The Texas Nursing Home Upper Payment Limit (UPL) could result in significant financial benefits for nursing home operators and many Texas governmental hospitals. Here is an update on the program’s status and key action steps. In October 2012, the Centers for Medicare & Medicaid Services (CMS) approved a Texas State Plan Amendment allowing for a nursing home Intergovernmental Transfer (IGT)/UPL program
The long-term care (LTC) mergers and acquisitions (M&A) market had an outstanding year in 2012, generating 189 deals worth $9.2 billion. The high transaction volume for the year makes 2012 the most active year in LTC M&A since the late 1990s, with approximately 60 percent more transactions than the annual average over the previous four years.
The results of recent recovery audit contractor (RAC) automated reviews of hospital services were outlined in the January 2013 Medicare Quarterly Provider Compliance Newsletter, Volume 3, Issue 2 . Among the hot topics discussed was a significant issue for physician providers: the RACs identified that inappropriate current procedural terminology (CPT) codes were being assigned for related professional evaluation and management (E/M) services “rendered in swing bed facilities (with nursing facility levels of care)” in the same episode of care as an acute inpatient stay, when the patient was not “on a leave of absence from the hospital.” Specifically, inpatient hospital CPT codes, i.e
Although compliance programs for skilled nursing facilities (SNFs) are not a new concept, the Patient Protection and Affordable Care Act , enacted March 23, 2010, requires nursing facilities to have a compliance and ethics program in operation by March 23, 2013, that effectively prevents and detects criminal, civil and administrative violations under the Social Security Act of 1935 and promotes quality of health care.
As last reported, the long-term care (LTC) merger & acquisition (M&A) market had a record year in 2011 in terms of transaction volume, reporting approximately 74 percent more transactions than the annual average for the previous three years. Although 2011 was a tough year to follow for LTC M&A, the first quarter of 2012 started strong, matching the same period in 2011 with 39 reported transactions.
2011 Long-Term Care M&A Activity Finishes Strong The long-term care (LTC) merger & acquisition (M&A) market saw its best year in 2011 since peaking in 2006 and 2007 in terms of publicly announced transactions and dollar volume. Results are still filtering in, but with a final year-end projection of 150 transactions, 2011 is slated to be the most active year in LTC M&A since the late 1990s. The first three quarters of the year alone exceeded transaction counts for full years 2008 through 2010 with 118 deals.
Long-Term Care M&A Activity Accelerates With consecutive increases in transaction volume each of the last six quarters, long-term care (LTC) mergers and acquisitions (M&A) volume has been on a torrid pace following the 40-transaction jolt in fourth quarter 2009. This accelerated deal volume can be traced to a number of factors affecting buyers and sellers. What’s driving sellers: Increased regulation and reimbursement pressures Uncertainty about future reimbursement Aging facilities needing major renovations or replacement Improving valuations Beginning wave of baby boomer owners nearing retirement age What’s driving buyers: The need to spread overhead costs due to regulatory and reimbursement changes Availability of cheap financing The impending wave of baby boomers needing future care As the graphs below illustrate, after 110 transactions in 2010, there have already been 74 reported through the first half of 2011