Arbitration null in MA coverage disputes, state supreme court rules

Arbitration null in MA coverage disputes, state supreme court rules

Coverage disputes between Medicare Advantage plans and healthcare providers must follow a federal appeals process even if their contract calls for arbitration, the Arizona Supreme Court ruled on Thursday.

Social media use linked to less chronic illness, loneliness in seniors

Facebook, Skype and instant messaging are among technology applications that may lessen depression among seniors, a new study has found.

Seniors who rarely exercise have 50% higher risk of dementia

Older adults who don't exercise often — or don't exercise at all — have a 50% higher risk of developing dementia as they age, according to a new study in the Journals of Gerontology: Medical Sciences.

Also in the News for Monday, August 29

Team-based primary care 'significantly' improves quality study finds ... NIH to dig into social factors of healthcare ... Diabetes-linked vision loss on the rise

Providers could face Five-Star sanctions for late PBJ data

Providers could face Five-Star sanctions for late PBJ data

Nursing homes that fail to submit electronic staffing data by the first required deadline may face sanctions and could see their Five-Star rating suffer as a result, Centers for Medicare & Medicaid Services officials said Thursday.

Medicare ACOs boosted quality, savings in 2015, CMS reports

More than 100 Medicare Accountable Care Organizations qualified for shared savings payments in 2015 by meeting quality performance standards and hitting their savings threshold, according to the Centers for Medicare & Medicaid Services. The total savings for the federal government through the program is up to $1.29 billion.

SNF Medicaid coordinator arrested for stealing $13,000 from residents

The former Medicaid coordinator of a Florida skilled nursing and rehabilitation facility was arrested Wednesday after she allegedly stole more than $13,000 from three residents.

Also in the News for Friday, August 26

Staff from Virginia SNFs pitch in to help facility damaged in Louisiana floods ... Nurse protocols shown to "dramatically" reduce ER stays ... Blood test may help predict stroke risk

Medicare beneficiaries with more continuity of care at lower risk of ED visits

Medicare beneficiaries with more continuity of care at lower risk of ED visits

Older Medicare beneficiaries who have more continuity of care and consistently visit the same outpatient physician are less likely to visit an emergency room than those who receive care from several different physicians, according to a recent study.

Feds release draft interoperability standards for health IT

The push for interoperability in health information technology continued this week with the release of draft standards for the industry by federal health IT officials.

Little Sisters of the Poor cite nun shortage in giving up operations of 147-year-old nursing home

The Little Sisters of the Poor will be leaving the St. Louis nursing home they've operated for 147 years amid a shortage of nuns to staff the facility, the group announced Wednesday.

Also in the News for Thursday, August 25

Medicaid, Medicare to make up 40% of all federal spending by 2026 ... Concerns grow as for-profit companies enter PACE program ... Older adults typically happier, despite physical ailments

SNF will challenge jury's $30 million negligence verdict

SNF will challenge jury's $30 million negligence verdict

A Tennessee skilled nursing facility plans to fight back against a jury's $30 million verdict in a lawsuit alleging negligence and medical malpractice that led to a resident's death.

ICD-10 'flexibilities' to expire Oct. 1 as planned

A 12-month grace period meant to ease providers' transition to Medicare ICD-10 will officially come to a close on Oct. 1, Centers for Medicare & Medicaid Officials said last week.

CDC: Sepsis a 'race against time' for healthcare providers

Most patients with sepsis have recently been treated in a healthcare facility, and many clinicians are missing the signs, according to the Centers for Disease Control and Prevention.

Also in the News for Wednesday, August 24

University gets $1 million grant to boost nursing home quality ... Geriatric-focused ERs may help reduce hospitalizations, readmissions ... CNA who hit, shoved resident could face 4 years in prison

Nursing home settlement spurs HHS to investigate small health data breaches

Nursing home settlement spurs HHS to investigate small health data breaches

A recent case involving a stolen iPhone containing nursing home residents' medical records has prodded federal officials to place more scrutiny on smaller healthcare data breaches, according to the Department of Health and Human Services Office for Civil Rights.

Doc gets 4 years in prison for multi-million dollar hospice scheme

A California physician who falsely certified more than 70 patients as terminally ill in order to refer them for hospice care was sentenced to four years in federal prison last week. He will also pay $1.3 million in restitution.

Rule to boost EHR oversight gets White House review

A proposed rule that would grant federal officials more oversight of complaints and safety issues related to electronic health records moved one step closer to finalization last week.

Also in the News for Tuesday, August 23

Study finds 'missed opportunity' to reduce prescriptions after fractures occur ... Language interpreters 'indispensable' in palliative care ... Close family relationships extend seniors' lives more than friendships

Experts argue court didn't go far enough in new 'Jimmo' case mandate

Experts argue court didn't go far enough in new 'Jimmo' case mandate

While pleased with a court decision mandating that the Centers for Medicare & Medicaid Services should do better in explaining maintenance coverage under the landmark Jimmo case, leading long-term care experts said more can be done.

Panel holds up $300k claim against state in SNF breathing tube case

An Arkansas panel voted last week to affirm a $320,000 claim against the state's Department of Human Services in a nursing home wrongful death lawsuit.

Pharmacy owner pleads guilty to obstructing Medicare audit, settles for $2.5M

The owner of two pharmacies in Alabama has pleaded guilty to charges of obstructing a Medicare audit. He will pay a $2.5 million government penalty.

Also in the News for Monday, August 22

Bandage helps diabetic ulcers heal faster, study finds... Former senators weigh in on bundled payments ... Nursing home employee arrested for allegedly stealing 117 oxycodone pills

Arbitration clauses in nursing home final rule getting federal scrutiny

Arbitration clauses in nursing home final rule getting federal scrutiny

The future of nursing home arbitration agreements is under scrutiny by the Office of Management and Budget as part of its nursing home final-rule review.

New CMS administrator among the expected changes, as Clinton and Trump set up transition teams

As Hillary Clinton and Donald Trump prepare their transition teams as part of their hoped-for march to the White House, one position is sure to catch long-term care officials' notice: The future leader of the Centers for Medicare & Medicaid Services.

Calcium supplements raise dementia risk in women surviving stroke sevenfold, study finds

Calcium supplements are tied to an increased risk of dementia in senior women who have had a stroke, researchers have found.

Also in the News for Friday, August 19

SEIU leads nurses, residents to fight for FL nursing home's future ... CDC begins next wave of LTC study ... Duke physician says ACOs have failed ... Nursing home fined after resident chews finger to bone ...

CMS wireless networks have vulnerabilities, watchdog finds

CMS wireless networks have vulnerabilities, watchdog finds

A wireless penetration test of certain Centers for Medicare & Medicaid Services Data Centers revealed security vulnerabilities, according to a new report from the HHS Office of the Inspector General.

Aetna withdrawal puts spotlight back on ACA

The announced withdrawal of health insurance giant Aetna from Obamacare exchanges this week has put the healthcare law back in the thicket of political debate. The announced withdrawal of health insurance giant Aetna from Obamacare exchanges this week has put the healthcare law back in the thicket of political debate.

Female docs paid less by Medicare than male counterparts, study finds

Long-term care providers working with female physicians may be surprised to learn that Medicare pays them less than their male peers, according to a new analysis.

Also in the News for Thursday, August 18

New osteoporosis drug shows progress in creating bone growth ... Growing number of foreigners moving into nursing homes in China ... Couple who falsified more than 10,000 diagnostic tests sentenced in $4.8 million Medicare fraud case

Providers invited to weigh in on IMPACT Act

Providers invited to weigh in on IMPACT Act

The public comment period for standardized assessment-based data items under the IMPACT Act of 2014 will run until Friday, August 26, the Centers for Medicare & Medicaid Services has announced.

Terminally ill patients might be allowed to take suicide drugs in Colorado

Voters in Colorado will decide in November whether to pass a bill that would allow suicide through drugs for the terminally ill.

Feeding tube use cut by 50% in nursing home residents with dementia, study finds

The proportion of long-term care residents who had advanced dementia and received feeding tubes dropped by 50% between 2000 and 2014, according to a new analysis.

Also in the News for Wednesday, August 17

Retirees need $130k for healthcare alone, not counting LTC ... Author of "Beating Obamacare," known for "death panels" label, joins Trump campaign ... Fake owner of home health company pleads guilty in $4.2M scheme

Obama administration races to make Medicare changes as healthcare industry objects

Obama administration races to make Medicare changes as healthcare industry objects

As the clock clicks down on President Barack Obama's days in office, the administration remains focused on adjusting Medicare reimbursements, much to the annoyance of healthcare providers.

Federal court backs NLRB: CareOne illegally pressured union vote

A U.S. District Court has agreed with the National Labor Relations Board, ruling that a CareOne skilled nursing facility unlawfully influenced employees before a unionization vote.

Iowa transgender stroke patient finds nursing home — after $140,000 in costs

After four months, a 52-year-old transgender stroke victim has been admitted to a nursing home in Iowa. But it cost a hospital $142,000, according to local reports.

Also in the News for Tuesday, August 16

Seniors housing absorption should see bounce, NIC economist says ... Phone checklist may be tool in preventing hospital readmissions.... Close to 100 residents evacuated from NY nursing home during heat wave

CMS proposes first PACE update in 10 years

CMS proposes first PACE update in 10 years

The Programs of All-Inclusive Care for the Elderly would get its first major update in a decade under a proposal announced by the Centers for Medicare & Medicaid Services Thursday.

SNF didn't report resident's death because of 'bad press' about operator

A Massachusetts nursing home was slammed this week in a state report that said the provider chose not to report the death of a resident because of "bad press" garnered by its parent company.

Common painkiller may help reverse Alzheimer's-related memory loss

An anti-inflammatory drug commonly used to treat pain associated from menstrual cramps may be able to reverse memory loss linked to Alzheimer's disease, new research shows.

Also in the News for Monday, August 15

AHCA awards Gold National Quality Awards to three facilities ... Virtual reality, treadmill training could reduce fall risk for residents ... Psych evaluation ordered for SNF resident charged with arson

Updated Five-Star doesn't fix accuracy issues, senator says

Updated Five-Star doesn't fix accuracy issues, senator says

New quality measures added to the Five-Star Quality Rating System this week are unlikely to improve the accuracy of the ratings, according to one lawmaker.

Dementia care added to Medicare Advantage insurance model

A value-based, clinically-focused insurance model will add benefits tailored for people with dementia in its second year, the Centers for Medicare & Medicaid Services announced on Thursday.

CNA fired while pregnant can't sue for discrimination, court rules

A certified nursing assistant can't claim she was discriminated against by the skilled nursing facility that fired her while she was pregnant, a federal court ruled this week.

Also in the News for Friday, August 12

Ryan Lochte's grandma goes viral for carrying "torch" in nursing home Olympic parade ... NOTICE Act requirements to cost $23 million annually ... Last suspect in CNA's sexual assault plot arrested

Provider groups put pressure on Supreme Court over arbitration ruling

Provider groups put pressure on Supreme Court over arbitration ruling

Stiff rules on arbitration in Kentucky are hurting the state's nursing homes and are not in compliance with the Federal Arbitration Act, according to a brief filed with the U.S. Supreme Court

New quality measures added to the Five-Star site

Five new skilled nursing quality measures were officially added to the Five-Star Quality Ratings system on Wednesday, the Centers for Medicare & Medicaid Services announced.

20% leave hospital with unstable vital signs, posing problem for providers

Nearly one in five adult hospital patients are discharged with at least one unstable vital sign, a new study from University of Texas researchers has found.

Also in the News for Thursday, August 11

Risk of addiction low for seniors prescribed opioids after surgery ... Death of SNF resident following altercation ruled a homicide ... CMS home care demo saves $10 million in second year

Value-based purchasing demo had little impact on Medicare spending, quality: study

Value-based purchasing demo had little impact on Medicare spending, quality: study

The Centers for Medicare & Medicaid Services' Nursing Home Value-Based Purchasing demonstration had little effect on participating facilities' Medicare spending or quality, a new study has found.

'Fair warning': New Medicaid 'pass-through' payments for SNFs may be blocked

So-called "pass-through" Medicaid payments may soon find themselves in the crosshairs of federal regulators, according to a recent bulletin from the Centers for Medicare & Medicaid services.

Medicaid expansion improved care for chronic conditions, study finds

Low-income adults in two states experienced significant improvements in care after Medicaid services were expanded as part of the Affordable Care Act, according to a recent analysis.

Also in the News for Wednesday, August 10

CMS releases training videos on Section GG ... White House completes review of PACE update proposal ... Healthcare costs for large employers to rise 6% in 2017

CMS to crack down on facilities' photo, video abuse policies

Nursing home surveyors will soon review facilities' policies on staff members' social media abuses following several high-profile reports into the issue, federal officials announced Friday.

Nursing home nurses enjoying a hot salary market: survey

Pay rates for registered nurses working in skilled nursing facilities rallied in 2016, with employers awarding raises at levels not seen in years.

NOTICE Act implementation pushed back to fall

The Notice of Observation, Treatment and Implication for Care Eligibility Act will go into effect in October, instead of this month, according to a final rule released by the Centers for Medicare & Medicaid Services last week.

Also in the News for Tuesday, August 9

Administrator arrested for theft during probe into VA healthcare facilities ... Underweight seniors may have increased Alzheimer's risk ... SNF resident overdoses on heroin given by relative of another resident

SNF administrator salaries jump nearly 4%, DONs 2.7%, survey finds

SNF administrator salaries jump nearly 4%, DONs 2.7%, survey finds

Nursing home administrator salaries across the country increased 3.78% over the past year, when using a same-facility comparison.

Health system to pay $5.55 million in largest ever HIPAA settlement

A major Illinois healthcare system will pay $5.55 million to settle allegations of HIPAA noncompliance, marking the largest settlement to date against a single entity, officials said.

LPN arrested for stealing drugs to support relative's addiction

A Pennsylvania nurse has been accused of forging co-workers' signatures more than 280 times to steal painkillers and sedatives to support her sister's drug addiction.

Also in the News for Monday, August 8

Acupuncture effective for pre-dementia memory loss ... Napping at work beneficial for night shift nurses ... Lack of pharmacy access may boost rehospitalizations for rural seniors

Ask the Legal Expert about ... disclosure of resident information

Ask the Legal Expert about ... disclosure of resident information

I trusted my software vendor but wound up having some resident personal information made available to the public. If a resident pursues a claim against us, can we seek damages from the vendor? What is our liability?

State News for August 2016

State News for August 2016

A proposal that would have dramatically increased fines and oversight of Massachusetts nursing homes was rejected by state lawmakers in late June.

Design Decisions: Not so common rehab

Design Decisions: Not so common rehab

Tutera breaks mold on 'cookie-cutter' design with a new therapy center and an environment aimed at the entire LTC spectrum

How to do it... Physical restraints

Since passage of healthcare reforms in OBRA 1987, the incidence rate of resident restraints has dropped considerably, to less than 5%, with a mantra to lower it further.

A Day in the Life: Happy Campers

A Day in the Life: Happy Campers

Like many kids in the U.S., third graders from Jefferson Elementary School in Pasadena, CA, headed to camp this summer

Reader Poll: "What was your first job, and what did it teach you?

"My first job going into this particular field was an administrator-in-training, where I would come in and work in a nursing home."

Proof HIPAA stakes may be higher than you think

Proof HIPAA stakes may be higher than you think

Like a kid who's staying up past his bedtime right in front of his parents' noses, long-term care operators have been enjoying a pass for at least a few years when it comes to HIPAA crackdowns.

Regulators gone wild

Regulators gone wild

You probably don't need to be reminded that skilled care is a heavily regulated field. Some say only nuclear power operators must comply with more mandates.

Where are they now: Abramson Center for Jewish Life

Where are they now: Abramson Center for Jewish Life

After winning a McKnight's Excellence in Technology Gold award in the High Tech/High Touch category in 2014, Abramson Center for Jewish Life's Karen Eshraghi and Tori Crumbie had goals: piloting levels of engagement, examining clinical outcomes, and developing an implementation manual for providers for their Match-Quality Indicator system.

Shutting out the noise

Shutting out the noise

As an occasionally obsessive hiker navigating the meandering trail of my existence, I'm constantly rediscovering it's a metaphor for everything — from life in general to long-term care.

Kindred wins whistleblower case: Docs not proven wrong

Kindred wins whistleblower case: Docs not proven wrong

A Kindred Healthcare subsidiary claimed victory in June in a False Claims Act case brought by a former employee.

SNF settles fraud, neglect suit for $28M

A New York skilled nursing facility has agreed to pay $28 million and implement reforms to settle a lawsuit alleging fraud, neglect and criminal conduct by the facility's owners and staff.

Video consultations provide boost to SNF dementia care

Video consultations provide boost to SNF dementia care

When aggressive behavior occurs among dementia patients, nursing home staff often must resort to using physical restraints or prescribing powerful antipsychotic medications to reduce it.

Profile: Israel Ray

Profile: Israel Ray

During college, when Israel Ray ran track and field and specialized in the 110-meter hurdles, his coach noticed he would do whatever it took to win during a practice.

Make it a clean sweep

Make it a clean sweep

Laundry and housekeeping staff are key to survey success; they buff a provider's record or can be the source of embarrassing, costly survey findings

Room for improvement

Room for improvement

Therapists and nursing homes are still looking for reimbursement — and clarity — 4 years after the landmark Jimmo settlement set the caregiving community abuzz.

Occupancy is steered by flu

Skilled nursing facilities experienced slightly increased occupancy rates in the first quarter of 2016, likely due to winter-related causes such as flu and falls, according to the National Investment Center for Seniors Housing & Care.

Look for business guidance in claims data, expert says

Look for business guidance in claims data, expert says

Nursing home providers should use claims data to identify trends that may shift their business plans, one expert recommended in June.

Ask the Payment Expert about ... how to calculate cost of care

Ask the Payment Expert about ... how to calculate cost of care

Our referral hospital system is asking us what our cost of care is. How do I calculate that?

Person-centered care saves

Skilled nursing operators can expect healthcare stakeholders to push for more person-centered care programs because of the wide savings they appear to offer payers.

Camera policies held up by privacy, litigation concerns

Camera policies held up by privacy, litigation concerns

In the battle of pros and cons for placing cameras in resident rooms, the potential negative legal and privacy implications are winning out with most providers, new research shows.

Ask the Nursing Expert about ... the highlights of the MSDS system

Ask the Nursing Expert about ... the highlights of the MSDS system

What are the highlights of this new rule?

Providers competing on nursing shortage

With increased nursing demand on the horizon in the U.S., long-term care providers are now offering a wide variety of incentives to bring more nurses to their facilities.

Second chance helps nurses overcome language mandate

Second chance helps nurses overcome language mandate

Amid the growing pressure of nursing staff shortages, an overseas healthcare regulator is relaxing its rules for language testing.

Ask the Treatment Expert about ... how pressure injury staging descriptions have changed

Ask the Treatment Expert about ... how pressure injury staging descriptions have changed

In addition to the change in terminology from pressure ulcer to injury, NPUAP's April 13, 2016, press release announced refined descriptions of pressure injury (ulcer) stages.

Aging sweat glands delay wound healing

Sweat glands play an important roll in how skin heals from injury, but they don't work as well in seniors, say University of Michigan researchers.

Researchers 'reboot' tissue to accelerate wound healing

Researchers 'reboot' tissue to accelerate wound healing

Tufts University researchers have for the first time reprogrammed skin cells from diabetic foot ulcers to make them more like stem cells.

Ask the Care Expert about ... prevalence of infections in LTPAC

Ask the Care Expert about ... prevalence of infections in LTPAC

It seems like we are now making a bigger deal out of infections in long-term post-acute care settings than before.

Many with stroke risk get wrong drugs

More than one-third of people at risk for stroke are given the wrong medications, according to a recent study.

60 Seconds with ... Judith A. Stein, JD

60 Seconds with ... Judith A. Stein, JD

What are some of the challenges involving seniors and outpatient observation stays in hospitals?... with Center for Medicare Advocacy's Executive Director, Judith A. Stein, JD

Top CCRC posts see salary increases, report discovers

Directors of nursing at continuing care retirement communities now make an average annual salary of $92,680, according to a new report.

LTC population is growing more diverse

The long-term care population has branched out further in age and ethnicity over recent decades, according to new research published in late June in JAMDA: The Journal of Post-Acute and Long-Term Care Medicine.

McKnight's earns APEX Grand

McKnight's Long-Term Care News earned a Grand Award and three Awards of Excellence at the 28th annual Awards for Publication Excellence contest.

Obama lauds change in payment schemes

Obama lauds change in payment schemes

The next president and congressional leaders should continue to promote value-based purchasing and alternative payment models, President Barack Obama said in an academic article last month.

MRSA rate falls due to tracking

MRSA rate falls due to tracking

An electronic hand hygiene monitoring system is responsible for a 42% decrease in MRSA infections in one health system, an analysis finds.

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