Medicare Advantage Organizations
Some long-term care providers are refusing to accept residents based on payor source. This type of discriminations is illegal. Research has already found that admissions discrimination among less profitable residents is “widespread” in nursing homes.
The industry claims admitting residents covered by managed care plans is not worth it because they doubt they’ll be reimbursed for their services. A federal report found that Medicare Advantage organizations have often improperly denied or delayed services to beneficiaries to increase profits.
Maureen McCarthy is CEO of post-acute care advisory firm Celtic Consulting. She wrote in a recent blog post.
“The reality is, when LTC providers admit managed care beneficiaries, they run the risk of not receiving reimbursement for care already provided.”
The American Health Care Association (AHCA) has projected 400 SNF closures in 2022. Nate Schema is the CEO of The Evangelical Lutheran Good Samaritan Society. They own hundreds of facilities nationwide. Schema wants more bailout funds.
“During the pandemic, it was an operational crisis. It truly has turned into a workforce and a financial crisis,” noted Schema. “Those stimulus funds aren’t there to support us and to buoy us up anymore, and you know, quite frankly, the occupancy hasn’t returned. Now we’re struggling to find staff.”
McKnight’s recently reported that Sabra Health Care REIT is shedding its ownership of skilled nursing facilities in favor of senior housing and behavioral health facilities. These facilities have less regulation and oversight than nursing homes. Sabra is a California-based real estate investment trust. Sabra CEO is Rick Matros who recently complained:
“No matter how well we think things may be going for us in terms of future opportunities, this industry has bad headlines — most of the time undeserved.”
See additional coverage of the earnings call in McKnight’s Senior Living.