OIG report prods federal regulators to get tougher

A Congressional watchdog group this week criticized the Department of Health & Human Services for failing to keep its improper payment rates low in its Medicare fee-for-service and Medicaid programs.

Preferred Care Partners seeks to dismiss suit over care, billing issues

One of the nation's largest nursing home chains is looking to thwart what it alleges is a conspiracy by private law firms trying to convince state officials to sue large corporations. Texas-based Preferred Care Partners Management Group also is arguing to dismiss a lawsuit the state Attorney General filed against it last March.

Nursing home under investigation for nude photos of resident

A skilled nursing home and rehabilitation facility in Indiana is under investigation after inappropriate photos of a resident were allegedly posted by employees on social media.

Also in the News for Friday, May 22

Nurse arrested for alleged painkiller theft ... Medicare Advantage Overbilling needs tightening, Grassley says ... Hackers could have reached 1.1 million CareFirst customers

Providers fuming after MedPAC calls for cancellation of Medicare pay raise

Providers fuming after MedPAC calls for cancellation of Medicare pay raise

The nursing home industry's largest trade group is pushing back hard against MedPAC's recommendation that the Centers for Medicare & Medicaid Services forego its planned request for $500 million in increased nursing home funding for fiscal 2016.

Collins: Patients stuck in 'medical twilight zone' from observation stays

Collins: Patients stuck in 'medical twilight zone' from observation stays

Hospital observation stays leave a Medicare beneficiary in a "medical twilight zone," Sen. Susan Collins (R-ME) said at the Senate Special Committee on Aging committee hearing Wednesday.

Bundled post acute payment plan could cost SNFs

Nursing homes' loss would be home healthcare's gain under a controversial plan that would create site-neutral payments for post-acute care.

Hospital stays worsen disabilities, study shows

Researchers say hospital re-admissions tend to worsen existing disabilities in people during their last year of life. The investigators are advising a more "palliative care approach" as a way to avoid exacerbating such problems.

Also in the News for Thursday, May 21:

Resident died due to lack of ventilator attachment, employee testifies ... Vermont replaces MN as healthiest state for seniors ... Rhode Island continues fight over Medicaid

Congress in a bind awaiting Obamacare subsidy decision

Congress in a bind awaiting Obamacare subsidy decision

On a big-picture level, nursing homes would seem to fare better if more and more prospective residents would enter their facilities with private insurance instead of Medicaid.

Depression leaves permanent, higher stroke risk: Study

Depression can cause irreversible damage leading to stroke even after depressive symptoms have subsided, according to new research.

Medicare coverage for male vacuum erection kits ends July 1

The Centers for Medicare & Medicaid Services has clarified catheter collection guidelines in its most recent DMEPOS fee schedule announcement.

Healthy diets link to enhanced cognitive flexibility: Study

Adults at risk of late-onset Alzheimer's disease who ingest more omega-3 fatty acids perform better in cognitive flexibility tests and have bigger anterior cingulate cortices, according to a new study conducted at the University of Illinois-Champaign.

Also in the News for Wednesday, May 20

Home health in NH says nursing home allotment belongs to them ... Sanders pushes for lower drug prices ... Long-term care investigations vary in CA, report finds

Unexpected surges in Medicaid begin to worry some states

Conservative governors who shunned Medicaid expansion in their states are feeling vindicated in light of unexpectedly huge surges in Medicaid enrollment in neighboring states.

PharMerica settles whistleblower complaint for $31.5 million

PharMerica settles whistleblower complaint for $31.5 million

National pharmacy services provider PharMerica said it has entered into separate agreements with the government and revised its controlled substances dispensing policies following a whistleblower lawsuit filed in 2009.

Sleep deprived, overweight shift workers at higher risk for diabetes: Study

New university-based research claims employees such as nursing home caregivers, factory and shipping workers who work outside normal 9 a.m.-5 p.m. schedules could be suffering a disproportionate share of serious sleep- and weight-related health problems.

Also in the News for Tuesday, May 19

Accents may not be so memorable, study shows ... Long-term care center put residents' health in 'immediate jeopardy' ... Residents evacuated from home due to broken boiler hose

Court honors unsigned arbitration agreement

Pennsylvania nursing home resident who sued for neglect was recently ordered by a federal judge to submit to binding arbitration instead, even though the document authorizing it was not signed by a facility representative.

Tittle named new NCAL leader, Kyllo to VP post at AHCA/NCAL

Tittle named new NCAL leader, Kyllo to VP post at AHCA/NCAL

Scott Tittle has been named the new executive director of the National Center for Assisted Living. He will succeed Dave Kyllo, who will become vice president of its parent group's insurance and membership programs.

Also in the News for Monday, May 18 ...

New Medicaid rules could be 'epic' ... Illinois paid more than $300,000 for dead people through Department of Aging ... Depressed elderly have twice the risks for stroke, even after symptoms subside ... DME fraudster gets 4 years in prison.

GAO: Medicaid demonstration project costs not justified

A new report to Congress says more justification is needed for the $146 billion being spent on demonstration projects, most of which have not been clearly shown to further the objectives of the Medicaid program. Medicaid funds more than two-thirds of U.S. nursing home care.

Nursing homes blamed for high opt-out rates in dual eligible demo

Nursing homes blamed for high opt-out rates in dual eligible demo

Huge numbers of dual-eligible beneficiaries are leaving a demonstration project that hopes to improve payments for people eligible for both Medicare and Medicaid.

CMS gives details on early submitting staffing data for quality ratings

CMS gives details on early submitting staffing data for quality ratings

Sooner or later, skilled nursing providers will have to submit staffing data tied to payroll. Those who want to get a jump on working out kinks can start submitting their data voluntarily this October, the Centers for Medicare & Medicaid Services said Thursday.

Lawmakers recommend $10M advisory panel to improve health data interoperability

Lawmakers have proposed changes that would significantly alter the way sensitive health data is prepared, managed and exchanged.

Pharmacy group wants SNF and AL beneficiaries exempted from Part D 'lock-in' provision

The head of a new long-term care pharmacy advocacy group urged Congress on Thursday to exempt Medicare beneficiaries in nursing homes and assisted living facilities from a plan that would require them to use a single pharmacy for all medications.

Report leads to question whether CMS has raised the quality bar too high

More than one-third of the nation's 15,500-plus nursing homes now bear the stigma of poor quality as a result of a tough new star ratings system implemented in February by the Centers for Medicare & Medicaid Services and posted on its Nursing Home Compare website.

Also in the News for Friday, May 15

Congressmen push for IPAB repeal ... Nursing home LPN accused of swapping Tylenol for Percocet ... Predictive analytics could help with congestive heart failure readmissions rates

Industry advocates hint new 'threat' in trade bill

Industry advocates hint new 'threat' in trade bill

The ink is barely dry on the historic Medicare Access and CHIP Reauthorization Act of 2015 and long-term care and other lobbyists are already voicing concerns about what ominous funding threat might come next.

Governor nixes new senior agency amid political turmoil

Georgia's governor went on a recent veto spree, striking down 11 separate laws, one of which would have created a separate state agency designed to serve older citizens.

Brain injuries hasten dementia, study finds

A great deal of recent research has explored the link between repetitive brain injury and dementia but a new study claims to have found the onset of the disease occurs much earlier than suspected.

Also in the News for Thursday, May 14

Medical transport company failing to get patients to appointments on time, audit says ... Ohio settles Medicaid lawsuit ... Nursing home owner charged in Mohawk case

NCAL extends assisted living quality campaign through 2018

NCAL extends assisted living quality campaign through 2018

Assisted living quality initiatives will focus on increasing satisfaction while reducing turnover, re-admissions and antipsychotics use, the National Center for Assisted Living announced on Tuesday.

OxyContin opioid suit moves forward while judge dismisses J&J, Actavis complaints

Chicago's massive suit over OxyContin alleges painkiller drug companies have misled prescribers and patients, leaving many woefully addicted and the city with enormous costs for treating them.

Assisted living resident kicked out after hiring prostitutes with liquor-sale proceeds

An assisted living facility was willing to look the other way whenever one of its residents would return from a "booze run" to pander liquor to other residents, but not when its staff discovered a prostitute under the man's bed, authorities said.

Also in the News for Wednesday, May 13

States look at protection for long-term care insurance buyers ... Right-to-die trial underway in Minnesota ... Unionized nursing home workers push legislators on Medicaid reimbursements

CMS plan would completely overhaul Medicaid managed care

Over the next few weeks, the Centers for Medicare & Medicaid Services is expected to unveil an ambitious and comprehensive policy-making effort that promises to completely transform and radically overhaul the Medicaid managed care marketplace.

Weak data, unclear policy plague Medicaid payments: GAO report

Medicaid provider payments are seriously hindered by limited data and "unclear policy," according to a new report to Congress that calls for greater oversight at numerous government-owned facilities where payments far exceed actual costs.

Floods force evacuations in NE, OK facilities

Several long-term care facilities across Oklahoma and Nebraska were damaged by flash floods after severe weather and high winds tore through the nation's midsection last weekend, forcing resident evacuations.

Also in the News for Tuesday, May 12

Audit says it's easier to get nursing home care than home care in Georgia ... Wyoming weighs options for troubled nursing homes ... Osteoporosis tied to hearing loss

McKnight's 2015 Tech Awards contest kicks off today

McKnight's 2015 Tech Awards contest kicks off today

The 2015 McKnight's Excellence in Technology awards program is now accepting submissions from skilled nursing, assisted living and continuing care retirement community operators.

Healthcare now the biggest cyber-attack target, report reveals

The leading causes for breaches and attacks on healthcare organizations Ponemon identified are (in order of severity): theft, employee negligence and malware. The biggest vulnerability for each of the past four years: Lost and stolen computers and paper files.

GAO: Small percentage of Medicaid beneficiaries costing much more

The Government Accountability Office last week released findings showing 5% of Medicaid-only eligible enrollees accounted for nearly 50% of the billions of government dollars paid in Medicaid-only eligible claims.

Poorly coded doctor claims cost Medicare $33 million: OIG report

The Health & Human Services' Inspector General is advising the agency to have its Medicare contractors chase down more than $33 million that might have been overpaid to physicians as a result of seemingly innocent coding errors for services.

Also in the News for Monday, May 11

Nursing home residents lead Medicaid protest ... Pharma company sues FDA over off-label use .. AHCA, NADONA among groups celebrating Nurses Week

Staying connected at Windsor Park

Staying connected at Windsor Park

When Community Consolidated School District 93 in Bloomingdale, IL, upgraded its computer hardware, it wanted to know if it could donate 25 laptop computers to Windsor Park, a continuing care retirement community in nearby Carol Stream.

Hebrew Home needs to sell

Due to economic hardship, Hebrew Hospital Home is seeking a New York court's permission to sell its 160-bed senior residence facility in Westchester County.

Greystone acquires Autumn amid a troubling indictment

Florida-based Greystone Healthcare Management has forged ahead with its acquisition of Autumn Health Care despite the central Ohio chain's former owner being indicted on charges of Medicaid fraud, forgery and operating a nursing home without a license.

Rehab amid the treetops

Rehab amid the treetops

Post-surgical patients at a 140-year-old organization can bathe themselves in healing, natural light as they engage in therapy.

Ready for a makeover

Ready for a makeover

It's imperative to roll out an appeal for new long-term care digs in the right way, starting with a master plan, and a strategy to minimize disruption to residents

How to do it ... Refinancing

There are many sound reasons for long-term care providers to refinance, says Chris Taylor, managing director, Real Estate Finance, GE Capital, Healthcare Financial Services.

Male RNs out-earning female colleagues

Female nurses may outnumber male nurses 10 to 1, but men in the profession still make more per capita, according to a report published in the Journal of the American Medical Association in March.

Ask the Nursing Expert ... about patient-centered care

Ask the Nursing Expert ... about patient-centered care

The National Quality Forum recently declared, "Person- and family-centered care emphasizes the inclusivity of recipients of healthcare services and their families and caregivers.

Overcoming objections

Overcoming objections

When it comes to bathing residents with special needs, many long-term care facilities find themselves in a slippery situation.

'Doc fix' legislation facing fewer hurdles

'Doc fix' legislation facing fewer hurdles

Providers found themselves holding their breath again at press time over a potential "fix" to a Medicare doctor payment formula that officially triggered a 21% pay cut April 1.

'Cost of care' put at $91,250

Providers may be under increased reimbursement restraints, but consumers might have a hard time believing it. The median charge for a private room in a skilled care facility exceeds $90,000 a year, a new survey finds.

PAD treatment is 'palliative'

Most nursing home residents with peripheral arterial disease (PAD) were not more mobile after lower extremity revascularization, according to a new analysis.

Ask the Payment Expert ... about Change of Therapy assessment

Ask the Payment Expert ... about Change of Therapy assessment

A COT is required when the RUG level increases or decreases. If you do not complete a COT when required, you will be considered to have a late or missed assessment.

Dates, accurate data remain problems, MDS expert warns

Dates, accurate data remain problems, MDS expert warns

Accuracy mistakes in MDS 3.0 data may cause additional payment problems, a reimbursement expert warns.

Education for opioids needed

Patients need more information about pain control and opioid misuse, according to researchers at the University of Pennsylvania.

Not the ideal vision for taking care of business

Not the ideal vision for taking care of business

Never mind the mantras about the long-term care profession being "high touch." The focus has been hijacked and it appears most providers are now consumed by documentation.

What the future holds

What the future holds

Like many people, I often wonder what operators should be doing to prep for the road ahead. So when the final program for last month's NIC Capital Business Strategies Forum listed a session called "The Future of Skilled Nursing," I made sure to attend.

Suit: SNF liable for overdose

A nursing home owner whose former employee died of an overdose is being sued in San Luis Obispo (CA) Superior Court.

Final bill for rehab dispute: $1.2 million

A Maine skilled nursing facility has agreed to pay $1.2 million to the federal government to settle allegations it did not prevent RehabCare Group East Inc. from providing unnecessary therapy.

60 Seconds With .. Beth Burnham Mace

60 Seconds With .. Beth Burnham Mace

Q: Do rising prices for properties in this field reflect an improving economy, or is something else going on?

Interoperability pressured

Congress is getting more involved in healthcare interoperability. Lawmakers have proposed legislation calling for changes to the process in order to speed up and broaden provider inclusion by the end of 2018.

Profile: Kari Olson

Profile: Kari Olson

The mother of 5-year-old twins and president of the Front Porch Center for Innovation and Wellbeing in California, Kari Olson epitomizes work-life balance.

Alzheimer's diagnoses not being shared

Only 45% of people with Alzheimer's disease or their caregivers say they were told the diagnosis by their doctor, according to the 2015 Alzheimer's Disease Facts and Figures report.

State News for May 2015

ILLINOIS — The state's House of Representatives will soon debate a new bill that would allow nursing home residents and their families to place video or audio monitoring devices in facility rooms.

I Couldn't Live Without ... Novaerus

I Couldn't Live Without ... Novaerus

Robert Reed clearly recalls the moment in 2012 when he and colleagues became impressed with a Novaerus air sanitizing system.

New software confirms it: Getting old costs a fortune

New software is helping financial advisors advise clients on their long-term care plans.

When silence is golden

When silence is golden

We don't have crickets in long-term care, but we should. They're very soothing insects. Experts on Crickipedia maintain that they actually emit four different sounds — a calling song, an aggressive song, a courting song and a copulatory song. Most human communication fits into those categories as well.

Dressings provide an alternative to NPWT

When it comes to treating chronic lesions such as postsurgical or stage IV pressure ulcers, one of the most effective treatments is negative pressure wound therapy.

Nursing homes announce campaign to lessen poor outcomes, decrease employee turnover

Nursing homes announce campaign to lessen poor outcomes, decrease employee turnover

Increasing staff stability, adopting a customer satisfaction questionnaire, reducing unintended healthcare outcomes, reducing hospital readmissions, improving discharges to the community, and adopting functional outcome measurements are the focus of the next round of quality improvement for the American Health Care Association.

Hospice care becoming costlier, less aggressive, study finds

Brown researchers examined the change in last-year-of-life Medicare expenditures during the most recent expansion of the program that began in 2004 and continued through 2009.

Couple to plead in Presbyterian Manors $1.5 million mail fraud case

A former Kansas couple facing up to 20 years in federal prison and $1 million in fines are expected to plead guilty to at least some of the charges alleging they submitted fraudulent invoices to his former employer, Presbyterian Manors of Mid-America.

New pharmacy owner agrees to $5 million settlement in anti-kickback case

A North Carolina pharmacy services company agreed Wednesday to pay a $5 million civil fine to settle federal anti-kickback violations alleged to have occurred under prior ownership, the U.S. Attorney's Office for the Eastern District of North Carolina announced.

Also in the News for Friday, May 8

FDA says there are 142 cases of infected duodenoscopes ... Nurses say EHRs help in patient safety in new survey ... Nursing home company hit with 45-count indictment .. New Hampshire nursing homes win back rate increase in budget

Fee-for-service still consumes most Medicare outlays: Report

Fee-for-service still consumes most Medicare outlays: Report

Far more than half of the $360 billion in Medicare payments made just two years ago were based on traditional fee-for-service models without regard to quality or value, according to an independent report released Tuesday.

AHCA previews new quality metric announcement

The American Health Care Association is expected to announce today six new quality metrics, some of which raise the bar on nursing home staff turnover and hospital readmissions.

Use of walking aids and other mobility devices soaring, study finds

Mobility device use soared almost 50% among the over-65 population from 2004 to 2012, and researchers say the reasons are varied.

Also in the News for Thursday, May 7

Nursing home chain accused of unfair labor practices; court date set for June ... Extra weight could help diabetes patients live longer ... Aging Committee hearing on tech helping seniors age in place

Credentialing, standards to be new assisted living focus, ALFA exec says

Credentialing, standards to be new assisted living focus, ALFA exec says

The Assisted Living Federation of America has unveiled plans to implement credentialing and new standards, as well as a six-month "listening tour" nationwide, as part of its Senior Living 2025 campaign.

CMS plan would hike hospice rates in 2016

The Centers for Medicare & Medicaid Services plans to raise hospice payment rates by nearly $200 million, or 2%, in fiscal year 2016. They come under a sweeping proposal establishing payment tiers based on length of stay and laying the groundwork for additional quality reporting measures.

$350,000 bail set for woman accused of stabbing SNF nurse in head, hands

The daughter of a Chicago nursing home resident faces multiple counts of aggravated battery and is being held in lieu of bail after stabbing a male nurse Saturday.

Study strengthens diabetes-Alzheimer's link

Washington University School of Medicine researchers believe they have found closer definitive links between diabetes and Alzheimer's disease after discovering elevated blood glucose levels stimulate the chemical culprit in the formation of AD's characteristic brain "plaques."

Also in the News for Wednesday, May 6

Senate passes budget bill, sets up Obamacare showdown ... New guide on catheter use ... Treatment cuts risk of C. diff recurrence ... Best and worst states for nurses.

House bill would eliminate RAC contingency fees, penalize bad auditors

House bill would eliminate RAC contingency fees, penalize bad auditors

Pending legislation would grant hospitals and other providers their wish of replacing percentage-based fees with flat fees on Medicare claims denied by recovery audit contractors.

Current budget proposal includes plans to chisel away the ACA

As the Senate narrows in on its budget goals, details are emerging from Congressional budget negotiations that aim to disintegrate the Affordable Care Act piece by piece. Negotiators also hope to cut Medicare spending by $430 billion over the next 10 years.

Hermes honors McKnight's with four Gold Awards

McKnight's has been honored with Gold Awards for writing, design and overall publication excellence in this year's Hermes Creative Awards program.

CMS to expand Pioneer ACO program

A government-sanctioned study published Monday in the Journal of the American Medical Association declared Pioneer ACOs saved more than $385 million in a two-year period, prompting the Administration to announce the same day it will expand the program.

Also in the News for Tuesday, May 5

Frailty called better indicator than age for heart patients' outcomes ... 91-year-old who sang way out of nursing home now threatened with eviction ... Green tea product, exercise slow Alzheimer's (in mice).

Certain brand name meds drive up Part D prices, CMS finds

Certain brand name meds drive up Part D prices, CMS finds

A popular acid reflux medication was the costliest drug paid for by Medicare Part D in 2013, while a blood pressure medication was the most frequently prescribed, according to a new report on prescription drug prices.

McKnight's receives top honors again for news coverage

McKnight's receives top honors again for news coverage

McKnight's Long-Term Care News was honored as having the best news coverage among U.S. healthcare publications for the sixth straight year. The McKnight's editorial team earned five honors overall in the 2015 ASHPE national awards program, which announced winners Friday.

Also in the News for Monday, May 4

FDA examines safety of antiseptic products ... Routine preoperative testing not recommended before cataract surgery ... CMS proposes 1.3% increase for hospices

Most older adults OK with dementia screening by phone: Study

People who believe in the benefits of catching medical problems early or have friends or loved ones with Alzheimer's disease tend to openly embrace advanced screening for dementia, according to new research.

Senate to vote this week on new federal budget

The U.S. Senate is scheduled to vote this week on a federal budget that promises to balance itself in nine years through billions of cuts in social programs and billions of extra dollars to defense.

Shady practitioners often go undetected across state lines: Report

Shady practitioners often go undetected across state lines: Report

Nursing homes with visiting physicians or providers would do well to uncover their troubled histories with Medicaid or Medicare programs in other states or face billing nightmares, and worse, federal scrutiny.

Plan would address inspection backlog, limit inspection duties

California Gov. Jerry Brown (D) is reportedly seeking to realign nursing home inspection and oversight duties to address a chronic backlog of investigations into abuse and other violations, while limiting enforcement requirements for entities charged with conducting them.

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