Medicare/Medicaid

Illinois hospice charged in $125M fraud case

An Illinois hospice services provider is accused of training employees to fudge hospice placements and upcharge for care. Read More »

What the omnibus bill means for long-term care

The federal omnibus appropriations bill for 2014 has more than $1 trillion in funding for government programs. See how programs related to long-term care are affected. Read More »

CMS clarifies use of Medicaid funds in home, community-based settings

Stakeholder input helps CMS improve the accessibility of services for seniors and people with disabilities. Read More »

CMS issues final rule about home- and community-based programs

Alternatives to institutional care are the focus of a final rule issued by the Centers for Medicare & Medicaid Services. Read More »

CMS proposes emergency preparedness procedures

Four components should be part of every senior care provider's emergency preparedness plan, according to the Centers for Medicare & Medicaid Services. Found out what the agency is proposing and how you can comment. Read More »

Facility rating, resident quality of life not linked

Certain factors relate to resident quality of life, but the government rating of the facility where they live is not one of them, according to new research. Read More »

U.S. spends more on SNF, CCRC care, but home healthcare spending growing faster: report

The United States spends more money for care provided at skilled nursing facilities and continuing care retirement communities than for care provided through home healthcare agencies, according to a new report, but spending for home healthcare is growing at a faster rate.  Read More »

In-home care becoming a national trend

District of Columbia program enables seniors to receive in-home services to meet their care needs. Read More »

Federal agency recommends annual CT scans for older smokers

Privately insured smokers age 55 to 80 now have access to free annual lung cancer screenings—but the tests are not covered by Medicare. Read More »

Recovery audits: SNF psychiatric conditions

Does your skilled nursing facility care for residents with mental heath conditions? Medicare recovery audit contractors for mental illness issues may threaten access to care. Read More »

2014: The year of the ACO?

After a mixed year of progress and stumblings, accountable care organizations are expected to surge as a care model in 2014, according to a year-over-year trends report. Read More »

PACE expands services in California

A growing senior population will require a variety of senior care sites and services. CalPACE hopes to meet the need. Read More »

Killing the SGR and therapy caps

Congress may be ready to do away with the sustainable growth rate (SGR), re-fix the “doc fix” and ditch therapy caps, but will skilled nursing become the scapegoat for the costs? Read More »

NCOA ‘cautiously optimistic’ for permanent QI fix in 2014

The National Council on Aging is “disappointed” that Congress has not acted to make permanent a program that pays Part B premiums for some Medicare recipients, but the organization remains hopeful that the program will be made permanent in 2014. Read More »

LTSS focus of Senate committee hearing

The recommendations made by the federal Commission on Long-Term Care related to long-term services and supports for seniors and disabled individuals are the focus of a Senate Special Committee on Aging hearing. Read More »

OIG releases strategic plan for 2014-2018

The Department of Health and Human Services and its oversight body, the Office of Inspector General, released reports this week identifying strategic goals for the next few years. Read More »

OIG to CMS: Add hospitalization rates to nursing home quality ratings and surveys

The Office of Inspector General wants hospitalization rates to be added to CMS's nursing home quality rankings. But will the numbers tell the real story or just muddy the waters? Read More »

California unprepared to meet LTC needs over next decade, new report says

In a challenge being faced in other parts of the country, too, California soon will have to make difficult fiscal trade-offs in an attempt to balance the long-term care needs of its residents with demands related to other programs, a new report finds. Read More »

New bill ties 3-day stay waiver to Nursing Home Compare ratings

Under a proposed bill, SNFs meeting certain criteria based on Centers for Medicare & Medicaid Services quality ratings automatically would qualify to waive the prior hospitalization requirement for Medicare coverage of Part A skilled nursing care benefits. Read More »

CMS offers temporary fire sprinkler citation fix

CMS has revised its fire sprinkler compliance measure to ease the burden on facilities that are in the middle of sprinkler installations. But is the workaround just as challenging as the fire sprinkler citation? Read More »

Congress acts to fix the Medicare SGR

A plan by Congress may finally fix sustainable growth rate (SGR) formula issues for physicians, but long-term care and outpatient therapy services could suffer in the process. Read More »

Hospice, home healthcare owners paying for fraud allegations

A hospice and a home healthcare agency are facing the consequences after being accused of committing healthcare fraud. Read More »

CMS issues 2014 Medicare payment rate updates

The Medicare payment updates for 2014 have been released. How can your facility best guide your own resident beneficiaries? Read More »

CMS clarifies ADL scoring process

The Centers for Medicare & Medicaid Services emphasize the importance of following the “Rule of 3” sequence when coding activities of daily living, as noted in the recently updated RAI User's Manual. Read More »

Eroding the payer/provider divide

Payers, providers and care networks are making vast efforts to combine care delivery, coverage and costs—merging control over the once-siloed segments of healthcare business. Will the post-acute care sector be the golden ticket to success or the cost-laden component that drags the system down? Read More »

Medication prescribing reflects regional variations, study finds

Study investigates the geographical differences and patterns in drug prescribing and drug therapies for Medicare patients and the potential risks involved. Read More »

Bundling without bungling

Bundling payments is becoming a reality for many long-term and post-acute care communities, but do you know where to start? Read More »

Omnicare settles $120M kickback suit

Long-term care pharmacy giant Omnicare has agreed to pay $120 million to end a lawsuit alleging kickbacks for skilled nursing medications. Read More »

LTC financing is focus of November observance

One organization is using an annual observance to remind the public about the importance of planning for long-term care. Read More »

Public weighs in on federal health agencies

A new survey gauges public perception of several national government agencies and departments. See where your opinion fits in. Read More »