For just about every skilled nursing facility out there, this is probably a good time to break out the flop sweat. That is, unless the prospect of being culled from one of your most vital revenue streams is nothing to worry about.
In some ways, 2014 has been a monumental year. But it's not over yet, especially with regard to Centers for Medicare & Medicaid Services steps regarding the historic Jimmo settlement agreement signed on Jan. 24, 2013.
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.
If outgoing MedPAC Chairman Glenn Hackbarth had his way, Medicare would pay for skilled nursing services without requiring a three-day hospital stay first.
Glenda Jimmo has reached a settlement with the federal government and will finally receive Medicare coverage for claims that were denied in 2007, which led her to file a class-action lawsuit over the so-called "improvement standard."
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.
Post-acute partnerships now have become a widespread strategy to reduce hospital readmissions, survey findsOctober 03, 2014
Hospital partnerships with post-acute providers can be considered a "key strategy" in reducing readmissions, according to market data gathered by executive advisory service Healthcare Intelligence Network.
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.
NJ physicians to face charges that they kept people as inpatients to qualify them for SNF coverage, judge rulesSeptember 03, 2014
A whistleblower can continue to pursue charges that a number of New Jersey physicians improperly designated Medicare beneficiaries as inpatients and sometimes prolonged their hospital stay to qualify them for skilled nursing care, a federal judge recently ruled.
When people are discharged from the hospital following an illness, injury or surgery, that's often not the end of the story.
Hospitals have been cast in a harsh light by long-term care advocates recently for allegedly over-using "observation stay" status. The practice can ultimately deny some patients subsequent Medicare coverage for nursing home admission.
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?
Medicare should cover people who go to a skilled nursing facility without a preceding hospital stay, experts recently told the Senate Special Committee on Aging.
When is a meager pay hike viewed as welcome news? When the source of that increase — namely, the federal government — seems intent on making cuts almost everywhere else.
A federal court in New York has tossed a whistleblower lawsuit charging that large long-term care pharmacies violated the False Claims Act by failing to dispense requested generic drugs.
NY man suspected of trying to smother nursing home resident ... Medicare agency publishes QIO evaluation criteria ... TX nursing home deaths raise questions about mentally ill residents
Depending on how you like to interpret the news, nursing home operators are either facing some of the worst of times, or they've been infused with new life.
Q: The government is notifying new participants in the Bundled Payments for Care Improvement initiative. Do you expect more post-acute providers in this latest round?
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.
AOD Software has bought Stratis Business Systems Inc., a home health and home care cloud-based software system.
Genesis nursing home fired dietary worker due to her disability, government alleges ... Rehabilitation provider groups brief Senators, present findings that IRFs outperform SNFs ... Medicare accounted for the most improper payments the government made last year
Elder abuse is inflicted upon many of the more than 2 million Americans in long-term care settings, and more oversight is needed, according to a government report published Wednesday.
The predominance of fee-for-service payment methods is the greatest barrier to improving efficiency in the nation's healthcare system, according to a May 29 report from a panel of White House advisors. The President's Council of Advisors on Science and Technology criticized the FFS payment model because it focuses on the volume of services provided rather than on better outcomes.
Minnesota routinely is named best state for long-term care, as it was last week in AARP's 2014 scorecard. AARP held a panel discussion to unveil the rankings, and of course an official from Minnesota was on hand to share his state's secret sauce. But the panel also featured a speaker from Mississippi, one of the lowest-ranking states. I came away thinking that Minnesota actually might not have much to teach Mississippi — and questioning what these types of state rankings accomplish.
For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.
A hospitalist company that works with thousands of post-acute care facilities is officially facing federal charges that its clinicians routinely overbilled Medicare and Medicaid, authorities announced Tuesday.
Medicare drug procedure could burden dying seniors ... Drugs-then-therapy regimen raises hopes of full stroke recovery ... Docs reaffirm position on long-term care EHRs
Documentation coding errors related to routine patient evaluation and management (E/M) visits are costing the Medicare program billions of dollars in improper payments a year — nearly $7 billion alone in 2010 — according to a new government report. But the investigation involved few claims involving nursing homes.
Dual eligibles more likely to go from hospitals to lower quality nursing homes, referral process might need reform, researchers sayMay 27, 2014
People eligible both for Medicare and Medicaid go to lower-quality nursing homes after being hospitalized at a rate higher than Medicare-only patients, according to researchers from Brown and Harvard universities.
House bill would create site-neutral payments for post-acute care, could save Medicare $100 billion over a decade, lawmakers sayMay 23, 2014
Federal lawmakers have drafted a bill to implement bundled, site-neutral payments for post-acute services, which they say would save the Medicare program up to $100 billion over a decade.