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Nursing Home Payment and Finance

We advocate for Medicare and Medicaid payment systems for nursing homes that will appropriately account for essential costs of high quality care. We work with the Centers for Medicare and Medicaid Services (CMS) to obtain the most up-to-date information on payment policies and updates.


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Skilled Nursing Facility Medicare Rate Calculation Tools Update

We have updated the Medicare Part-B rate calculation tool for final rates reflecting provisions of the Bipartisan Budget Act signed into law in December 2013. The law allowed for a 0.5% average increase in Medicare payment rates and extended the 2% sequestration cut for all health care providers for another 2 years. Access to this tool requires login via My.LeadingAge.

CMS Publishes Proposed Rule for SNF PPS and Consolidated Billing for Fiscal Year 2015 

On May 6, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that would update the payment rates used under the skilled nursing facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2015. Comments will be accepted by CMS until June 30, 2014.

Refinancing and Consolidation Accomplished through Lean

Sims Mortgage Funding, Inc. used the Lean program to refinance 2 health care facilities located in Orange County, New York. Elant at Goshen is a 236-bed skilled nursing, assisted living and adult day care facility that was constructed in 1985 and expanded in 1995. Elant at Meadow Hill is a 192-bed skilled nursing facility built in 1973 and expanded in the 1980s.

Nursing Homes: MedPAC Recommends No 2015 Payment Update

In its recent report to the U.S. Congress, the Medicare Payment Advisory Commission (MedPAC) projected Medicare payment margins among skilled nursing facilities will average 12% in 2014. Based on the size of those margins, without taking account of the continuing 2% sequestration, MedPAC recommended that Congress cancel the payment update that is supposed to take effect on October 1, 2014. Given sequestration and MedPAC's finding that total nursing home margins, including Medicare, Medicaid and private pay, average 1.8%, we will urge Congress to allow the payment update to take effect as scheduled under current law.

Positioning Yourself in a Managed Care/ACO World

Cheryl Phillips, our senior vice president of advocacy, takes a look at how LeadingAge members should be positioning themselves for the new world of integrated systems of care. Learn about the 3 major measurements the payors and health care systems will be looking at.