CMS

CMS expands therapy payment research

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The government is expanding its research into alternative therapy payments, to consider more holistic changes to the way Medicare reimburses skilled nursing facilities, the Centers for Medicare & Medicaid Services announced Tuesday.

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.

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.

SNF, CCRC spending expected to rise 69%

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Spending on nursing homes and continuing care retirement communities is expected to roughly keep pace with total U.S. healthcare spending during the next decade, according to the annual "National Health Expenditures Projections" report released last month.

Lawmakers demand answers about rating system quirks

Lawmakers demand answers about rating system quirks

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After The New York Times noted that providers are apparently gaming the Five Star rating system by enhancing staffing and quality data, federal lawmakers quickly put an indignant pen to paper.

Reporting neglected, OIG says

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Slightly more than half of the nation's nursing facilities reported abuse or neglect allegations as required in 2012, a new report from the Office of Inspector General alleges. Such relatively low compliance indicates that more guidance and oversight is warranted, the report concludes.

Also in the news for Oct. 1, 2014 . . .

CMS releases new version of software for collecting assessment information ... CT hospitals must now inform patients of observation status ... CA assisted living facilities face multiple requirements under new laws ... Govt. launches Open Payments website

Also in the news for Sept. 30, 2014 . . .

CMS clarifies appropriate use of power strips in long-term care resident rooms ...GAO: Integrating Medicare and Medicaid may not reduce costs on dual-eligible care ... Brookdale discriminated against worker with fibromyalgia, EEOC claims ... State standards for physician access under Medicaid managed care vary widely, OIG finds

Providers must see clearly before they CHOW down

Providers must see clearly before they CHOW down

When a skilled nursing facility changes ownership, the change is known in healthcare vernacular as a change of ownership or "CHOW." Because this could wind up endangering a Medicare provider agreement, It is imperative that more people understand the process, know the parties they're involved with and develop better awareness of the regulatory issues involved.

Senators push CMS to expand program for long-term care outside nursing homes

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The Centers for Medicare & Medicaid Services should loosen regulations to allow more people to receive care in the community rather than in nursing homes, a bipartisan group of Senators wrote in a recent letter to the top CMS official.

White House to providers: New antibiotic regs on the way

White House to providers: New antibiotic regs on the way

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Long-term care providers should take pride in their antipsychotic reduction efforts, and certainly should work hard to meet the new goals announced Friday. But it should not escape their notice that just a day earlier, the White House released an ambitious national plan for addressing antibiotic resistant infections. The plan suggests that a facility's antibiotic stewardship is about to join its antipsychotics rate as a defining feature of quality in the eyes of the government.

Antipsychotics reduction goal raised to 30% by end of 2016, CMS and provider groups announce

Antipsychotics reduction goal raised to 30% by end of 2016, CMS and provider groups announce

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Long-term care providers are being asked to reduce the use of antipsychotic medications among residents by 25% by the end of 2015, and 30% by the end of 2016. Providers have already achieved a 17.1% reduction since 2011.

Also in the news for Sept. 19, 2014

Americans are the most worried about losing their eyesight as they age, poll says .... AHCA says MedPAC Chairman is 'spot-on' with three-day stay comments ... Medicare Advantage enrollment rises for fifth straight year, CMS says.

Medicare Part B could have saved $110 million, OIG asserts

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If the Medicare Part B program had used average Medicare Part D drug dispensing and fee rates, it would have saved the government $110 million in 2011, according to a report from the Department of Health and Human Services Office of Inspector General released Sept. 16.

ICD-10 is around the corner, for real this time

ICD-10 is around the corner, for real this time

There's a looming massive report on all the hospital readmissions data in your area and the strategic plan your facility needs to pursue. It involves talking to lots of employees, gathering data, doing statistics and the actual writing, not to mention proofreading, and having your boss sign off on it. It's due Oct. 15.

Stakeholders need to prepare for the loss of long-term care's exemption to e-prescribing

Stakeholders need to prepare for the loss of long-term care's exemption to e-prescribing

The Centers for Medicare & Medicaid Services is set to lift long-term care's exemption from its e-prescribing rule as of Nov. 1. This is bigger news than most realize right now, and there has been no indication CMS is going to postpone things.

November 1: Will you be ready?

November 1: Will you be ready?

This year, it is the day after Halloween that might be scary. On November 1, prescribers, pharmacies and facilities in the long-term-care industry must cease the transmission of electronic medication orders via the HL7 and e-fax methods that predominate today.

The end of fee for service

The end of fee for service

The seeds that have flowered into the burgeoning of ACOs - groups of providers accepting the responsibility, and risk, for caring for the health of a designated patient population according to defined quality benchmarks (CMS measures quality of care using 33 measures in four key domains) - was planted long ago, in the baby boom.

CMS 'Open Door Forum' Wednesday

The next Skilled Nursing Facilities/Long-Term Care Open Door Forum operated by federal regulators will be Wednesday.

Latest therapy-billing showdown could be ominous sign for long-term care providers

Latest therapy-billing showdown could be ominous sign for long-term care providers

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Don't let anyone tell you that long-term care operators don't know how to read between the lines. They might not have known to fear a McKnight's Monday news item before it broke, but it definitely has their attention — and apprehension — now.

CMS should publicly push Congress to reform therapy payment system, long-term care provider association urges

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The Centers for Medicare & Medicaid Services should openly urge Congress to change the way therapy services are reimbursed, the nation's largest long-term care provider association stated in recent written comments to CMS Administrator Marilyn Tavenner.

The government plans a 'computer matching program' to combat improper Medicare, Medicaid payments

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The government plans to start a "computer matching program" to reduce improper payments from government health programs to providers and other entities, the Centers for Medicare & Medicaid Services announced in a memorandum Friday.

Why the survey system may never be fixed

Why the survey system may never be fixed

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Given certain realities about skilled-nursing facility inspections, we should not be wondering why cheating has occurred. Rather, we should be amazed it hasn't been more rampant.

Federal judge blocks new RAC contracts

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Adding to the ongoing controversy around Medicare's Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.

CMS updates coding instructions for hospice site of service, principal diagnosis

CMS updates coding instructions for hospice site of service, principal diagnosis

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A new Medicare hospice manual update includes instructions for which principal diagnosis codes are acceptable, and clarifies which codes should be used for services in a skilled versus non-skilled nursing facility. Billing staffs should be aware of these changes, which go into effect Oct. 1, the Centers for Medicare & Medicaid Services stated in an educational memorandum sent Friday via email.

The nursing home survey system is about to get a much closer look

The nursing home survey system is about to get a much closer look

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You had to know this was coming. Earlier this week, the New York Times reported that many nursing homes are submitting massaged staffing and quality indicator data to the feds. The alleged reason? So facilities could pull better Five Star ratings.

CMS: Discharge assessments must be completed when residents transfer to a non-certified bed within the nursing facility

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Skilled nursing facilities must complete a discharge assessment when a resident is transferred from a certified to a non-certified bed, even if both beds are in the same building, the Centers for Medicare & Medicaid Services emphasizes in a recent memorandum.

Also in the news for August 27, 2014 . . .

Dementia sharply increases stroke risk ... CMS releases training tool to build respect for LGBT long-term care residents ... Canes fitted to the hip are better for stroke patients ... 'Mindfulness' training improves sleep, reduces depression in early-stage dementia

Readmission penalty categories inspire more analysis and opportunity

Readmission penalty categories inspire more analysis and opportunity

The Medicare stakes are about to get higher.

CMS: Many skilled nursing providers have poor Medicare certification and recertification practices

CMS: Many skilled nursing providers have poor Medicare certification and recertification practices

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The rate of improper Medicare payments to skilled nursing facilities has increased largely due to issues with certification and recertification statements, according to a recently released government memorandum. The Centers for Medicare & Medicaid Services document summarizes requirements that SNF physicians, non-physician practitioners (NPPs) and billing staffs must meet for compliance.

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