Centers For Medicare & Medicaid Services

The value of attending national Open Door Forum calls

The value of attending national Open Door Forum calls

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.

CMS allows less-severe citations for nursing homes installing a sprinkler system

CMS allows less-severe citations for nursing homes installing a sprinkler system

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Nursing homes might be able to reduce the scope and severity of deficiency citations related to sprinkler systems, the Centers for Medicare & Medicaid Services recently announced.

DME bidding saved 37%

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A second group of contracts in a competitive bidding program for durable medical equipment items showed savings of more than one-third, according to the Centers for Medicare & Medicaid Services.

PET scans for Alzheimer's rejected for Medicare pay

PET scans for Alzheimer's rejected for Medicare pay

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Earlier this year, the Department of Health and Human Services released an action plan for tackling Alzheimer's diagnostics, treatment and funding.

CMS: Nursing homes may not establish blanket no-CPR policies

CMS: Nursing homes may not establish blanket no-CPR policies

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Nursing homes will face survey citations for facility-wide policies that prohibit cardiopulmonary resuscitation for residents, according to a recent Centers for Medicare & Medicaid Services memorandum.

CMS puts surveyors on alert for those 'gaming' system

CMS puts surveyors on alert for those 'gaming' system

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Federal regulators say surveyors need to prevent providers from possibly "gaming" the system when it comes to the timing of surveys and sales.

CMS 'arbitrarily' approved SNF Medicaid cuts in Pennsylvania, appeals court rules

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A group of nursing home operators has won a moral victory over the Centers for Medicare & Medicaid Services, with a federal appeals court saying the agency made Medicaid reimbursement cuts without considering the consequences, but without the court ordering financial relief.

Some personality types are more likely to receive nursing home care, researchers find

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Seniors who fit a particular personality profile are more than twice as likely to receive long-term care in a nursing home, according to newly published research in The Milbank Quarterly.

Bigger trash cans allowed in updated LSC waiver rule

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The Centers for Medicare & Medicaid Services updated its Life Safety Code Waivers on Aug. 30. The update is designed to prevent "unreasonable hardship" for providers while maintaining resident safety.

Nursing homes will be subject to escrow for all civil monetary penalties, CMS announces

Nursing homes will be subject to escrow for all civil monetary penalties, CMS announces

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Nursing homes facing a civil monetary penalty due to any type of deficiency will be subject to escrow and entitled to request an independent informal dispute resolution process, according to a newly issued memorandum from the Centers for Medicare & Medicaid Services.

More hospice info wanted

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Federal regulators have added another layer of bureaucracy for hospice providers operating within skilled nursing facilities.

Don't consolidate quality groups to regionals: AHCA

Don't consolidate quality groups to regionals: AHCA

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The Centers for Medicare & Medicaid Services should not waver from its long-standing support of state-based quality improvement organizations, the American Health Care Association and nearly 50 other organizations have told government officials.

$30 million cut from Medicare

$30 million cut from Medicare

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Skilled nursing facilities will see $470 million in aggregate 2014 Medicare reimbursements, which is $30 million less than projected in a proposed rule, according to the Centers for Medicare & Medicaid Services.

CMS let off the hook in contempt case

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The Centers for Medicare & Medicaid Services is not guilty of contempt in a case over payments to a nursing facility facing Medicare termination, a U.S. appeals court recently ruled.

CMS issues guidance on incomplete, unsubmitted MDS discharge assessments

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The Centers for Medicare & Medicaid Services has clarified steps providers must take to comply with Minimum Data Set requirements regarding incomplete or unsubmitted discharge assessments.

Advancing Excellence unveils new goals, including resident mobility, infection management

Advancing Excellence unveils new goals, including resident mobility, infection management

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The Advancing Excellence campaign has released updated goals and called on nursing homes to actively use the framework for achieving better quality care.

CMS releases reference chart for new therapy-related G-codes

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The Centers for Medicare & Medicaid Services has released a reference chart listing the new G-codes needed for outpatient therapy services claims under the Medicare fee-for-service program.

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