For many skilled nursing operators, the Medicare Advantage (MA) “value proposition” has turned into an operational and financial strain. What was meant to streamline care has instead become a daily drain on staff time, budgets, and—ultimately—resident outcomes.
A new AHCA survey shows just how widespread the problem is: nearly two-thirds of nursing homes face MA denials or delays daily or weekly. For administrators, that doesn’t just mean frustration. It means real costs:
Staff Hours Lost: Each denial triggers an appeal. That process can involve medical records, phone calls, multiple staff reviews, and weeks of back-and-forth. What could have been minutes of care delivery becomes hours of paperwork.
Increased Overhead: Providers must allocate compliance staff or pull clinicians away from resident care to handle insurance disputes. Either way, payroll dollars are burned on administrative cycles rather than frontline service.
Cash Flow Disruption: When denials pile up, reimbursements stall. Facilities can wait months for payments on services already delivered, tightening cash flow in an industry already operating on razor-thin margins.
Readmission Risk: Early discharges “against medical advice” often lead to hospital readmissions. Not only do these outcomes compromise quality scores, but they also increase long-term costs for providers and the system.
The Hidden “Denial Tax” on Facilities
It’s no secret that most denials are eventually reversed—54% of providers say “sometimes,” 3% say “always.” But by then, the damage is done. Facilities have already absorbed the “denial tax”: the hidden expense of chasing dollars instead of focusing on care.
Consider this: even if one denial is overturned, the hours spent appealing it are unrecoverable. Multiply that across dozens of residents and multiple insurers, and the cost rivals major budget line items.
A Call for Balance
Operators don’t oppose oversight, nor do they resist accountability. But they can’t afford a system that forces them to divert scarce resources from care to claims. As policy evolves, the industry must push for a balance where oversight protects against abuse without punishing providers who are delivering medically necessary care.
Until then, nursing homes are left to navigate a broken cycle—absorbing the financial and operational hit while advocating for the seniors in their care.
📌 Key Takeaways for Operators
✅ Denials = hidden costs. Each reversal still drains staff hours and payroll.
✅ Cash flow suffers. Reimbursements stall, creating financial strain for facilities.
✅ Quality scores at risk. Premature discharges often drive readmissions.
✅ The “denial tax” is real. Even when facilities win appeals, they lose time and money.
How SupplyLine Supports Operators
At SUPPLYLINE, we understand the operational and financial pressures facilities face every day. While policy challenges like Medicare Advantage denials create unavoidable hurdles, your supply chain doesn’t have to.
Our team helps nursing homes and senior care communities nationwide lower procurement costs, simplify purchasing, and protect margins — all without contracts or system changes. From everyday essentials to large-scale projects, we provide sharp pricing, fast logistics, and reliable service so you can focus your resources where they matter most: delivering quality care.
👉 Learn more or create your account today