Providers tentatively welcome Medicare payment goals tied to quality

Providers tentatively welcome Medicare payment goals tied to quality

Long-term care leaders on Monday called a first-ever federal timeline for greater levels of bundled and other alternative payments "aggressive" but "a good thing."

Lawmakers demand better adherence to Medicaid's eligibility and asset transfer rules

Two federal lawmakers are calling on the Centers for Medicare & Medicaid Services to crack down on states that don't enforce eligibility and asset-transfer regulations.

Court: Nursing home must pay bed tax, even if it receives no benefit

The Illinois Supreme Court unanimously ruled that a nursing home must pay a bed tax even if it does not receive a benefit.

Also in the news for January 27, 2015 ...

Nursing homes ripped over use of guardianship law for debt collection ... Dementia linked to common drugs: hay fever, insomnia, other over-the-counter meds ... Widespread flu activity expected to continue for weeks: CDC ... Severe Alzheimer's improved with drug-therapy regimen, small study shows.

Lawmakers predict work cutbacks if ACA coverage floor raised to 40 hours per week

Raising the definition of a full-time workweek from 30 to 40 hours would result in fewer work hours for many employees, Senate Democrats argued at a hearing last week.

Also in the news for Jan. 26, 2015 ...

Senate Democrats back faster union elections ... Gentiva approves Kindred deal ... Life after stroke riskiest for those living alone, especially older men ... Heart failure patients bounce back to ERs for complex reasons

Setting up an ACO a dangerous business proposition for many providers, lawmaker says

Don't count Rep. Diane Black among the supporters of the current model for accountable care organizations. The Tennessee Republican said late last week that it's too risky for providers who wish to participate.

Study to examine Medicaid-centric nursing homes that excel

Study to examine Medicaid-centric nursing homes that excel

Evidence-based reasons for why some nursing homes serving Medicaid-heavy populations outperform others will soon be available.

Lengthy 'doc fix' hearing could mean bad news for provider payments

Lengthy 'doc fix' hearing could mean bad news for provider payments

Long-term care providers could have good reason to worry that forthcoming Medicare reforms could cut into their reimbursements, following a two-day hearing on Capitol Hill. Lawmakers reiterated pledges to permanently change the way physician payment rates are calculated. They also emphasized that provider reimbursement cuts and beneficiary cost-sharing might very well be needed due to the price-tag on the policy shift.

Appeals court keeps observation stay case alive, questions the role of doctors

Medicare beneficiaries can continue to press their case that hospitals' observation stay practices are violating patient rights, a federal appeals court ruled Thursday.

Medicare penalties far exceed bonus payments to hospitals, analysis finds

Recently implemented Medicare penalties are having a greater impact on hospitals than newly available bonuses, according to a Kaiser Health News analysis.

Also in the news for Jan. 23, 2015 . . .

Former nursing home CNA gets probation, fine for providing resident info to notorious identity thief ... Number of nurse practitioners doubled in the last decade ... CMS launches star ratings for dialysis providers ... Chicago is worst city for bedbugs

Major problems with the pipeline of LTC workers, report states

Major problems with the pipeline of LTC workers, report states

Workers are leaving long-term care at a faster rate than they are joining the field, according to a new report from the University of California, San Francisco. And many people experience poverty after leaving long-term care jobs, suggesting that employers and policymakers urgently need to ensure the safety of these workers and boost professional development efforts, report authors argue.

Supreme Court appears divided on whether providers can sue for higher Medicaid rates

The Supreme Court appears to be split over the question of whether healthcare providers have a right to sue states over low Medicaid rates, court watchers noted after oral arguments on Tuesday.

Providers, Senate leader focus on long-term care financing after State of the Union address

The White House and Congress should work together to ensure that older Americans have necessary financial resources, including for long-term care, provider associations and prominent lawmakers said in response to Tuesday's State of the Union address.

Also in the news for Jan. 22, 2015 . . .

Older Americans Act up for reauthorization again, would ensure access to LTC ombudsmen ... New understanding of blood-brain barrier suggests method to beat back dementia ... Rosenbloom urges passage of long-term care drug dispensing bill ... ONC selects first Chief Health Information Officer

Congressional advisors waver on eliminating observation stays

Congressional advisors waver on eliminating observation stays

Getting rid of hospital observation stays might not be a good idea after all, according to Medicare Payment Advisory Commission members who previously pushed for the change. Even if observation status is not scrapped as a category, there are other potential solutions on the table to make post-acute care more accessible.

Quality improves in rural nursing homes with 1 RN per 4 nurses, study finds

When it comes to caring for long-stay residents, rural nursing homes do better if they hit a staffing ratio of one full-time registered nurse for every four full-time nursing employees, according to recently published findings.

Hatch: Doc fix is a 'must pass'

Fixing Medicare's broken physician payment system is a "must pass" order of business, a key Senate leader said on Tuesday.

Also in the news for Jan. 21, 2015 . . .

Nursing home residents are in less pain overall, but more severe pain still poses problems ... Universal screening, decolonization do not improve nursing home MRSA rates

Flu now rampaging in long-term care facilities nationwide, officials confirm

Flu now rampaging in long-term care facilities nationwide, officials confirm

Long-term care facilities across the country are being hit hard by the seasonal flu, due in part to a problem with this year's vaccine, federal officials stated late last week.

Prolonging mealtimes could lead to health complications for LTC residents, study suggests

Long-term care providers should be aware that residents' chewing and swallowing ability might be worse at the end of a prolonged meal, increasing the risk of aspiration pneumonia and other conditions, suggest recently published findings.

No evidence that opioids are effective for long-term pain management, NIH panel says

There is no solid research showing that long-term opioid use is an effective treatment for chronic pain, a National Institutes of Health panel has determined.

Also in the news for Jan. 20, 2015 . . .

CMS chief Tavenner to step down ... House committee announces hearing on SGR ... Lawyer wants WV Supreme Court justice off nursing home case

MedPAC unanimously votes to recommend site-neutral payments

MedPAC unanimously votes to recommend site-neutral payments

The Medicare Payment Advisory Commission has unanimously voted to recommend site-neutral payments for certain post-acute services. Skilled nursing interests have championed the policy, but opponents also have been vocal and blasted the vote that took place Thursday in Washington.

Nursing home podiatrist admits overbilling 'thousands' of times after clipping toenails

A Missouri podiatrist has agreed to pay nearly $1 million for repeatedly billing for more complex services after clipping nursing home residents' toenails, federal authorities recently announced. The podiatrist also faces a maximum 10-year prison sentence.

Draft bill proposes equal Medicare reimbursement for telehealth, in-person visits

A draft bill in the House of Representatives proposes reimbursing Medicare providers at the same rate for telehealth and in-person visits. Members of the House Energy and Commerce Committee's subcommittee on Health began circulating the draft on Monday, according to news sources.

Also in the news for Jan. 16, 2015 . . .

RAC changes could mean more attention on skilled nursing ... Medicare spending peaks at age 96, then declines ... Home health wage increase was an overreach and will not take place, judge rules ... Depression, appetite loss are earlier signs of dementia than previously thought

McKnight's Daily Update to pause for Martin Luther King Jr. Day

McKnight's will not publish its Daily Update on Monday, Jan. 19 in honor of Martin Luther King Jr. Day.

Assisted living facilities are prime settings for questionable hospice care, OIG finds

Assisted living facilities are prime settings for questionable hospice care, OIG finds

Hospice services have rapidly expanded in assisted living facilities, giving rise to suspicions about Medicare billing patterns, according to a new report from the Department of Health and Human Services Office of Inspector General.

Quality measurement is getting out of hand, MedPAC says

Providers are being overly burdened by increasing numbers of quality measures, the Medicare Payment Advisory Commission stated in a recent letter to a top health official. The government should take a step back and reevaluate its approach, the letter added.

Federal money has not yet made a big difference in reducing hospital readmissions, report states

Federal funding might not be a critical factor in bringing down hospital readmissions rates, suggests a recently released report on a program out of the Center for Medicare and Medicaid Innovation.

Also in the news for Jan. 15, 2015 . . .

Government proposes making it easier for some facilities to get loans for fire safety equipment ... Protein associated with animal hibernation could help freeze Alzheimer's in its tracks ... LTC software market to grow 14% globally by 2019 ... Hospitals reduced MRSA and C. diff by about 10%

Skilled nursing reimbursement has become worse, MedPAC report states

Skilled nursing reimbursement has become worse, MedPAC report states

Years of Medicare reforms actually have worsened the way skilled nursing providers are reimbursed, and more sweeping changes are needed urgently, according to a new report from the Medicare Payment Advisory Commission and the Urban Institute.

Antipsychotics increase fall risk 50% for long-term care residents and those living in community, study finds

Taking an antipsychotic medication greatly increases the chances that a senior will fall or sustain a fracture, regardless of where that person is living, what drug is involved or what dose is taken, according to recently published findings.

Special gas kills norovirus on surfaces, researchers say

Long-term care providers might be able to use a special type of gas to rid surfaces of norovirus, recently published findings suggest.

Also in the news for Jan. 14, 2015 . . .

AHCA applauds reintroduction of bill to eliminate 3-day stay requirement ... Joint Commission launches new online portal with HAI resources ... Trial begins for cop accused of killing resident with bean bag rounds ... J&J strikes potential $500 million deal to develop Alzheimer's vaccines ... Common spice could hold powerful weapon against Alzheimer's

Genesis Healthcare improperly uses background checks, federal lawsuit charges

Genesis Healthcare improperly uses background checks, federal lawsuit charges

One of the largest nursing home chains in the nation uses background checks on potential employees in a way that violates the Fair Credit Reporting Act, according to a federal lawsuit filed last week.

Providers charging even $1 per page for EHR access could be violating HIPAA, report warns

Long-term care providers that charge people to access their electronic health records might be violating federal law, according to recently released findings from the American Health Information Management Association.

Playing catch could help seniors avoid falls, study suggests

Older adults can reduce their risk of falling by playing catch with a weighted medicine ball, according to recently published findings.

Also in the news for Jan. 13, 2015 . . .

Night shifts significantly increase black women's diabetes risk, study finds ... Nursing homes, other providers spent $94 billion on paperwork that could be avoided in streamlined healthcare system, study finds ... Fragility may be more important than gender as a risk factor for sexual abuse in nursing homes, analysis suggests ... FDA approves enteral medication for advanced Parkinson's

AHCA launches campaign for Sustainable Growth Rate reforms

AHCA launches campaign for Sustainable Growth Rate reforms

Today marks the launch of a comprehensive new effort from the nation's largest long-term care provider association, aimed at encouraging constructive reforms of Medicare's Sustainable Growth Rate.

Judge admits he took a bribe to reduce $5 million nursing home award

A former Arkansas circuit court judge has pleaded guilty to charges that he took a bribe in exchange for reducing a $5.2 million judgment against a nursing home, authorities announced Friday.

NIC: Nursing home and assisted living occupancy remained static in 4th quarter

The occupancy rate for nursing facilities and assisted living facilities held steady in the fourth quarter of 2014, while the rate for independent living continued its surge, according to data released Friday by the National Investment Center for Seniors Housing & Care.

Also in the news for Jan. 12, 2015 . . .

Multi-drug cocktail could be the future of Alzheimer's treatment, early trial suggests ... Former assisted living chief pleads guilty to Ponzi scheme ... Self-audits essential to avoiding therapy-related False Claims suits, attorneys advise ... Nursing home owner sentenced to 3 months in a halfway house over campaign corruption

CMS-funded program to reduce hospitalizations shows promise after year one, researchers say

CMS-funded program to reduce hospitalizations shows promise after year one, researchers say

A federally funded project to reduce avoidable hospitalizations of nursing home residents got off to a strong start in its first year, according to recently published findings.

Insulin spray leads to significant benefits for those with dementia, study finds

Taking a man-made form of insulin improved memory and cognition in people with mild to moderate Alzheimer's disease, according to recently published findings.

Collins to lead Aging committee, says Alzheimer's will be special focus

Sen. Susan Collins (R-ME) on Thursday was elected chairman of the Senate Special Committee on Aging, a group that frequently addresses issues related to long-term care.

Also in the news for Jan. 9, 2015 . . .

LeadingAge launches survey for renaming CCRCs ... Triglyceride slows progression of Huntington's disease in pilot trial ... Google searches suggest 'nursing home' falling into disfavor

Nursing home broke federal labor law by posting memo urging staff unity, NLRB finds

Nursing home broke federal labor law by posting memo urging staff unity, NLRB finds

A New Jersey nursing home broke federal law by posting a memorandum pleading for staff unity after a tumultuous union election, a National Labor Relations Board panel recently determined.

New antibiotic could be a silver bullet against MRSA, researchers suggest

A newly discovered type of antibiotic could be an ideal weapon against potentially fatal infections that plague long-term care facilities, according to findings published yesterday in Nature. It might also be a breakthrough in the effort to create drugs that harmful bacteria cannot develop resistance to, the researchers announced.

Thief alleged to have posed as phone worker to steal AL pipes

Long-term care operators might want to review policies for identifying visitors, following allegations that a man posing as a T-Mobile worker gained access to an assisted living facility and stole copper pipes and wiring from the roof.

Also in the news for Jan. 8, 2014 . . .

Congress moves to redefine ACA definition of full-time work ... Discovery could lead to inhalable vaccines for flu and pneumonia, researchers say ... New resource on resident-on-resident aggression from Consumer Voice

SNF's bankruptcy protected Medicare certification, judge rules in 'nightmare decision' for govt

SNF's bankruptcy protected Medicare certification, judge rules in 'nightmare decision' for govt

The government cannot cut off reimbursements to a nursing home that entered bankruptcy while appealing the termination of its Medicare and Medicaid certification, a federal judge recently ruled. The controversial decision could lead other nursing homes to enter Chapter 11 to preserve reimbursements, according to legal experts.

Rotating night shifts increase nurse death risk by 11%, Harvard study finds

Long-term care nurses who work rotating night shifts might be at increased risk of death, particularly from heart disease and lung cancer, according to recently published findings from Harvard Medical School.

Failure to administer meds, poor supervision are linked to nursing home UTIs, researchers say

Lapses in nursing home care are significantly linked to the incidence of urinary tract infections, according to recently published findings.

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

Breaking the law can signal dementia onset, researchers find ... Most caregivers believe EHRs are best for advance directives, but paper still prevalent, study shows ... Judge delays boost in home health pay until Jan. 15

CMS begins new round of recovery audit contracts, says improvements will be seen

CMS begins new round of recovery audit contracts, says improvements will be seen

Connolly LLC will be the recovery audit contractor responsible for reviewing durable medical equipment, hospice and home health claims on a nationwide basis, the Centers for Medicare & Medicaid Services recently announced. This kicks off the new round of RAC contracts, and promised changes to the program now will start to be implemented, CMS stated.

Accused Assisted Living Concepts CEO sues government agency over use of 'in-house' court

The former chief executive of an assisted living provider has sued the Securities and Exchange Commission, arguing against its practice of bringing cases before an "in-house" court, Reuters reported Monday.

Better death notifications could improve CNA work experience, study suggests

Nursing homes should evaluate how certified nursing assistants learn about the death of residents in order to improve the workers' on-the-job experience, according to recently published findings.

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

Flu has reached epidemic levels, CDC announces ... Dramatic growth of for-profit hospice chains should inform future policies, researchers say ... Flooding prompts nursing home evacuation in WA ... Living with children could mean you underestimate future LTC needs, study finds

NQF endorses rehospitalization tool

The National Quality Forum has endorsed the PointRight® Pro 30™ rehospitalization measure, the company and the American Health Care Association/National Center for Assisted Living announced today.

More than $80 million paid out to Pioneer ACO beneficiaries, report finds

Nearly $81 million has been made in payments on behalf of beneficiaries in Pioneer accountable care organizations through Sept. 30, a new report finds.

Also in the News for Monday, January 5

Chinese authorities remove cross at nursing home...Seniors accurately reporting cognitive function through self-monitoring tool, study finds...Wyoming woman sues Kindred over negligent care allegations

BusinessBriefs for January 2015

» Walker & Dunlop said a $9.9 million loan for the refinance of Vista Healthcare Center in California has closed. The center has 187 skilled nursing beds. The transaction was processed through the HUD's LEAN program. The borrower, LifeHOUSE Health Services, will be able to pay off existing intra-company debt and take advantage of a long-term sub-4% rate. The loan is "somewhat unique," the firm said, as it carries a one-year lockout period with four years of lower-than-standard prepayment penalties.

Kindred to add 500 jobs in KY

Kindred Healthcare will expand its headquarters and add about 500 jobs, the company announced in December.

LTC liability costs projected to increase by 5% nationally

LTC liability costs projected to increase by 5% nationally

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

Ask the payment expert ... about ABNs and denial letters

Ask the payment expert ... about ABNs and denial letters

Can you demystify the ABNs and denial letters process?

Dual-eligible future cloudy

The National Association of Medicaid Directors is asking for more guidance on the dual-eligible program and for regulators to "articulate next steps for existing financial alignment demonstrations."

HHS gives shooter guidance for healthcare facilities

HHS gives shooter guidance for healthcare facilities

Federal agencies have issued guidance for how healthcare providers should prepare for an active shooter emergency. The 33-page document covers threat assessment, actions to take during and after an emergency, and other best practices.

Ask the treatment expert ... about updated guidelines

Ask the treatment expert ... about updated guidelines

What can you tell us about the new 2014 edition of "Prevention and Treatment of Pressure Ulcers: Clinical Practice Guidelines"?

Improving venous leg ulcer outcomes

When healthcare professionals provide clear, tailored exercise and education to adults with venous leg ulcers, the patients are more likely to engage in regular exercise — which can improve outcomes.

New skin patch helps keep diabetic foot ulcers at bay

New skin patch helps keep diabetic foot ulcers at bay

Researchers at Stanford University School of Medicine have developed a drug delivered through a skin patch that not only helps diabetic foot ulcers heal faster, but prevents the wounds from recurring.

Ask the care expert ... about smartphone apps

Ask the care expert ... about smartphone apps

Do you know of any smartphone apps we should look at to improve the quality of life for our residents and nursing staff?

Half-brain theory for stroke rehab tested

A dozen top rehabilitation centers are testing whether suppressing a brain's healthy side might aid stroke recovery.

Study examines 'elderspeak' tendencies in LTC caregivers

Study examines 'elderspeak' tendencies in LTC caregivers

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

60 seconds with ... Dale Bell

60 seconds with ... Dale Bell

Q: You produced a famous documentary about youth culture, "Woodstock." Your new film, "Homes on the Range," focuses on long-term care. Why this subject?

BLS: Nursing home injury rate still high

Nursing homes still are among the most dangerous U.S. workplaces, and there was little improvement in safety from 2012 to 2013, according to the latest annual data from the Bureau of Labor Statistics.

With budget out of the way, Congress eyes Medicare fix

With budget out of the way, Congress eyes Medicare fix

Now that President Obama has put his signature on a $1.1 trillion spending package, long-term care providers can focus on another looming spending challenge: the so-called "doc fix."

New approach to regain sight

New approach to regain sight

A new type of "prosthetic retina" could restore vision to seniors with macular degeneration, researchers announced last month.

A prior warning for Alzheimer's

The latest Alzheimer's blood test appears to predict the disease 10 years before a clinical diagnosis could be made, researchers announced in November.

CDC expecting bad flu season

The Centers for Disease Control and Prevention announced that this year's flu vaccine might not provide robust protection against H3N2, the dominant strain circulating as of mid-December.

Bill would speed up post-acute coverage

Bill would speed up post-acute coverage

Observation stays would count toward establishing Medicare eligibility under reforms in a recent draft bill from the House Committee on Ways and Means.

Payback time for auditors?

Payback time for auditors?

Recovery Audit Contractors that make incorrect accusations should be penalized, an influential physicians group is urging.

Signed budget fuels agencies and ACA

Signed budget fuels agencies and ACA

President Obama has signed a $1.1 trillion spending package that funds most federal agencies through September.

Pay equality endorsed again

Congress should consider site-neutral payments for post-acute providers as a way to cut federal healthcare spending, a Medicare Payment Advisory Commission official told a House panel in December.

Profile: Offering a voice of reason

Profile: Offering a voice of reason

While he was growing up in Washington, D.C., there was a running joke in Clifton Porter's family. His mother would go on a "work trip," and his family would say that "six months later there would be news" from the region where she went.

A Day in the Life: Blankets for the brotherhood

A Day in the Life: Blankets for the brotherhood

A World War II soldier's wool coat had hung in a closet since 1948 — until the man's wife brought it to A.E. Casey Hermanson. She knew that Hermanson could give the coat a second life by turning it into a blanket for a veteran in long-term care.

Back to faxing orders?

Back to faxing orders?

Medication order transmission standards changed from HL7 to NCPDP 10.6, but not all providers are caught up, increasing risks, time and possibility of errors

Investing in your people

Investing in your people

Lenders are increasing examining staff ratios, quality metrics and stability in long-term care facilities in order to determine capital availability for operators

Parkinson's, psychosis

The single most important precipitant for placement of Parkinson's disease patients in a long-term care facility is psychiatric dysfunction, particularly psychosis.

Less may offer more

Less may offer more

In an attempt to learn if I'm allergic to gluten, nuts or dairy, I might have also simultaneously stumbled onto a strategy for solving all problems in life and long-term care management.

ACO rule polishing could mean good things ahead

ACO rule polishing could mean good things ahead

Federal health officials have signaled that they are intent on getting this accountable care organization thing right.

More reasons to worry

More reasons to worry

There's a saying among basketball coaches: The best way to cover up problems is to score a lot of points.

Design Decisions: A hospitality twist

Life Care Center of Ooltewah finds success in two centers near Chattanooga that feature elegant exteriors and comfortable amenities

How to do it ... Furnishing outdoors

Many facilities and communities may be overlooking an invaluable annex right under their noses — outdoor spaces that can provide a welcome and inviting place for residents to relax, reflect and commune with others. Consider these tips from the experts for furnishing and equipping these areas.

CompanyBriefs for January 2015

» LifeShare Technologies released LifeShare Family, a mobile app connecting seniors with their families and caregivers. LifeShare Family allows seniors and families to share mobile pictures and send messages, as well as see menus and activities and for family members to set appointments. The app is available through Google Play and the Apple App store.

Hallmark partners with LTC collaborative

The Advancing Excellence in Long-Term Care Collaborative has partnered with Hallmark Business Connections for an employee recognition program called "You Make a Difference."

Omnicare and McKesson to extend drug distribution deal

Omnicare and McKesson to extend drug distribution deal

Omnicare Inc. and McKesson Corporation have decided to extend their agreement through 2019, which will include the sourcing and distribution of branded, specialty and generic pharmaceuticals.

Ask the legal expert ... about residents refusing treatment

Ask the legal expert ... about residents refusing treatment

Can documenting a resident's refusal of care-giving recommendations keep us out of being successfully sued?

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