Managed care plans need protection from 'carve-outs' to ensure services across the continuum, group tells senators

State "carve-outs" and lack of transparency in rate-setting threaten the ability of managed care plans to support services across the whole continuum, the Medicaid Health Plans of America stated in a recent letter to leaders of the Senate Finance Committee.

Researchers pinpoint brain's 'weak spot' for Alzheimer's, connection to schizophrenia

A particular part of the brain appears to be a "weak spot" that is vulnerable to Alzheimer's disease, according to recently released findings out of the United Kingdom.

Also in the news for Nov. 26, 2014 . . .

MI delays dual-eligible program ... Guidelines urge 86% of people over 60 to start statins, researchers confirm ... IN legislator resigns in wake of nursing home scandal

McKnight's Daily Update to pause for Thanksgiving

McKnight's will not publish its Daily Update on Nov. 27 and Nov. 28 in observance of Thanksgiving. We will resume our regular publishing schedule on Monday, Dec. 1.

Nursing homes should focus on improving communications to prevent in-room cameras, survey suggests

Nursing homes should focus on improving communications to prevent in-room cameras, survey suggests

Most people would consider video cameras to monitor a loved one's nursing home care but would prefer other methods, according to recently released survey results.

Nursing home resident died during evacuation, NY Times reports

A 92-year-old resident died during the evacuation of a nursing home in western New York last week, The New York Times reported Sunday.

Residents often experience significant opioid reductions while ill, researchers find

Nursing home residents with an acute illness frequently experience increased pain after opioid use is interrupted, according to recently published findings.

Also in the news for Nov. 25, 2014 . . .

New method allows rapid detection of antibiotic resistance in UTIs, other infections ... Analytics is the 'special sauce' that is largely missing from LTC technology, leader says ... Judge puts the brakes on plan to kick out assisted living residents to turn building into condos

Draft bill proposes counting observation stays for SNF coverage, limiting RAC oversight

Draft bill proposes counting observation stays for SNF coverage, limiting RAC oversight

Hospital observation stays would count toward establishing Medicare eligibility for post-acute services, under comprehensive reforms in a new draft bill from the House Committee on Ways and Means. The Hospitals Improvements for Payment (HIP) Act of 2014 proposes a new hospital prospective payment system to be in place by fiscal year 2020. Its goal is to address problems with how short stays are reimbursed.

Largest US healthcare union praises Obama's action on immigration

Nursing home workers and other members of the country's largest healthcare union praised President Barack Obama for allowing certain undocumented immigrants to obtain legal status through an executive action announced last Thursday.

Nurses should be able to reject shifts to prevent fatigue risks, ANA states

Registered nurses should have more control over scheduling in order to reduce the risk of fatigued workers, according to a new position statement from the American Nurses Association.

Also in the news for Nov. 24, 2014 . . .

Robotic walker could help stroke survivors regain natural gait, researchers say ... Former hospice owner faces potential 200-year sentence for fraud ... US seniors among the world's sickest, Commonwealth Fund finds ... Magnetic stimulation to suppress healthy side of brain could help stroke recovery, researchers say

New payment models clash with fraud laws; waivers might not be the answer, official says

New payment models clash with fraud laws; waivers might not be the answer, official says

Healthcare payments linked to the quality of care are causing challenges to existing fraud and abuse laws, a government official said Wednesday.

'Elderspeak' study reveals prevalence: study

Certified nursing assistants are more likely to use "elderspeak," a form of patronizing speech used with seniors, if they are familiar with the resident, if the resident has dementia, or others are not around, a study finds.

FDA approves extended-release opioid painkiller

The U.S. Food and Drug Administration gave market clearance to an extended-release opioid painkiller yesterday. It is designed for those with severe pain.

Also in the News for Nov. 21, 2014

Hearing held on potential new National Labor Relations Board member Lauren McGarity McFerran .... Buffalo nursing home evacuates all residents ....Niall Brennan named to lead CMS data office

Medicaid rule could be an obstacle for dementia care in AL, Stateline reports

Medicaid rule could be an obstacle for dementia care in AL, Stateline reports

As states begin to implement a new Medicaid rule for home- and community-based care, there is a danger that assisted living facilities might face difficult requirements that could limit access to care, according to an article published Wednesday by Stateline, a news service of the Pew Charitable Trusts.

Massive snowstorm forces partial evacuation of NY nursing home

Ten New York counties were in a state of emergency Wednesday, and one nursing home near Buffalo had to partially evacuate the building after a deadly winter storm swept through the area.

Legislation would scrutinize long-term care owners

The Centers for Medicare & Medicaid Services would have to more scrupulously verify that providers are not owned by people with a history of fraud, if a recently introduced House bill becomes law.

Also in the news for Nov. 20, 2014 . . .

Night shift workers are at increased risk for weight gain, researchers find ... DOJ tripled recoveries from civil and criminal actions this year, reaching $25 billion ... Researchers develop molecular therapy that could improve memory in Alzheimer's patients

Nursing Home Compare better than other government 'transparency tools' but has room for improvement, GAO finds

Nursing Home Compare better than other government 'transparency tools' but has room for improvement, GAO finds

Government websites are not especially good tools for helping consumers choose healthcare providers, but Nursing Home Compare is in some ways the best model so far, according to a report released Tuesday by the Government Accountability Office.

Nursing home oversight makes OIG's top challenges list for second straight year

Ensuring nursing home quality remains one of the top 10 challenges facing the Department of Health and Human Services. That's according to a newly issued list from HHS' Office of Inspector General. After not appearing on the list in 2012, nursing home oversight was ranked the No. 7 priority in 2013 and now is No. 5.

CMS clarifies 45-day deadline for additional documentation requests

Certain auditors that are doing prepayment reviews of Medicare claims must tell providers that they have 45 days to produce any additional documents requested (ADR), according to a recent Survey & Certification memo.

Also in the news for Nov. 19, 2014 . . .

Hispanics are more realistic about long-term care needs than other groups, poll shows ... Hazmat teams investigating lingering air contamination at twice-evacuated nursing home ... American Geriatrics Society releases guidelines for postoperative delirium

Nursing homes that primarily serve whites have sharply higher RN staffing, CPI claims

Nursing homes that primarily serve whites have sharply higher RN staffing, CPI claims

Nursing homes that serve mostly minority residents tend to have drastically lower registered nurse staffing levels than other facilities, according to the Center for Public Integrity, an investigative journalism organization.

New Alzheimer's blood test could detect the disease 10 years before clinical diagnosis, researchers say

The latest Alzheimer's blood test is the most promising yet, as it appears to accurately predict the disease 10 years before a clinical diagnosis could be made, researchers announced Sunday.

Video allegedly catches long-term care owner sexually assaulting resident with dementia

A hidden camera allegedly caught the owner of a long-term care facility sexually assaulting a resident with dementia, leading to his arrest in Washington state, according to local news sources.

Also in the news for Nov. 18, 2014 . . .

Tau, not amyloid-beta, triggers Alzheimer's dementia? ... CBO increases doc fix price tag to $144 billion ... A-fib plus anti-clotting drugs means increased dementia risk

GA nursing home resident charged with murdering roommate

GA nursing home resident charged with murdering roommate

A nursing home resident has been charged with strangling her roommate to death. She is being held by authorities in Georgia.

Older adults with pain fall significantly more often, study finds

Pain is a significant contributing factor in falls among older individuals, suggesting that pain management initiatives could help long-term care facilities improve resident safety, according to recently published findings.

Court rules against religious nonprofits in contraception mandate case

Religiously affiliated employers have been given an appropriate method to opt out of providing contraception insurance coverage to their workers, a U.S. appeals court ruled Friday. The issue is of concern to certain long-term care providers, and Catholic nursing home organization the Little Sisters of the Poor is challenging the government in a similar case.

Also in the news for Nov. 17, 2014 . . .

Researchers identify new disorder similar to Alzheimer's ... Family and friends bear a large, unexamined burden due to policies that shift care from nursing homes, expert says ... More than half of hospice patients have a very long or very short stay, research shows ... 50% of chronic kidney disease patients should be on statins but are not, analysis finds

SNF staffing data will be submitted quarterly, payroll vendors might be responsible, CMS officials say

SNF staffing data will be submitted quarterly, payroll vendors might be responsible, CMS officials say

The Centers for Medicare & Medicaid Services soon will begin collecting quarterly staffing information from skilled nursing facilities, albeit on a voluntary basis, an official said during an Open Door Forum call Thursday.

Long-term care liability costs expected to increase 5%

Long-term care providers should prepare for higher liability costs, which are anticipated to increase by 5% on a national basis in 2015, according to an analysis released Thursday by the American Health Care Association/National Center for Assisted Living and Aon Global Risk Consulting, an arm of insurer Aon plc.

'Spending down' for Medicaid is the most practical LTC financing plan for most Americans, researchers assert

Forgoing long-term care insurance and relying on Medicaid is the smartest financial planning decision for the majority of unmarried Americans, according to investigators at Boston College's Center for Retirement Research.

Also in the news for Nov. 14, 2014 . . .

Assisted living worker sues facility for allegedly failing to protect her from racist residents ... Hundreds of one-star nursing homes have received HUD mortgages, Center for Public Integrity says ... PACE should emphasize 'boots on the ground' to partner with new payers ... Government seeks to expand federal workers' long-term care insurance eligibility ... Lame-duck session is 'perfect opportunity' for permanent doc fix, AMA president says

80% of nursing homes report misleadingly high staffing levels, Center for Public Integrity claims

More than 80% of skilled nursing facilities might have inflated registered nurse staffing levels on the Nursing Home Compare website, according to the Center for Public Integrity, a investigative journalism organization.

Providers, CMS at odds over dual eligible program

Some nursing homes and other providers are engaging in "bad behavior" by trying to persuade people to opt-out of a managed care demonstration project, a top government official recently claimed. But a long-term care leader disputes that providers acted with bad intentions, and told McKnight's that guidance from the Centers for Medicare & Medicaid Services was lacking.

Electronic records can reveal which nurses are most effective, researchers say

Nursing homes might be able to identify and reward their highest performing nurses by analyzing data, and those with a bachelor's degree are likely to be in that group, suggest recently published findings from the University of Michigan.

Also in the news for Nov. 13, 2014 . . .

Superabsorbent dressings have "positive role to play" in pressure ulcer care ... Cancer patients are much more likely to die in a nursing home or hospital if they are not in hospice ... AMA declines to censure Emanuel over his stance on aging, death ... Per-person care costs for Alzheimer's expected to double by 2050

Provider networks up for debate among Catholic bishops

Provider networks up for debate among Catholic bishops

Catholic healthcare providers are important players in the increasingly integrated U.S. healthcare system, but now church leaders are considering more stringent guidelines for these partnerships.

Supreme Court allows nursing home wrongful death case to proceed

A South Carolina woman can continue to pursue a wrongful death action against a nursing home even though she signed an arbitration agreement, according to the U.S. Supreme Court.

Alzheimer's care is split evenly between homes and facilities, survey finds

About half of people with Alzheimer's reside at a facility and half are being cared for at home, suggest newly released survey results.

Also in the news for Nov. 12, 2014 . . .

ACOs saved Medicare $417 million in year two ... Lack of reimbursement is No. 1 impediment to telemedicine, healthcare execs say ... Stem cells and lasers are the future of wound care, expert says

MedPAC will recommend site-neutral payments, but not for strokes

MedPAC will recommend site-neutral payments, but not for strokes

The Medicare Payment Advisory Commission is preparing to recommend that skilled nursing facilities and inpatient rehabilitation facilities receive equal reimbursement for 17 conditions, the panel's chairman announced at a meeting Friday.

FEMA tells assisted living residents to pay back Hurricane Sandy aid

Residents of a New York City assisted living center recently received letters from the Federal Emergency Management Agency demanding they repay thousands of dollars in Hurricane Sandy aid.

MI nursing home fined $100,000 for failure to perform CPR on resident calling for help

A Michigan nursing home has been fined more than $100,000 for failing to administer cardiopulmonary resuscitation to a resident, local news sources reported Monday.

Also in the news for Nov. 11, 2014 . . .

Antibiograms improve appropriate nursing home antibiotic prescribing by 40% in study ... Providers can share HIPAA-protected info to safeguard public health, feds say ... Date falsification charges add to turmoil over lax LA nursing home oversight

MedPAC considers eliminating observation stays

MedPAC considers eliminating observation stays

Observation status is not working as a way of classifying hospital patients and should be eliminated, members of the Medicare Payment Advisory Commission proposed at a Nov. 6 meeting. The increasing prevalence of hospital observation stays has been of sharp concern to post-acute providers.

Half of nursing home workers say problems unfairly blamed on staff, survey shows

Many nursing homes need to treat staff more fairly so that workers feel safe to report mistakes, according to the results of a large survey from the Agency for Healthcare Research and Quality.

Extendicare to sell US businesses for $870 million

Extendicare will sell nearly all of its U.S. operations to an investor group in an $870 million deal, the Canada-based long-term care company announced Friday.

Also in the news for Nov. 10, 2014 . . .

Depression, but not dementia, linked to insomnia in long-term care ... Baby boomers could mobilize for universal long-term care coverage, expert says ... Medicare will continue to cover speech generation devices

Resident on resident mistreatment is an urgent problem, researchers say

Resident on resident mistreatment is an urgent problem, researchers say

About 20% of nursing home residents experience mistreatment from a fellow resident in a given month, according to findings announced Thursday by Weill Cornell Medical College and Cornell University.

Skilled nursing dealmaking continues to be strong, average price per unit hits $78,000

The trend of strong merger and acquisition activity in the senior housing market has not abated, with the average price per skilled nursing unit up 7% from a year ago. This is according to the latest quarterly figures from business intelligence firm Irving Levin Associates Inc.

Daybreak Venture to pay $360,000 settlement over employment of excluded workers

Skilled nursing operator Daybreak Venture has agreed to pay more than $357,000 to settle charges that it employed workers excluded from federal health programs, authorities recently announced.

Also in the news for Nov. 7, 2014 . . .

Major LTC insurer posts $844 million loss, shares tumble ... Kindred's quarterly numbers suggest restructuring is paying off ... Monkey study raises hopes of weekly injections to fend off Alzheimer's ... Dementia can be predicted by walking speed and memory complaints, research suggests

Republicans gain Senate control; McConnell puts ACA provisions in crosshairs

Republicans gain Senate control; McConnell puts ACA provisions in crosshairs

Congress will try to dismantle some parts of the Affordable Care Act now that the Republican Party has the majority of seats in both chambers, prospective Senate Majority Leader Mitch McConnell (R-KY) said Wednesday.

COPD patients discharged to a skilled nursing facility are twice as likely to die within a year

People who go to a skilled nursing facility after being hospitalized for chronic obstructive pulmonary disease are about twice as likely to die within a year, according to recently released findings.

Nursing home background checks, foot care being scrutinized by OIG

Government investigators are preparing reports on skilled nursing facilities' Part B billing practices and background check processes, according to the recently released annual work plan from the Health and Human Services Office of Inspector General.

Also in the news for Nov. 6, 2014 . . .

AVIV makes $305 million skilled nursing deal on heels of Omega merger ... Only 2 in 5 people discuss long-term care preferences with loved ones, survey finds

Hospice is growing fastest in skilled nursing facilities, new report shows

Hospice is growing fastest in skilled nursing facilities, new report shows

Hospice services increased in nursing homes more than in any other care setting last year, according to the latest annual report from the National Hospice and Palliative Care Organization.

Government asks for suggestions on how to reduce Medicare appeals backlog

The federal government is asking the public to suggest ways of reducing Medicare appeals and cutting down on a backlog at the administrative law judge level. The request for information was filed by the Office of Medicare Hearings and Appeals and published in today's Federal Register.

Shift work linked to cognitive declines

Nursing home staff on shift schedules might experience diminished memory and thinking skills, recently published findings suggest.

Also in the news for Nov. 5, 2014 . . .

Supreme Court hears arguments over whether Omnicare misled investors ... Hospice medical director faces up to 20 years in prison for improper patient certifications ... Lack of interoperability is hindering accountable care organizations, ONC report says

Expanded surveys will focus on staffing, MDS coding

Expanded surveys will focus on staffing, MDS coding

Special surveys to determine Minimum Data Set coding accuracy and nursing home staffing levels will occur nationwide in 2015, the Centers for Medicare & Medicaid Services announced in an Oct. 31 memorandum. A five-state pilot of the focused surveys concluded in August, and there were deficiencies reported on 24 out of 25, according to CMS.

Nursing home settles case of resident hit, killed by food cart

A California long-term care facility has agreed to settle a wrongful death case involving a resident who was struck by a dining cart, local news sources reported Monday.

CMS promises ICD-10 software six months in advance

Providers will receive needed coding and billing software six months before the ICD-10 transition date, the Centers for Medicare & Medicaid Services has announced. This is double the lead time that providers had for a planned 2014 transition, which was delayed by a year.

Also in the news for Nov. 4, 2014 . . .

Health center owner fined $43 million in nursing home patient recruiting scam ... CMS defines "one-on-one" provider training ... Men shorter than five-foot-five are 50% more likely to die from dementia ... UK docs to begin telling patients their 'brain age'

Omega purchases Aviv REIT for $3 billion

Omega purchases Aviv REIT for $3 billion

Omega Healthcare Investors is poised to own nearly 875 skilled nursing properties across 41 states, following its merger with Aviv REIT in a $3 billion deal announced Friday. The combination of the powerhouse REITs is just the latest mega-deal in the long-term care sector, and it signals further consolidation is coming.

CA facilities slapped with $3 million in labor violations fines, workers slept on sofa in garage

Four assisted living facilities in the San Francisco Bay area are facing a total of $3 million in fines for how they allegedly treated and paid workers, California authorities announced Thursday.

ACO patients report higher satisfaction, better care coordination

Seniors are more satisfied with their healthcare and believe it is more coordinated if their providers are part of an Accountable Care Organization, according to first-of-its-kind research from the Harvard Medical School Department of Health Care Policy.

Also in the news for Nov. 3, 2014 . . .

$37 million settlement makes Dignity the latest large hospital system to pay out for observation stay charges ... Vibrating insoles could reduce falls among seniors ... Audit shows 11,000 unresolved nursing home complaints in CA

Profile: Mor than meets the eye

Profile: Mor than meets the eye

While Brown University Professor Vince Mor's accomplishments may be heralded in the long-term care profession, what may be less known is his dedicated work with the Jewish Alliance of Greater Rhode Island.

Raising sensitive issues

Raising sensitive issues

Wound care gets most of the attention, but ostomy management is another critical need for long-term care residents that deserves study, improvement

Thanks, Mata Hari

Thanks, Mata Hari

You Mystery Shoppers have spoken: Assisted living communities do a bad job making a good first impression. If true, it's definitely a problem, and I'd thank you for sharing if I knew your real names.

Making a quality bet on ACOs a risky proposition

Making a quality bet on ACOs a risky proposition

If there's anything that's become clear about this ACO business lately, it's that it's not going to be as simple as A-B-C.

Open beds no mystery

Open beds no mystery

For more than a decade, students learning about senior housing administration at George Mason University have been "mystery shopping" operators via phone calls. The latest results are just in. And believe me, they are nothing to call home about.

How to do it ... Professional development

Dementia care is an ever-changing discipline that requires a long-term commitment to training and staff development. Approached sensibly, a strong program will pay dividends far down the road. Experts give tips here on how to best prepare staff to care for residents with Alzheimer's disease or other dementias.

Ask the legal expert ... how to avoid deadbeat families

Ask the legal expert ... how to avoid deadbeat families

What's the best way to prevent deadbeat families?

Official: HIPAA audits to bring penalties

In apparent acknowledgement that HIPAA violation enforcement has been less than aggressive so far, a government adviser said that HIPAA audits would soon produce swift results — and penalties, when appropriate.

Rehab firm's overbilling will cost provider $1 million-plus

Rehab firm's overbilling will cost provider $1 million-plus

The fallout from a recent spike in rehabilitation charges to government payers continued to make headlines in September. This time, a nursing home company was blamed for insufficient oversight of its contract therapy provider.

State news for November 2014

State news for November 2014

MISSISSIPPI — Postal inspectors allege nursing home employees here and in California may have unwittingly referred families and residents seeking help with Medicaid and veterans' benefits to an individual who allegedly filed troublesome paperwork and defrauded others of hundreds of thousands of dollars in what they described as a sophisticated Ponzi scheme.

Technology award winners raise bar for third annual McKnight's Tech Awards

Technology award winners raise bar for third annual McKnight's Tech Awards

Compelling stories of improved resident engagement is how some winners of the third annual McKnight's Excellence in Technology Awards caught the eyes of our independent panel of judges.

ITUpdate for November 2014

» Nurses are increasingly relying on mobile devices, social media and the Internet, according to a survey from Wolters Kluwer Health. Their results, released in September, said 65% of nurses are using mobile devices at work for professional purposes at least 30 minutes a day, with 20% using them for 120 or more minutes. Half of the respondents said their organization blocks Facebook, Twitter, Pinterest and YouTube on company networks.

Online tool helps providers target ICD-10 preparations

Online tool helps providers target ICD-10 preparations

As providers get back into gear for the ICD-10 changes to hit in 2015, researchers at the University of Illinois at Chicago have developed a free online tool to help healthcare facilities determine where more time and effort will be needed to prepare for the transition.

BusinessBriefs for November 2014

» Large nonprofit senior living groups continue to be largely the domain of faith-based operators, according to the latest LeadingAge Ziegler 100 report. Presbyterian-, Methodist- and Lutheran-run organizations were the most common, investigators found.

Prospects not well courted

Many senior living operators could do a better job of attracting potential customers, a study by students at George Mason University has found.

LTC-related deals took the lead in the second quarter

LTC-related deals took the lead in the second quarter

Long-term care bucked healthcare industry trends with strong merger and acquisition activity in the second quarter, according to newly released data from professional services firm PricewaterhouseCoopers.

Ask the payment expert ... about regs vs. resident choice

Ask the payment expert ... about regs vs. resident choice

We are going through culture change and wonder if surveyors will be more lenient with regulations if we do something that is resident choice?

RACs snatch back $1.8M

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

Ask the nursing expert ... about overseeing immunizations

Ask the nursing expert ... about overseeing immunizations

I am a new assistant director of nursing and my administrator asked me to oversee immunizations. Where do I start?

Flexible work, pressure ulcer rates linked

Nursing homes where staff had more control over scheduling registered lower rates of pressure ulcers among residents, according to a study published in the Journal of Applied Gerontology.

More than 1 in 3 nurses leave first job by third year: study

More than 1 in 3 nurses leave first job by third year: study

Nearly 18% of new nurses leave their first job within a year, according to a study in Policy, Politics & Nursing Practice.

Ask the treatment expert ... about linens and pads

Ask the treatment expert ... about linens and pads

Does placing multiple pads and linens under residents who are incontinent protect their skin?

Diabetes growth to drive wound market

A rise in diabetes and obesity will drive the increase in the wound care market over the next four years, a research group asserts.

Ask the care expert ... about documenting falls

Ask the care expert ... about documenting falls

If a nurse's aide is in a room when a resident begins to fall, and lowers her to the ground, we are NOT counting those on our count for falls. Are we correct?

Depression tool's accuracy questioned

A familiar tool for diagnosing depression in dementia patients might not be very effective in the nursing home setting, according to recent findings in The American Journal of Geriatric Psychiatry.

60 seconds with ... Mark Parkinson

60 seconds with ... Mark Parkinson

Q: Last month was the third AHCA/NCAL annual conference with you at the helm, and the healthcare landscape has become increasingly complex. Is there something simple providers can focus on?

AHCA goes on offense, backs 5 Star audits

Following victories such as the newly signed IMPACT Act, provider advocates now will be more aggressive on Capitol Hill, leaders of the American Health Care Association and the National Center for Assisted Living said at their annual convention last month in Washington, D.C.

New strategy for antibiotics

New strategy for antibiotics

The White House unveiled a national plan in September to combat antibiotic-resistant bacteria. It includes an executive order to "reduce the emergence and spread" of these bacteria and ensure availability of treatments.

Don't miss any McKnight's news