Medicare/Medicaid

3-day waiver rule on the way out?

The 3-day hospital stay rule might be waving goodbye, but the American Health Care Association warns the new CMS proposal would put some nursing homes—and their residents—at a disadvantage. Read More »

CMS finalizes Medicaid prescription drug reforms

The Centers for Medicare & Medicaid Services finalized reforms to the rebate and reimbursement systems for Medicaid prescription drugs. Read More »

Unprecedented $350 million federal funding increase for Alzheimer’s research

The fiscal year 2016 federal spending bill includes $350 million more for Alzheimer's disease research funding. It's the first time in 12 years the National Institutes of Health have seen a boost in funding. Read More »

Who should do medication reconciliation safety: RNs, LPN or both?

Registered nurses (RNs) and licensed practical nurses (LPNs) have different skills and work processes when it comes to medication reconciliation, say researchers at the University of Missouri. Read More »

Congress to consider VA provider agreement legislation

Will veterans soon be able to obtain care from non-VA LTC facilities? Long-Term Living's Washington reporter Bob Gatty takes a look at the proposed care model. Read More »

AGS studies person-centered care definitions, quality scope

What does “person-centered care” entail? The American Geriatrics Society teamed up with The SCAN Foundation and the University of Southern California to research the definitions and quality scope of healthcare that is focused on the person and not on the condition. Read More »

National health spending picks up steam

The national healthcare spending growth rate has accelerated for the first time after five years of sluggish growth, according to new annual data from CMS. Read More »

Why aren’t Californians connecting with MediConnect?

The opt-out rate for California’s new pilot program for dual-eligibles is so high the UCLA Center for Health Policy Research just got a massive grant to study why. Read More »

Texas ALF settles fire sprinkler suit

The owners of a Fort Worth, Texas assisted living complex learn the cost of sprinkler system violations. Read More »

CMS gets to work on new value-based fee structure

Now that the SGR is history, the Centers for Medicare & Medicaid Services is tackling the new value-based payment model. Leading long-term care organizations are playing important roles in advising the new policies. Read More »

Study: More insurance options can improve long-term services and supports

A new study sponsored by LeadingAge, The SCAN Foundation and AARP found the number of Americans who need long-term help with daily activities will more than double by 2055. New insurance options are needed to pay for increasing costs.  Read More »

CA advocates sue to stop illegal unloading of nursing home residents

California Advocates for Nursing Home Reform and three nursing home residents have filed a lawsuit against the state saying it is allegedly illegally allowing residents to be "dumped" from nursing homes to hospitals. Read More »

Office of Inspector General plans to crack down on fraud and cut costs

The OIG released its Work Plan for fiscal year 2016. Long-term care providers can expect reviews of claims and payment documentation as well as consolidated equipment and pharmaceutical purchases. Read More »

Skilled nursing facility provider accused of falsifying Medicare claims

Department of Justice intervenes in three separate lawsuits alleging SavaSeniorCare provided unnecessary therapy treatment and delayed discharges to increase Medicare payments to help meet unrealistic corporate financial goals. Read More »

CMS issues proposed rule for patient preferences in discharge summaries

The proposal would affect long-term care hospitals, inpatient facilities and home health agencies that participate in CMS reimbursement programs. Read More »

UPDATE U.S. Senate passes budget bill to avert shutdown, keep 2% Medicare cuts

With Senate passage, the bill retains the reimbursement cuts created by the sequstration in 2011. Read More »

Budget deal could include 2% Medicare cuts

Congressional and White House leaders reached a late-night federal budget deal that would include across-the-board 2-percent Medicare cuts. Read More »

Psychologists charged in $25 million Medicare fraud scheme

Two psychologists have been charged with billing Medicare for unnecessary, or never performed, psychological tests and services to nursing home residents. Read More »

Fight brewing over proposed CMS arbitration rule

The long-term care industry argues that the CMS arbitration rule goes too far; state attorneys general seek an outright ban. Read More »

HHS Alzheimer’s Advisory Council welcomes six new members

The Department of Health and Human Services (HHS) Advisory Council on Alzheimer’s Research, Care and Services announced its new members this week. The council advises the HHS secretary on federal programs for people who have Alzheimer’s and other dementias. Read More »

National hospice provider found guilty of filing false claims

The Department of Justice is expected to seek more than $202 million in Medicare reimbursement, fines and other penalties in the largest-ever whistleblower lawsuit involving a hospice care provider. The second phase of the trial against AsercaCare is scheduled to begin next week.  Read More »

CMS launches ACO kidney dialysis model

The new accountable care organization model creates a shared-cost program for end-stage renal disease. Read More »

Report: New regs are a bitter pill for LTC pharmacies

Long-term care pharmacies provide crucial senior-specific medication management services to skilled nursing facilities. But will the current regulatory environment drive independent LTC pharmacies out of business? Read More »

Mastering the new SNF regs to maximize reimbursement

The new skilled nursing facility regulations under the IMPACT Act are coming. Has your facility adopted the best processes and attitudes to maximize reimbursement? Policy experts explain why sticking to the old status quo on processes won't be good enough. Read More »

AHCA/NCAL opening session: Team leadership, quality improvement needed in changing times

The opening general session of the AHCA/NCAL Annual Conference and Expo focused on the importance of cross-discipline teamwork, with special highlights on the role of the Certified Nursing Assistant (CNA). Read More »

CMS proposes individualized care plan for long-term care patients

CMS proposes revising the requirements long-term care facilities must meet to participate in Medicare and Medicaid programs. Read More »

AHCA/NCAL: New CMS nursing home regulations ‘simply too much’

The new proposed rules from the Centers for Medicare & Medicaid Services are not sitting well with the head of the American Health Care Association, who says they will takes years and extraordinary cost to implement. Read More »

CMS to issue payment reduction for 2014 PQRS reporting

Registrants who did not satisfactorily report quality measures will be subject to a 2 percent reduction in 2016. Read More »

MedPAC reviews possible new post-acute pay model

The commission discusses how to balance quality of patient care with new Medicare payment system. Read More »

New tool identifies ways to improve 5-star quarterly rating

LeadingAge is launching a reporting tool to calculate how to improve resident care and increase 5-star ratings. Read More »