Medicare/Medicaid

Top 10 nursing home deficiencies, top 10 trouble states

The latest version of the Nursing Home Inspect tool includes more ways to search nursing home survey data and to assess the historial track record of a skilled nursing facility. Read More »

OIG alleges rampant skilled nursing billing errors

The Wall Street Journal reported that the OIG is using the term “Operation Vacuum Cleaner” to refer to its review of nursing home billing issues. This term is perhaps even more foreboding than the report itself. With the fiscal cliff looming and sharp negotiations set to begin over the future of Medicare reimbursement, the timing and substance of this report are less than ideal for an industry already under fire. Read More »

Seniors to Congress: Don’t push us off the ‘fiscal cliff’

A post-election survey shows that seniors 50+ years of age do not want changes to Medicare or Social Security at this time. Read More »

BREAKING: Health exchanges: Holdout states get last-minute reprieve

Today was to be decision day for states on whether they intend to participate in the new state health exchange program, but an eleventh-hour extension from Health and Human Services Secretary Sebelius gives the remaining eight states another few weeks to decide. Read More »

SNFs erred on 25% of claims in 2009; $1.5 billion in overpayments

The Office of Inspector General continues to unearth massive misreporting and over-billing in nursing home claims, especially where therapy is involved. Read More »

One-on-one with… Eileen Malo

Eileen Malo, CEO of Schervier Nursing Care Center in Riverdale, N.Y., shares her insights on continuing to provide efficient and compassionate care to the growing numbers of seniors whether they reside in an LTC facility or in the community. Read More »

SNFs: Be nimble, resourceful and ready to fight

The clarion call to action grows ever louder: In addition to lobbying their local lawmakers, long-term care providers must best position their organizations to serve a rapidly changing healthcare system or face demise. Read More »

HHS submits rules for state insurance exchange benefits

The Department of Health and Human Services has submitted another rulemaking piece on state health insurance exchanges to the Office of Management and Budget—the last step before publication. Read More »

AHCA launches Ad firestorm at Congress: No Medicare/Medicaid cuts

Long-term care organizations are using an aggressive advertising campaign to tell Congress to end the deep cuts to Medicare and Medicaid reimbursements. Read More »

Providers get $8.36 billion in Meaningful Use payouts for EHR goals

Under the Centers for Medicare & Medicaid Meaningful Use incentive program for the use of electronic health records, eligible providers have received more than $8 billion in incentive payouts since the program began in early 2011, according to this week's report. Read More »

What President Obama’s re-election means for the future of long-term care

The votes are in: The Obama Administration now has four more years to further the healthcare initiatives begun under the 2010 Affordable Care Act. So, what happens next? Long-term care leaders, providers and industry experts weigh in on the implications of President Obama's reelection for the U.S. healthcare system and, specifically, the LTC industry. Read More »

Medicare rule is a barrier to hospice, study finds

Skilled nursing or hospice? Medicare policy prevents residents from seeking both types of care simultaneously, which can result in unwanted levels of treatment at the end of life, especially for residents with dementia. Read More »

CMS: Waiver status issued for New York state in Sandy’s wake

An emergency response meeting held by the Centers for Medicare & Medicaid Services answers some questions on coping with the aftermath of Hurricane Sandy in New York, but many issues remain for long-term and acute care facilities in other states. Read More »

LTC transitions of care: Get collaborative or play catch-up, says national TOC group

Are transitions of care on your mind? You’re not alone. Read our on-site coverage of the National Transitions of Care Coalition (NTOCC) Midwest Regional Summit, held this month in Cleveland, for tips and free tools to improve your TOC efforts. Read More »

National collaborative will foster innovation in senior housing and financing models

A national learning collaborative, launched at this week’s LeadingAge conference, is focused on creating new financial and service strategies for senior living. Read More »

LTC industry uses election campaign to combat federal program cuts

With the national elections drawing ever closer, the long-term care industry continues to turn up the heat on lawmakers, urging them to avoid additional cuts in federal funds for programs that support services to the elderly. Read More »

Most Medicare seniors overspend by choosing the wrong Part D drug plan

Most Medicare beneficiaries are spending more than they need to on Medicare drug plans and should find Plan B within Part D, according to a University of Pittsburgh School of Public Health study. Read More »

DOJ & HHS charge 91 people with $430 million in Medicare fraud

A federal strike force from the Department of health & Human Services and the U.S. Atorney General’s office have charged almost 100 people with a total of $430 million in fraudulent Medicare billing practices. Read More »

Turning a blind eye to the rules

Sharon A. Nazarchuk and Timothy Legg studied a pool of skilled nursing facilities to uncover discrepancies in survey data, including why skilled nursing facilities can fail to employ qualified activity directors yet still escape citations during the survey process. Read More »

Hospital readmission penalties off to a rocky start

CMS’ new program to make hospitals financially accountable for excessive readmissions stumbles at the starting gate, as CMS issues a document to correct errors in the final rule. Read More »

Report compares healthcare plans under Obama, Romney

As the presidential debates begin this week, Medicare is predicted to be a hot-button topic. One private foundation released a report that explores the differences and similarities between the healthcare plans of both presidential candidates. Read More »

New surgical guide for elderly optimizes care coordination

A new guide, co-developed by the American Geriatrics Society and the American College of Surgeons, outlines the key assessment needs and risks of elderly surgery patients, including dementia, mobility and medication management. Read More »

Observation units could ease emergency rooms, save inpatient costs, study says

Hospitals could save billions if they used special units dedicate to observation stays instead of admitting patients for short-term stays, according to estimates in a new Health Affairs study. Read More »

CMS launches SNF program to reduce hospital readmissions

As concerns over hospital readmissions grow, the Centers for Medicare & Medicaid Services has launched a program to encourage SNFs and state agencies to collaborate on avoidable conditions and the costs they incur. Read More »

DOJ & HHS: Stop abusing electronic record technology for fraudulent Medicare billing

Five of the leading U.S. healthcare organizations got a prickly letter from the Department of Justice and Health & Human Services Monday: Stop misusing documentation and electronic medical record technology systems for fraudulent billing purposes, or else. Read More »

Preparing for the ‘silver tsunami’ across the globe

The United States isn’t the only country experiencing explosive growth within the senior demographic. As the elderly population and the costs of senior care rise across the globe, other countries are weighing the U.S. long-term care experience. How will they handle the need for expanded senior services? Read More »

Preparing for the ‘silver tsunami’ across the globe

The United States isn’t the only country experiencing explosive growth within the senior demographic. As the elderly population and the costs of senior care rise across the globe, other countries are weighing the U.S. long-term care experience. Read More »

Congress introduces Medicare transitions of care legislation

A bipartisan Congressional group introduces the Medicare Transitional Care Act of 2012, moving ahead to formalize reimbursement for care transitions. Read More »

LTC industry launches campaign to fight budget cuts

The long-term care industry has launched a campaign to oppose "devastating" sequestration cuts. An AHCA ad campaign came less than a week after the Office of Management and Budget (OMB) issued a report detailing how federal agencies would implement the $110 billion in mandatory, across-the-board budget cuts for 2013. Read More »

Investigation triggers Medicare coding questions; suspicions of upcoding

A new report reveals increased use of high-cost Medicare services, leading investigators to suspect upcoding and billing abuse. Providers defend their practices, saying increased costs are partly because of senior care. Read More »