Medicare/Medicaid

CMS boosts Medicare Advantage reimbursements for 2015

The Centers for Medicare & Medicaid Services issues several changes to 2015 pay rates amid pressure from the insurance industry. Read More »

HR 4302: AHCA, LeadingAge express mixed feelings

Leaders in organizations representing long-term care providers expressed satisfaction with some parts of the proposed law but disappointment with others in this Long-Term Living exclusive. Read More »

Senate passes HR 4302; what it means to SNFs

The U.S. Senate has passed a bill that delays enforcement of the “two midnight rule” for certain hospital stays as well as creates programs to establish readmission-related measures for skilled nursing facilities and rewards for those facilities that meet them. Read More »

Congress, LTC industry deliver bill to standardize post-acute care services

The draft legislation is here. But how much “IMPACT” would the Improving Medicare Post-Acute Care Transformation Act of 2014 have? Read More »

SGR ‘doc fix’ bill could delay ICD-10 by a year

A bill up for vote this week could extend the current "doc fix" and could delay the ICD-10 implementation deadlines for a year. Read More »

CMS to test new hospice payment model

Hospice patients could receive curative care as well as palliative care under a new payment model to be tested by the Centers for Medicare & Medicaid Services. Here’s how the program would work. Read More »

Improved care transitions will aid resident health: study

New research suggests how health policymakers and caregivers can better coordinate the transitions of care that find 22 percent of older adults moving from and among hospitals, rehabilitation facilities, long-term care communities and their homes. Read More »

Staffing levels seldom cited by state surveyors

Sufficient staffing is an important, yet overlooked, component in providing quality care to nursing home residents, according to a new analysis. Read More »

Proposed budget cuts concern LTC groups

Long-term care provider associations express appreciation for the proposed 2015 budget’s support of some senior housing and services but disappointment in potential program cuts. Read More »

OIG report details fraud, abuse, neglect cases

An annual report from the Office of Inspector General highlights criminal convictions and recoveries as well as civil settlements and judgments related to nursing facilities, home health agencies and other long-term care and healthcare providers. Read More »

CMS postpones some Medicare Part D changes

The agency will seek additional input before implementing several controversial proposals affecting the Medicare Advantage (Part C) and Part D prescription drug program. Read More »

Nursing home enforcement actions decreasing: LTCCC

Fewer citations aren’t a sign of better care; they’re a sign of danger to residents, says one advocacy group. Read More »

Obama’s FY15 budget proposal: What’s in it for long-term care?

President Obama’s budget for 2015 focuses heavily on healthcare, offering new funding for some and deeper cuts for others. Read More »

Ensuring regulatory compliance in your facility

As a long-term care provider, you must understand who your clients are, how the regulations govern your businesses and how the regulations and the clients' needs intersect. Six actions may keep you out of trouble. Read More »

7 things your compliance plan must include

As home health and hospice care spending comes under increased scrutiny from the government, providers must make sure their compliance plans evolve to meet federal requirements and their own needs. Read More »

SNF adverse event reduction needed, OIG report says

Adverse events related to post-acute care are harming residents and costing the government money, according to a new report from the Office of Inspector General, so skilled nursing facilities must find a way to reduce their incidence. Read More »

Maine lawmakers mulling long-term care funding

Members of Maine’s legislature are considering the recommendations of its Long-Term Care Facilities Study Commission as the state grapples with how to pay for the care of its aging population. Read More »

CMS puts recovery audit program on temporary hold

The backlog of cases appealing audit decisions and payment denials has cause CMS to make a radical move: Hit the pause button on the audit program until contractors can catch up. Read More »

One MDS assessment may take a NAC more than five hours to complete: study

Where does the time go in a NAC’s day? Results from an American Association of Nurse Assessment Coordination study answer that question. Read More »

Challenging surveys

Deficiencies and enforcement actions don't always have to be accepted without a challenge. Long-Term Living's legal expert, Alan Horowitz, explains the steps to appealing state survey deficiency reports. Read More »

Reauthorizing OAA: Maintaining flexibility, addressing demographic changes

The Older Americans Act should be reauthorized with a focus on maintaining program flexibility and addressing demographic changes, according to policy and aging experts who testified during a recent government hearing on the matter. Read More »

Post-acute orgs fear financial decline/buyouts due to technology gaps

Long-term and post-acute providers who fail to adopt information technology may find themselves at a distinct disadvantage—or owned by someone else—down the road, one survey report suggests. Read More »

Congress continues to wrangle with Medicare, Medicaid issues

Medicare physicians will automatically see a 24 percent reduction in pay if Congress does not act by March 31. Read More »

Legal logjam in Medicare appeals process

The Medicare appeals process allows providers to challenge payment denials—once you can get a hearing date. Read More »

Telehealth reimbursement reform gets major support

Three former senators and some major companies join forces in support of telehealth reimbursement reform.  Read More »

Is it rejection of care or resident choice?

Clearing the blurred lines between choice and rejection of care ensures correct coding of the Minimum Data Set. Read More »

Study examines new payment model for dementia care

A new study seeks to show the value of home- and community-based care for those with memory disorders, in hopes that more insurers might cover the cost of such programs, leading people away from nursing homes and assisted living facilities. Read More »

Facility-to-community transition program success highlighted in report

A recent report highlights the success of a federal program to transition Medicaid recipients from long-term care facilities to home- and community-based settings, including reinstitutionalization rates and residential preferences of senior participants. Read More »

Bipartisan lawmakers strike deal to repeal SGR, set physician pay increases

A bipartisan team of lawmakers has struck a deal to repeal the sustainable growth rate (SGR) and set new guaranteed pay increase for physicians that provide services under Medicare. Read More »

HHS rule grants direct access to residents’ lab results

A new federal rule will allow senior care residents and their family designees direct access to lab test results, encouraging consumer care involvement. Read More »