The largest-ever fraud case involved the owner of more than 30 skilled nursing facilities and two others accused of kickbacks and false billing, the Department of Justice indictment says. Read More »
The Centers for Medicare and Medicaid Services has saved $42 billion in fiscal years 2013 and 2014 by proactively preventing potential fraud and dispersing improper payments. Additional savings are expected for fiscal year 2015. Read More »
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Advance care planning: Easing the difficult conversation
By Dan Hogan, founder and CEO, Medalogix Discussing and documenting end-of-life choices is a key component of person-centered care, yet advance care planning is something we often put off far longer than we should. Learn More »
Skilled nursing facilities are quickly finding the Payroll-Based Journal Reporting, mandated timekeeping regulations from the Centers for Medicare and Medicaid Services, are more time-consuming than anticipated. Read More »
Setting up a Qualified Income Trust/Miller Trust to fulfill the Medicaid requirements can be tricky business, so Ohio's Medicaid recipients shouldn't wait to get started on the process, says SNF resident blogger Kathleen Mears. Read More »
The Centers for Medicare and Medicaid Services has proposed changes to the Physician Fee Schedule to change how Medicare pays for primary care with an emphasis on care management and behavioral health. Read More »
The Centers for Medicare and Medicaid Services Nursing Home Enforcement Report has found one in five Texas nursing home residents are improperly given antipsychotic drugs as a means of restraint. Read More »
The U.S. House of Representatives Appropriations Committee has proposed increasing Alzheimer’s disease and dementia research funding by $350 million for the National Institutes of Health to $1.26 billion. Read More »
A civil lawsuit filed by a whistleblower claims Caris Healthcare, which provides hospice services in five states, deliberately documented any illness that could be considered terminal in order to keep its hospice beds occupied. Read More »
The Occupational Safety and Health Administration (OSHA) has passed rules that forbid retaliation and discrimination for reporting injuries, including post-accident drug testing and "incentive" programs that retaliate against those who bring workplace safety violations to light. Read More »
The Medicare Payment Advisory Commission (MedPAC) submits it recommendations to Congress for how to establish a unified, cross-setting post-acute care payment system. The plan would redistribute payments among types of stays, making profits more uniform and hopefully reducing unnecessary services and admission preferences. Read More »
A new study on implementation of electronic health records (EHR) has identified several obstacles for doctors, chief among them poor user experience. Read More »
The U.S. Supreme Court has decided not to hear a case that would have challenged the Department of Labor’s ruling on labor protections for home care workers. Read More »
Republicans from the U.S. House of Representatives announced a healthcare reform proposal that would challenge parts of the Affordable Care Act but retain some of the Act’s more popular provisions. Read More »
The Medicare Payment Advisory Commission (MedPAC) has issued its annual report on refinements to Medicare payment systems and on issues affecting the medicare program Read More »
The Centers for Medicare & Medicaid Services announced it will not begin surveying for compliance with the 2012 fire safety codes until November. The July 5 ruling still applies when considering which code chapters facilities must comply with. Read More »
Stay compliant with CMS requirements by using the proper editions of the National Fire Protection Association (NFPA) Codes and Standards. Read More »
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Learning to operate under the value-based payment model
By Richard A. Royer, MBA, CEO of PrimarisFor nursing homes, learning to operate under a new payment model is challenging after existing in the fee-for-service sphere for so long. But the introduction of new value-based programs requires nursing homes to adapt and embrace payment changes. Learn More »
Unclear or incomplete documentation of end-of-life care choices makes a paramedic’s job even harder, especially when transferring residents from a nursing home to the hospital, says a British explorative paper. How much training are you giving residents and families on the importance of a POLST form? Read More »
A U.S. district judge ruled the Federal Nursing Home Reform Act doesn’t give individuals the right to sue states, thereby dismissing a lawsuit alleging California nursing homes denied Medi-Cal patients readmission. Read More »
Despite efforts to ease the backlog of appeals, no relief is in sight for the backlog of appeals from facilities that choose to appeal Medicare claims denials and deficiency citations. Read More »
Dennis McCullough practiced geriatric medicine for several years but it was his own personal experiences inspired him to rethink end of life care. He became an advocate for hospice and palliative care. Read More »
Congressional subcommittees have proposed changes to the Social Security Act to cover an initial care plan for Medicare beneficiaries newly diagnosed with Alzheimer’s disease and related dementias to help them understand the disease and treatment options. Read More »
The pressure is on for skilled nursing facilities: Compliance for CMS reimbursement means proper charting, documentation of therapy minutes and shaking out those RUGs. Read More »
Getting that handy touchpad laptop made life seem easier, but it wasn't so great for her hand's range of motion, says SNF resident blogger Kathleen Mears. Read More »
The Centers for Medicare & Medicaid Services (CMS) has opened up its new Comprehensive Primary Care Plus (CPC+) initiative to 1,500 eligible primary care practices currently in the Medicare Shared Savings Program (MSSP). Read More »
Mistakes and “near misses” can and will happen. But, how a facility discloses an error can affect everything from the CMS response to the family’s reaction. Read More »
An OIG investigation determined the LPN had falsified charting records stating she had performed neuro checks after the resident had fallen out of his wheelchair. Read More »
