Genesis evades insurance shakedown over COVID cases thanks to federal ruling
By
Kimberly Marselas
Dec 20, 2023
A federal appeals court has overturned a decision that could have cost skilled nursing provider Genesis Healthcare millions of dollars in COVID-19 claims not covered by its insurer.
Prior authorizations 2.0 : A pilot study
By
Steve Shain
Dec 19, 2023
There is one thing more frustrating than a delayed flight: an on-time flight, with a delay mid-air. The pilot announces some airline jargon about a gate change and holding pattern, and next thing you know...
An insider’s guide to managed care contract exclusions
By
Susie Mix
Dec 18, 2023
There’s a key question more providers need to know the answer to: What is a contract exclusion? A contract exclusion details the medications and treatments that are not included in the levels of a managed...
A bum rap?
By
John O'Connor
Dec 18, 2023
I’ve written on topics ranging far and wide across the long-term care spectrum. But I’m pretty sure this will be my first foray into the world of fake butt accusations.
Class action suit targets Medicare Advantage insurer’s use of AI to end rehab stays
By
Josh Henreckson
Dec 14, 2023
Two skilled nursing patients filed a class action suit against Humana Tuesday — alleging their Medicare Advantage benefits were cut prematurely short because of Humana’s wrongful reliance on artificial...
Nursing home thrust into controversy after dangling KitchenAid prize for 5-star reviews
By
Josh Henreckson
Dec 14, 2023
Nursing homes are always under pressure to receive stellar online reviews. But the aggressive tactics of one Massachusetts facility has raised questions of how far they should go to get 5-star reviews. ...
Exploitation concerns persist as push for immigrant workers grows
By
Josh Henreckson
Dec 13, 2023
Immigrant nurses are already a key demographic in long-term care, and are likely to become more vital in the future. But allegations of coercive labor practices by some providers and staffing agencies...
This year they’ll give you something to cry about
By
Kimberly Marselas
Dec 13, 2023
The holidays are here, and that means it’s time for the second-best advertising season of the year. Yes, I know it’s all consumerism designed to make me spend my hard-earned money, but I can’t help...
Green House providers finally finding traction with state governments
By
Josh Henreckson
Dec 08, 2023
Providers pursuing Green House projects and prioritizing steps to enhance care quality such as private rooms have won significant victories on Medicaid reimbursement funding in Ohio.
Even as prevalence shrinks, PE chaos tarnishes nursing home sector
By
Kimberly Marselas
Dec 05, 2023
The plight of a private-equity backed, multi-state nursing home chain demonstrates the ugly challenges operators could face as officials ratchet up regulatory and transparency pressures and large-scale...