Risk Factors Update Summary

• CMS proposed minimum nurse staffing requirements for SNFs: 0.55 HPRD for RNs and 2.45 HPRD for NAs.
• Changes in Medicare reimbursement rates may significantly impact revenue, with a 3.34% decrease in CY 2024.
• Proposed California legislation may increase minimum wage for healthcare workers, impacting profitability.
• CMS proposed rule requires a RN on-site 24/7, with potential financial hardship accommodations.
• Medicaid changes include a 6.2% increase in FMAP payments in Q1 2023, declining to 2.5% in Q4.
• Texas bill restores Medicaid funding for SNFs through August 31, 2023, providing financial relief.
• Increased scrutiny on staffing levels may impact operations and profitability, with potential adverse effects.
• Increased scrutiny on SNFs may lead to penalties, fines, and sanctions, affecting financial condition.
• California law raises minimum wage for healthcare employees, affecting labor costs and profitability.
• Direct spending requirements in certain states may impact operational results and compliance.
• CMS proposed rule sets SNF minimum staffing requirements, likely increasing demand for labor.
• Proposed federal standards may require hiring substantially more staff, impacting financial performance.
• Increased quality measure thresholds by CMS may impact star ratings and ability to attract residents.
• Proposed federal staffing changes may result in increased labor costs and competition for skilled workers.
• Potential changes to ACA regulations could adversely affect business operations and financial condition.
• CMS changes in staffing case-mix adjustment methodology may affect staffing ratings and evaluations.
• Proposed federal rule may lead to increased operating costs and require additional compensation for staff.
• Increased audits and investigations by CMS may lead to penalties, fines, and operational challenges.
• Potential unionization due to forthcoming regulations may impact operations and employee relations.
• Changes in state laws may intensify competition for labor, impacting revenue and profitability.
• Ongoing reviews and audits of claims data may result in payment denials and regulatory oversight.