Multiple studies have illustrated concerns regarding private equity and investment trusts purchasing and managing such facilities.
The U.S. Department of Health and Human Services (HHS) has announced additional action to increase transparency of nursing-home ownership and management. The Department recently issued a proposed rule to require nursing homes to disclose to the Centers for Medicare & Medicaid Services (CMS) additional ownership and management information. The rule also includes private equity and real estate investment trust definitions, setting the stage for the disclosure of which nursing-home owners fall under either category.
This sounds like an important development in the effort to improve nursing-home care. Such transparency can help ensure that nursing homes are held accountable for the quality of care they provide, and it can give residents and their families the information they need to make informed decisions about their care.
Private equity and real estate investment trusts have increasingly become involved in the ownership of nursing homes in recent years. While these types of investors can bring financial resources to the table, there have been concerns about their focus on profits at the expense of quality care.
Requiring nursing homes to disclose ownership and management information, including whether they are owned by private equity or real-estate investment trusts, can help ensure that these facilities are providing the highest quality of care possible. It can also help identify any potential conflicts of interest that may be impacting care provided to residents.
A study published in the Journal of the American Medical Association (JAMA) found that nursing homes owned by private-equity companies had more deficiencies in quality of care, including more deficiencies related to infection prevention and control, compared to non-private equity-owned nursing homes. Another study published in the New England Journal of Medicine found that private equity-owned nursing homes had higher rates of hospitalizations and lower nurse staffing levels, compared to non-private equity-owned nursing homes.
These findings suggest that there may be a link between ownership type and quality of care in nursing homes.
Overall, this proposed rule is a positive step toward improving the quality of care in nursing homes and ensuring that residents and their families have access to the information they need to make informed decisions.
It finally happened! The Centers for Medicare & Medicaid Services (CMS) finally released the 2026 Outpatient Prospective Payment Final Rule on Friday at 4:15 pm,
Lots of things happening last week for me to talk about. First, still no sign of the 2026 Outpatient Prospective Payment System (OPPS) Final Rule.
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Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
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Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
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