Author Bio

Brad Granger

Brad Granger is a vice president of operational and clinical underwriting with Lancaster Pollard in Columbus. Prior to joining Lancaster Pollard, he worked for Ultra Risk Advisors as a vice president and underwriting manager for the long-term care professional liability program. Past experience also includes American Safety Insurance, PointRight Analytics, Inc., Trilogy Health Services and HCR Manor Care, where he was a regional director of operations for nine facilities. He is a licensed nursing home administrator and licensed property and casualty (P&C) insurance broker. He holds a BSBA in finance from The Ohio State University and an MBA from Franklin University.

More by this author

Transitioning to Value-Based Reimbursement

2/12/2018 In an ever-evolving environment, hospitals and health care systems in the United States are steering away from a fee-for-service (FFS) model. While FFS has exhibited value, it also has the potential to create perverse incentives. Recognizing the incentive problems with FFS, the Center for Medicare and Medicaid Innovation (CMMI) introduced several models over the past few years that have challenged participants in the health care system.  Read More

New Final Rule Requirements Move Forward


As reported in a previous article in The Capital Issue, “Focusing on Patient Care: The Final Rule,” Centers for Medicare & Medicaid Services (CMS) has recently implemented the second phase (Phase Two) of the 700-page rule for skilled nursing facilities (SNFs), commonly referred to as either “The Final Rule” or the “Requirements of Participation.” 

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Medicaid Block Grants and the Prospective Effects on States

12/11/2017 In the last edition of The Capital Issue, we detailed Medicaid spending trends and explored how recent block grant proposals would affect health care providers. In this issue, we examine the effects of block granting on states in general while also providing a detailed analysis focused on three specific states—Illinois, Michigan and Ohio. Read More

Medicaid Block Grants and the Prospective Effect on Providers

10/9/2017 Obamacare repeal has become a zombie. It won’t die, but it’s not exactly living either. The fact that it won’t completely die is telling, however, and signals that the possibility of repeal will likely linger as an issue through the next several election cycles. Of the many difficult aspects of reforming health care, perhaps the most debated is what to do with Medicaid spending and block grant proposals. And no matter what form the zombie resurfaces in down the road, be it repeal or reform, there will be big questions regarding the future of Medicaid. Below, we take a close look at Medicaid spending trends and detail what recent block grant proposals might look like if they were to become reality.  Read More

The Five-Star Rating System for Skilled Nursing: Perceptions and Effects

6/10/2017 The Centers for Medicare & Medicaid Services (CMS) introduced its Nursing Home Compare five-star system for skilled nursing facilities in December of 2008 to assist the public in identifying meaningful distinctions among skilled nursing providers. The skilled nursing facility (SNF) five-star rating is based on health surveys, staffing numbers and quality measures and has become a frequently referenced metric in the industry nine years after its introduction. Read More

Focusing on Patient Care: The Final Rule

12/10/2016 For the approximately 16,000 nursing home operators across the country, increased scrutiny and constant realignment have become a way of life. And if trying to prepare for a new administration that is likely to enact significant regulatory and reimbursement changes in the near future wasn’t enough, long-term care providers also end 2016 with a new 700-page rule from the Centers for Medicare & Medicaid Services (CMS). Read More

The Costs of Clinical Risk

2/5/2016 The nursing home industry has often been described as one of the most regulated industries in the country. This is not surprising, as nursing homes care for the most fragile individuals within the health care spectrum and are predominately reimbursed through government programs. The financial instability that can arise as a result of clinical and operational risk can affect refinancing efforts in various ways, which explains why risk management is a major area of focus for nursing home providers. Read More

The Capital Issue: December 2014-January 2015

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