Many of the biggest announcements the past 12 months will continue to play out in 2019 and beyond. Those, of course, include a new payment model that will dramatically reshape how skilled care is delivered, along with new methods of measuring staffing at SNFs, and a high-profile bankruptcy that just begun winding its way through the courts.

Here is a quick chronological look at seven of the stories that resonated most with McKnight’s readers in 2018.

HCR ManorCare strategy to exit bankruptcy gets OK; will sell 74 facilities

Six weeks after entering Chapter 11 bankruptcy, HCR ManorCare won federal approval for its exit strategy from the process. In mid-April, Judge Kevin Gross approved the $7.1 billion reorganization plan to transfer ownership to HCR’s landlord, Quality Care Properties Inc., by the end of 2018.

CMS gives skilled nursing 2.4% Medicare pay raise, unveils another new resident classification system

The Centers for Medicare & Medicaid Services made a big splash in late April, when it announced an $850 million pay raise for SNFs in fiscal 2019, alongside major simplifications to the previously pitched resident classification system. The Patient-Driven Payment Model will reduce the number of payment group combinations by 80, and use more standardized items for payment calculations to “greatly simplify” providers’ paperwork, officials said in the spring.

New Patient Driven Payment Model (PDPM) driving questions about therapy

Days after the announcement, providers began drilling down into the details of the new payment model, questioning how the new formula will influence therapy services in the future.

Close to 1,400 nursing homes lose a rating star due to new staffing info

Nearly 1,400 nursing homes lost star ratings in Nursing Home Compare staffing levels because of inadequate numbers of registered nurses or from a lack of reporting reliable staffing information, we reported in late July. Influenced by the new Payroll-Based Journaling method of measuring staffing, CMS updated the ratings on July 25, leaving 1,387 out of 15,616 facilities (nearly 9%) with the lowest ratings for staffing.

Study claims nursing homes increasingly pushing residents into ‘unnecessary’ rehab at end of life

A University of Rochester Medical Center study in October contended that nursing homes may be pushing dying patients into unnecessary and potentially harmful high-intensity rehab services. Provider advocates, meanwhile, blasted the findings in the week’s that followed.

Nursing homes feeling the squeeze after feds release new quality data online

CMS released new data on the quality of care delivered in skilled nursing facilities in late October, ratcheting up pressure on providers to improve outcomes. Federal officials added five brand new quality-related measures to Nursing Home Compare, relating to pressure ulcers, falls and spending per beneficiary.

Senior Care Centers files for bankruptcy

A troubled Dallas-based operator with more than 100 skilled nursing and assisted living facilities filed for bankruptcy earlier this month, hoping to get out from under the weight of skyrocketing lease costs. Senior Care Centers announced the move Dec. 4, noting that it would allow the company to continue operating without interruption.