Policy

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 »

Congratulations to the 2012 LeadingAge honorees

The future of aging is in good hands as LeadingAge presented its 2012 awards to outstanding individuals dedicated to serving America’s senior population. Read More »

Criminal activity found in background checks of disciplined aides

Long-term care facilities advised to conduct background checks on employees with direct access to residents to reduce abuse, neglect and theft. Read More »

LeadingAge to LTC providers: Demand change in healthcare delivery system

The overriding message from LeadingAge thought leaders at the group's annual meeting is that providers must step up to the plate and demand a say in the future of the country’s bloated and broken healthcare delivery system. Read More »

Study suggests social factors play a role in hospital readmissions

A new study suggests that nonmedical factors may hamper hospitals’ efforts to meet CMS’ outcome and readmission guidelines that went into effect Oct. 1. 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 »

One-year look-back: Assessing 2012’s Final Rule and its impact on providers

The Centers for Medicare & Medicaid Services’ (CMS’) skilled nursing facility 2012 Final Rule has had a huge impact on SNFs that were still adjusting to the transition to MDS 3.0 the previous year. 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 »

The Q word dominates long-term care

October looms as a month of major change for the skilled nursing industry with the Hospital Readmissions Reduction Program slated to launch next Monday. With hospitals facing stiff penalties for patient readmissions, SNFs are poised to play a key role in efforts to reduce readmissions with quality issues taking center stage. Read More »

New website helps employers navigate benefit changes under ACA

In California, business owners are taking a positive approach to the ACA. Answers to their questions on how to provide the health benefit to employees and comply with the ACA mandate are available online. 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 »

OMB: Medicare providers could see $11 billion in reduced payments in 2013

Medicare providers could be facing a $11 billion reduction in reimbursements if the government's sequestration process goes forward, according to an OMB report released today. Read More »

Largest ACO model project sees significant savings among dual-eligibles

Five years of data from Center for Medicare & Medicaid’s largest experiment in performance-based reimbursement are mixed, but physician groups succeeded in slashing the costs for dual-eligibles. Read More »

5 measurable quality initiatives form core of CMS Action Plan

As nursing homes compete in the post-reform environment for new direct patient admissions and more hospital discharges, several data driven tools—from Five Star rankings to hospital readmission benchmarks—that form the core of CMS’ focus on quality will be critical to nursing homes’ success. Read More »

UTI payment study reveals big holes in datasets used for performance measures

What started out as a comparative analysis on reimbursement rates related to catheter-based urinary tract infections (CAUTIs) has opened a huge can of worms concerning hospital datasets and their reliability as performance measurements. Read More »

California passes bill restricting emergency room charges for out-of-network patients

California legislature has passed a bill limiting what emergency departments can charge out-of-network payers. Will other states follow? Read More »