Centers For Medicare & Medicaid Services

CMS: Nurse shortage means hospices can keep using contracted workers

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Hospices can continue to rely on contract nurses because an ongoing nurse shortage is preventing providers from meeting their staffing needs, the Centers for Medicare & Medicaid Services announced in a recent memorandum to state survey agencies.

Judge blocks award of new RAC contracts

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Medicare's Recovery Audit Contractor program continues to struggle with controversy.

Hospice billings changed

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The Centers for Medicare & Medicaid Services recently updated instructions on coding hospice claims. Billing staffs should be aware of these changes, which went into effect Oct. 1, CMS stated in a memorandum about the Medicare manual update.

RACs collected nearly $2 million from skilled nursing facilities last year, report shows

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Recovery Audit Contractors recovered $1.8 million in Medicare overpayments made to skilled nursing facilities in fiscal year 2013, according to a Congressional report released Monday.

Rate hike will be only a part of the new Medicare reality

Rate hike will be only a part of the new Medicare reality

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Many providers are relieved that Medicare rates are slated to go up by 2% in the next fiscal year. After all, who wants to turn down $750 million, especially in a rate-cutting climate?

Why the New York Times' 'hatchet job' shows better days are coming to long-term care

Why the New York Times' 'hatchet job' shows better days are coming to long-term care

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A pall hangs over this sector at the moment, thanks to the New York Times.

CMS finalizes 1.4% increase for hospices

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Hospices can expect an estimated 1.4% increase in their payments for the fiscal year 2015, the Centers for Medicare & Medicaid Services announced Monday.

Looking at dementia beyond drugs and disease

Looking at dementia beyond drugs and disease

The emerging literature on "nonpharmacological interventions" has not succeeded in providing long-term solutions for many people, such that expressions of need continue to recur on a regular basis.

Medicare SNF rate finalized, reimbursements to increase by $750 million next year

Medicare SNF rate finalized, reimbursements to increase by $750 million next year

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Medicare skilled nursing facility reimbursements will increase by $750 million next year under a final payment rule announced Thursday by the Centers for Medicare & Medicaid Services.

Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators

Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators

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The time has come to eliminate hospital stay requirements for beneficiaries to qualify for Medicare coverage of skilled nursing services, experts told a Senate committee Wednesday.

Increased 'bed taxes' on nursing facilities warrant 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.

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