Skilled services 101: Understanding the medical appropriateness exception
By
Renee Kinder
Oct 07, 2021
In our industry, we have all read it numerous times. Some of us can quote portions of it in our sleep… three consecutive calendar days, for a condition that was treated during the qualifying hospital...
Four tips on making smarter purchasing decisions
By
Rich McKeon
Oct 31, 2014
Rising drug costs and declining reimbursements significantly impact profits, and long-term care pharmacies today have to do more with less.
Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators
By
Tim Mullaney
Jul 31, 2014
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.
Bill addressing admission status receives praise
By
Stephanie H. Kim
Jul 30, 2014
A bill that would require hospitals to give patients a formal notice of their admission status has received strong support from healthcare associations.
CMS announces Medicare appeals without administrative law judge hearings
By
Tim Mullaney
Jul 07, 2014
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...
Charges that Omnicare forgave nursing providers’ debts as a form of kickbacks can proceed, judge...
By
Tim Mullaney
Jun 17, 2014
A whistleblower can pursue charges that long-term care pharmacy Omnicare ignored skilled nursing companies’ overdue bills in exchange for certain kinds of business, a federal district court recently...
Ultra-High therapy keeps surging: CMS
By
James M. Berklan
Jun 01, 2014
Providers aren’t just being accused of coding therapy patients in higher payment categories than ever before. The charge is being backed by hard numbers in a recent memorandum from the Centers for...
June 3 Super Tuesday webinar: why you need to pay attention to PEPPER reports
May 22, 2014
Providers will learn how the government’s PEPPER reports are connected to their facilities’ health during a June 3 McKnight’s Super Tuesday webcast. Featured speaker Leah Klusch, the...
More than half of skilled nursing facility rehab residents classified under Ultra-High, CMS finds
By
Tim Mullaney
May 07, 2014
Skilled nursing facility therapy billings in the Ultra-High RUG category increased steadily in recent years and passed a significant threshold in 2013, according to a government memorandum.
Palliative possibilities: Therein lies the rub
By
Shelly Mesure, MS, OTR/L
Apr 22, 2014
When a patient is referred to therapy, and they are receiving hospice care, then therapy needs to seek permission from the hospice company to provide any treatment. Hospice is required to reimburse the...