Maybe you can blame overly inflated healthcare costs or maybe you can blame more austerity measures.  In the end, all that matters is that nursing home coverage, rehab, and skilled nursing coverage reimbursement rates are being cut by Medicare and Medicaid.  The move is wreaking havoc among some of the providers that cater to this segment.

The Centers for Medicare & Medicaid Services has issued a final rule that cuts Medicare skilled nursing facility Prospective Payment System payments by 11.1% in FY 2012 by $3.87 billion. The cuts are listed as being to “correct for an unintended spike in payment levels and better align Medicare payments with costs.”

The 2012 recalibration will result in a reduction of 12.6% to skilled nursing facility payments of $4.47 billion, but this would be partially offset by the FY 2012 update with an increase of 1.7% to Medicare payments to skilled nursing facilities.  This reflects a market basket of goods and services reduced by a 1% multi-factor productivity adjustment mandated by the Affordable Care Act.

A 2.5% increase for hospice reimbursement is not going to be anywhere close to offsetting the losses here.

Kindred Healthcare Inc. (NYSE: KND) is in three segments of hospitals, health services, and rehabilitation.  It gets somewhere close to 30% of its revenues from this segment being cut.  Its stock opened down at $14.06 and shares are down almost 27% at $13.77 versus a 52-week range of $11.52 to $28.99.

Sun Healthcare Group Inc. (NASDAQ: SUNH) may have its entire profits gone or at risk now as it has awful exposure here.  Its shares opened down at $3.21 versus a $7.00 close.  Shares are now down a total of 55% at $3.13 and its shares hit a low so far of $3.10 (52-week low) versus a 52-week high of $15.01.

Skilled Healthcare Group Inc. (NYSE: SKH) operates skilled nursing facilities, as well as assisted living facilities, hospice service providers, home health providers, and a rehabilitation therapy business. Its stock is down a sharp 37% at $5.44 after opening at $6.61 this morning.  Its 52-week trading range is $2.33 to $15.93.

Five Star Quality Care Inc. (NYSE: FVE) operates senior living communities via independent living or congregate care communities, assisted living communities, and nursing facilities, is down “only” about 8% at $4.55 versus a 52-week trading range of $3.50 to $8.95.

Sunrise Senior Living Inc. (NYSE: SRZ), which offers senior living services and independent living services, is down only 3% at $8.53 against a 52-week range of $2.18 to $12.44.

National Healthcare Corporation (NYSE: NHC) operates and manages long-term health care centers, and associated assisted living and independent living centers.  Its stock is down 12% at $41.78 against a 52-week range of $33.51 to $53.08.

Amedisys Inc. (NASDAQ: AMED) is in home health and hospice services and its shares are down 3% at $25.08. Almost Family Inc. (NASDAQ: AFAM), a home health provider, is down 3.7% at $24.33.

Senior Housing Properties Trust (NYSE: SNH) is a REIT in hospitals, nursing homes, senior apartments, independent living properties, and assisted living centers.  Its shares are also down today by 2.4% at $23.37 versus a 52-week range of $20.42 to $25.28.

Here is what is interesting about this move… This was “pre-budget deal.”  If you think that Medicare and Medicaid payments are the only ones at risk in the weeks, months, and years ahead, you might want to think again.  Cuts will be coming for a myriad of reasons and from many angles.  Companies which rely heavily or solely on government contracts for goods and services are all under more scrutiny.

JON C. OGG

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