Centers For Medicare & Medicaid Services

Increased 'bed taxes' on nursing facilities warrants stricter federal oversight, report states

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States have been increasingly taxing skilled nursing facilities and other healthcare providers to fund Medicaid in recent years, and federal authorities should look more closely at this trend, according to a government report released Tuesday.

Long-term care facilities refusing free CMS resource on dementia, nurses association says

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Some nursing homes are not accepting a dementia training resource sent by the government, even though it is free and recommended, according to the American Association for Long-Term Care Nursing.

Congressional lawmakers grill top ALJ on appeals backlog, say too many providers are being put out of business

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Efforts to root out Medicare fraud have put far too many above-board providers in auditors' crosshairs, leading to a staggering backlog of appeals that has no easy fix, Congressional lawmakers and a top government official said during a hearing Thursday.

Senators blast Medicare audits, say RAC payments should be changed

Senators blast Medicare audits, say RAC payments should be changed

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The Medicare claims review process is unfairly burdening healthcare providers and failing to improve program integrity, due in part to the payment system for certain auditors, Senate leaders said during a roundtable hearing Wednesday.

Reducing readmissions should be No. 1 priority for reducing healthcare costs, quality experts say

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Reducing readmissions would have the most significant impact in bringing down U.S. healthcare costs, according to a survey of health quality experts.

 Skilled nursing facility readmissions should be an ACO quality measure, government proposes in payment rule

Skilled nursing facility readmissions should be an ACO quality measure, government proposes in payment rule

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Accountable care organizations should be assessed on the number of people who return to a member hospital within 30 days of being discharged to a skilled nursing facility, the Centers for Medicare & Medicaid Services has stated in a proposed rule.

CMS updates manual to reflect F-Tag guidance dating back to 2003

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The Centers for Medicare & Medicaid Services has revised the manual that long-term care facility surveyors refer to, updating interpretive guidelines related to F-Tags.

CMS announces Medicare appeals without administrative law judge hearings

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Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced Thursday.

AHA pushes for payment policies to benefit hospital-based skilled nursing facilities

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The government should adjust Medicare payment policies to better support the type of care provided in hospital-based skilled nursing facilities, the American Hospital Association urged in a recent letter to a top healthcare official.

Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments as Congress hears testimony

Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments as Congress hears testimony

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Proposed Medicare payment changes have put the nation's largest long-term care association at odds with inpatient rehabilitation providers, and the two sides sought to sway legislators in advance of a Congressional hearing Wednesday.

Nursing homes achieved 40% pressure ulcer reduction by working with Medicare quality organizations, new data shows

Nursing homes achieved 40% pressure ulcer reduction by working with Medicare quality organizations, new data shows

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Nursing homes dramatically reduced pressure ulcer rates and restraint use in the last three years by participating in Medicare Quality Improvement Organization initiatives, according to new government data circulated Thursday.

AMA to submit information to federal regulators regarding end-of-life care planning

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The American Medical Association is expected to release recommendations soon for what physicians should be reimbursed for end-of-life medical consultations. The physicians group issues advisements regularly to the Centers for Medicare & Medicaid Services, which typically adopts them for its programs, the Pew Charitable Trust noted on Monday.

CMS loosens nursing home infection control guidance for single-use devices

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Nursing homes now have new guidance about using certain types of reprocessed medical devices, the Centers for Medicare & Medicaid Services announced.

Federal government notes slowdown in nursing home spending

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Decreased payouts for nursing home care was one reason that healthcare spending grew more slowly for seniors than for any other age group between 2002 and 2010, the Centers for Medicare & Medicaid Services announced Monday.

Senators urge tougher LTC survey process

Senators urge tougher LTC survey process

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The Centers for Medicare & Medicaid Services said it plans to focus more on quality improvement initiatives rather than stricter surveys, but that didn't stop a pair of veteran U.S. senators from calling for more stringent measures.

Plan of correction can be anything but, as this provider learns the hard way

Plan of correction can be anything but, as this provider learns the hard way

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Justice has an odd way of showing itself if you're a nursing facility that disagrees with a deficiency citation but decides to work with inspectors to clear your name. You're not going to believe this one.

The value of attending national Open Door Forum calls

The value of attending national Open Door Forum calls

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I often describe the monthly CMS Open Door Forum call as a monthly staff meeting; if you miss the meeting you better read the minutes to see what projects were assigned to you!

States can designate more nursing homes in urgent need of quality improvement, government says

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The federal government is reactivating the special focus facility program for nursing homes with quality issues, the Centers for Medicare & Medicaid Services has announced. The program was minimized due to budget cuts last year.

The potential break-up between hospitals and long-term care

The potential break-up between hospitals and long-term care

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The attempts of the hospital lobby and long-term care to move beyond casually dating to going steady hit a snag at the steps of a courthouse Monday.

CMS releases Medicare physician payment information, includes some nursing home affiliations

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Long-term care providers and residents now can glean insights into where their local doctors stack up nationally by referring to newly released data on Medicare physician payments. For the first time ever, the government made this information publicly available Wednesday.

LTC must pursue collaboration to reduce readmissions

LTC must pursue collaboration to reduce readmissions

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Acute and post-acute providers are increasingly uniting around a shared goal - to lower hospital readmission rates for elderly and other vulnerable patients. Many caregivers and payers agree that readmission rates are unacceptably high.

CMS clarifies rules regarding vaccines, respite care for hospice patients

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The Centers for Medicare & Medicaid Services has loosened regulatory language regarding which providers can furnish vaccines to hospice patients, and has tightened enforcement of a five-day payment limit for respite care.

CMS wants tighter oversight for Medicare prescriptions

CMS wants tighter oversight for Medicare prescriptions

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The Centers for Medicare & Medicaid Services has seen enough and wants to gain more control over drug-prescribing practices for the Medicare Part D program.

Nursing home optometrist gets 33-month sentence for overbilling

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An optometrist who served Georgia nursing homes faces a 33-month prison sentence for defrauding Medicare.

Top 5 news stories reveal varied interests among long-term care professionals

Top 5 news stories reveal varied interests among long-term care professionals

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What do neck abnormalities, dangerous bacteria, a murder-suicide, a defensive nursing home chain, and antipsychotic guidelines have in common? These five developments were voted the most popular news stories appearing on the McKnight's website during 2013.

OIG probes hospitalizations

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A fourth of the 3.3 million Medicare beneficiaries who lived in a nursing home in 2011 were hospitalized for at least one day. This came at a cost of $14.3 billion, according to a Nov. 18 report from the Office of the Inspector General in the Department of Health and Human Services.

Two-midnight rule sends hospital inpatient admissions crashing to record lows, analysis finds

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A newly implemented admissions policy has driven hospital inpatient stays to record low levels, according to an analysis from researchers associated with Citigroup.

CMS announces declining readmission rate for Medicare patients, credits Affordable Care Act

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Improved transitions between acute and post-acute settings are partly responsible for continuing nationwide declines in hospital readmission rates, according to the Centers for Medicare & Medicaid Services.

Feds ease auditing reviews, anti-fraud efforts to surge

Feds ease auditing reviews, anti-fraud efforts to surge

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Providers likely will embrace House legislation that eases billing reviews for operators deemed a low fraud risk.

CMS too burdened and focused on cost to be the epicenter of long-term care reform, experts say

CMS too burdened and focused on cost to be the epicenter of long-term care reform, experts say

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Most long-term care reforms rely on the Centers for Medicare & Medicaid Services for implementation, but the overburdened agency cannot manage all the needed changes in this area, according to a panel of experts.

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