In a milestone report released today, the Institute of Medicine (IOM) analyzes why the U.S. healthcare system needs a new business-based attitude, and why it struggles to learn from its own data. Read More »
Mandating that nursing home providers institute both a formal, facility-wide compliance and quality assurance and performance improvement (QAPI) program while enhancing nurse aide training across their facilities, the Affordable Care Act (ACA) aims to elevate the quality of care in America’s nursing homes over the next few years. Read More »
The Centers for Medicare & Medicaid Services' rule on hospital "observation stays" has generated much controversy. The American Health Care Association strikes back with a long list of changes that should be made--and why. Read More »
In early August, Massachusetts became the 17th state to protect registered nurses from mandatory overtime. Massachusetts Gov. Deval Patrick signed a healthcare law that identifies restrictions. In California and Missouri, regulations contain provisions for mandatory overtime. Read More »
When it comes to getting Medicaid assistance for long-term care costs, too many rule variations among the states have created a chaotic system, a GAO report concludes. Read More »
Knowing that the quality measures (QMs) are used by surveyors and the public to evaluate your facility’s care outcomes should convince you to give high priority to understanding the details of the QMs. Read More »
Last month I blogged about the Centers for Medicare & Medicaid Services’ controversial Five-Star Quality Rating System in light of news of its revamped Nursing Home Compare website. I invited readers to share their thoughts on the rating system and the website, knowing that this was one issue certain to generate some commentary. And it sure did. Read More »
The Centers for Medicare & Medicare Services on Friday published a final rule pushing back the compliance deadline for converting to the ICD-10 system of diagnostic and procedural coding to October 1, 2014 from October 1, 2013. Read More »
Ohio is the latest state to launch a pay-for-quality program for skilled nursing reimbursement. But with 10 percent of reimbursement riding on passing the quality program, is the test tough enough? Read More »
As Medicare and Medicaid programs grow, the insurance market is spending billions to get a larger slice of the government-backed healthcare markets. Read More »
The Center for Medicare & Medicaid's requested extension for the ICD-10 transition hasn’t been made official yet, but providers shouldn’t waste any time continuing their planning. Read More »
As reimbursement becomes increasingly tied to clinical quality and performance, Ohio joins the list of states that are trying a bigger carrot instead of the stick. Read More »
As boomers reminisce about their skateboards while shopping for bed boards, the nation’s communities, healthcare systems, and long-term care are preparing to meet their expectations. A recent survey discovered how this generation views aging—their concerns and their outlook. Read More »
The billing differences between inpatient and observation hospitalizations are causing plenty of headaches, but the American Health Care Association believes CMS’ new pilot program is a step in the right direction. Read More »
A growing number of seniors who have observational hospital stays are getting stuck with the bill for their SNF care. CMS is launching a new pilot to try to iron out the wrinkles in the claims system. Read More »
Seniors in seven states soon will need prior authorization for powerchairs under Medicare. The homecare industry voices its disappointment in the lack of physician documentation standards for authorization. Read More »
Home healthcare agencies are the focus of $5 million in suspect Medicare claims, according to this week's report from the Office of Inspector General. Read More »
What is a LTC provider to do when contracted service providers fail to follow through with certain responsibilities, resulting in denial of Medicare/Medicaid payments and civil penalties? LTC provider Daniel Farley shares the approach used by his organization to be proactive in resolving potential problems in advance. Read More »
The Centers for Medicare & Medicaid Services is finally set to begin a three-year project to reduce fraud and errors by using RACs to check Medicare claims before they move to the payment stage. Read More »
With increased government oversight and efforts to find inappropriately paid Medicare funds, facility staff may end a Medicare stay prematurely for fear of being audited and having their claim denied. What is the key to balancing provision of skilled care and avoiding auditor take-backs? Read More »
As states debate whether to adopt Medicaid expansion or not, the latest public health study from Harvard suggests expansion might be a healthy idea. Read More »
CMS will increase prospective payment system pay rates to skilled nursing facilities by almost 2 percent, based on its yearly rate adjustment report. Read More »
HHS has announced a public-private collaboration aimed at stemming healthcare fraud. Tougher sentences, suspended payments and enhanced screenings are tools now available for enforcement through the Affordable Care Act. Read More »
The Department of Health & Human Services has released the LTC chapter in the national plan to reduce infections: C. difficile and urinary tract infections are the first of many high-priority targets. Read More »
Many changes are ahead for employers concerning employee health insurance benefits. Some of the rules will begin as early as this fall. Nancy Taylor, co-chair, Health & FDA Business Practice at global law firm Greenberg Traurig, LLC, discusses the key strategies employers should consider in preparing for compliance. Read More »
