings for Nursing Homes, JAMDA Study Finds
A new JAMDA cross‑sectional study of 9,473 freestanding nursing homes finds that higher Medicaid payment rates are linked to a greater likelihood of earning 4‑ or 5‑star overall, health‑inspection and staffing ratings on CMS’s Care Compare. Nearly 79% of facilities...
Cautious on Acquisitions, Some Nursing Home Operators Shift Focus to Value-Based Investments
Nursing home operators are slowing mergers and acquisitions in 2026 as inflated asset prices and an aging facility stock raise concerns about long‑term sustainability. Leaders such as A.G. Rhodes, Diversicare and Focused Post‑Acute are prioritizing capital for modernization, data analytics...
State Bills Target Nursing Home Transparency, Staffing and CNA Funding
Virginia lawmakers are debating a suite of bills aimed at improving nursing home oversight, staffing, and transparency. One proposal sets minimum nursing care hours at 3.08 per resident per day through 2027, rising to 3.25 by 2031 for facilities in...
‘We’re Not Through’: More Hybrid QM Data Collection Likely Ahead for Nursing Homes
The Centers for Medicare & Medicaid Services (CMS) is expanding its hybrid quality‑measure (QM) methodology, merging Minimum Data Set (MDS) information with Medicare claims to improve accuracy. Recent OIG reports on antipsychotic medication use and falls with major injury prompted...
CareTrust Execs on Larry H. Miller Operating Partnership, Nursing Home Sector Upswing, ‘Beefy Coverage’
CareTrust REIT reported a transformative 2025, marking its most active investment year by a factor of five. The REIT completed 14 skilled‑nursing facility acquisitions in Q4 and added six more through a new operating partnership with Larry H. Miller Senior...
Sabra CEO: Skilled Nursing M&A Remains Relationship-Driven and Limited in 2026
Sabra Health Care REIT sold seven skilled‑nursing properties for $51 million in Q4, signaling a sharp pullback in nursing‑home M&A for 2026. The REIT’s pipeline will focus almost entirely on senior housing, which represents roughly 95% of its investment opportunities and...
Senate Democrats Revive Biden-Era Push for Federal Nursing Home Staffing Minimums as Advocates Call Policy ‘Outdated’
Seven Democratic senators reintroduced the Nurses Belong in Nursing Homes Act to restore federal staffing standards that were struck down by courts. The bill would require a registered nurse on site 24/7 and a minimum of 3.5 care hours per...