Medicare/Medicaid

MedPAC targets Medicare payments to SNFs

With margins averaging 18.5 percent in 2010, MedPAC contends SNFs are making a killing on Medicare. Under the proposed rebasing plan, there would be a zero update in 2013, followed by an initial reduction of four percent in 2014. Read More »

J & J to pay $158 million to settle Texas Medicaid fraud case

The drug maker was accused of providing state officials kickbacks in exchange for including its Risperdal antipsychotic drug on an approved list for Medicaid recipients. Read More »

MedPAC recommends no market basket increase for LTC services in 2013

The Alliance for Quality Nursing Home Care decried MedPAC’s recommendations, calling them a “failure to recognize the obvious link between Medicare and Medicaid in financing SNF care.” Read More »

CBO: Raising Medicare eligibility age increases revenue, leaves people without insurance

The CBO estimates that if the Medicare eligibility age was raised to 67, annual federal spending on Medicare would be reduced by $148 billion from 2012 through 2021. Read More »

Long-term care seen better days?

Already faced with the prospect of absorbing $127 billion in Medicare funding reductions through 2021, the long-term care industry may find itself confronted with even more strife in the year ahead. Read More »

Whistleblower suit alleges AseraCare Hospice defrauded Medicare

Hospice company is charged with misspending millions of tax dollars intended for Medicare recipients in need of hospice care. Read More »

NCPA: Changes to LTC pharmacy consultants ‘jeopardize rural healthcare’

CMS has proposed changes to LTC pharmacy consultants that the NCPA says could imperil independent community pharmacies. Read More »

10 top LTC news stories of 2011

This year, providers faced waves of regulatory, economic and societal challenges that tested their adaptability and fortitude. Read More »

What’s going on with nursing homes in the news?

The Detroit Free Press ran a provocative overview on the state of Michigan nursing home quality. And the Star Tribune reported on Minnesota granting waivers to former criminals seeking employment in nursing homes. Read More »

Medicaid LTC funding shortfall projected at $6.3 Billion in 2011

The projected shortfall in Medicaid funding for long-term care represents a new high for Medicaid, according to a new report. Read More »

Provider groups: GOP spending bill would mean more SNF Medicare reductions

AHCA and the Alliance decry bad debt provision within the Middle Class Tax Relief and Job Creation Act of 2011. Read More »

Future cuts may realistically push SNFs over the edge (and into the red)

Provider groups have been saying this for years: Skilled nursing facilities cannot survive another round of cuts. (Actually, it’s usually stated more Read More »

Could reimbursement cuts be the impetus for lawsuit reform?

Long-term care providers are justly lamenting the harsh 11.1 percent Medicare reimbursement cuts that took effect on October 1. But in the Read More »

A patient-centered pragmatist may take helm of CMS

It came as no great surprise last week when Donald Berwick, MD, announced his resignation as administrator for the Centers for Medicare & Medicaid Read More »

‘Super committee’ teeters toward stalemate

It’s going to be a long weekend for certain members of Congress. The bi-partisan 12-member “super committee,” tasked with finding $1.2 trillion in Read More »

Adult day centers a new casualty of Medicaid cuts

The warnings have been well reported up to this point. Unfortunately, providers have little say in the matters of Medicaid and the transformations Read More »

CMS admin Berwick stresses provider collaboration at LeadingAge

Donald Berwick wants you to forget about the current strife in Washington and get back to the basics: “better health, better care, lower costs”—the Read More »

Try these 3 programs to increase Medicare census and reimbursement

October 1st is looming. That dreaded date, what with its Medicare cuts, is causing facilities to scramble and evaluate budget savings and other Read More »

AHCA/NCAL conference report: Medicaid crisis demands provider action

Medicaid is in transition—many would say crisis—and skilled nursing providers attending a panel discussion Monday at the 62nd Annual AHCA/NCAL Read More »

AHCA/NCAL conference report: ‘Our industry is under attack’

Rat Pack tribute? Check. Cheesy Elvis impersonator? Check. Scantily clad showgirls? But of course. It’s conference week in Las Vegas for the Read More »

Cuts, market volatility rattle providers

For long-term care providers, summer 2011 will be remembered for a rollercoaster ride of congressional clashes over the U.S. debt ceiling, Read More »

Feeling the fire of SNF PPS rule

The final SNF PPS rule for FY2012 published in August will cause all operational professionals to stop and think about their implementation plans for Read More »

National MDS 3.0 training call recap

Wow, we are closing in on one year of using the MDS 3.0 and are finally getting the “hang of it” with all the changes that occurred with its Read More »

Does anyone out there care?

Janet Gerber, RN-BC Mathematically, I have always “assumed” that if you were dividing a whole into “quarters” that would mean you would have four Read More »

Final rule cuts deep

Bob Gatty The long-term care industry is now facing an 11.1 percent Medicare payment reduction to SNFs for 2012 in new rates to be implemented Read More »

Medicare cuts will cause pain—but for whom?

October 1, 2011, is the day that an 11.1 percent reduction in Medicare payments to SNFs is implemented. It’s when we really begin feeling the pain. Read More »

It’s time for a look-back period

Everyone needs a good sounding board. For many nurses, that forum is oftentimes a listserv. In commemoration of last year's big MDS package, Read More »

Take control of incontinence

Facility staff empathizes with the pain and discomfort of the resident with incontinence, but they frequently do not have the opportunity to discuss Read More »

A year later: LTC providers speak out on MDS 3.0

This time last year skilled nursing facilities across the nation were in the throes of gearing up for the implementation of MDS 3.0 in October. Read More »

What your team needs to know about the COT OMRA

At the end of July, the Centers for Medicare & Medicaid Services (CMS) published the “Medicare Program; Prospective Payment System and Consolidated Read More »