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PENNSYLVANIA - The state's nursing home operators say they are approaching fiscal disaster as facilities look at razor-thin margins half the national average.

House to vote on skilled nursing facility readmissions penalties, ICD-10 extension

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Skilled nursing facilities could see reimbursements tied to their number of hospital readmissions starting in 2018, under Medicare legislation announced by House and Senate leaders Wednesday. The bill also would delay the transition to the ICD-10 coding system for a year and prevent scheduled payment cuts to physicians.

Part A claims under scrutiny

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Government investigators will issue a report on skilled nursing facilities' Medicare Part A billing practices later this year, according to the latest annual work plan from the Department of Health and Human Services Office of the Inspector General.

Ground-level falls lead to high rates of SNF admission, return trips to the hospital, study finds

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Even if they do not hit the ground from a great height, elderly people who seek hospital care for a fall commonly go on to a skilled nursing facility, according to a recently published study. These seniors also have a greater risk of returning to the hospital and have a significantly elevated risk of dying, the researchers found.

Borrowing to build

Borrowing to build

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New construction funding for skilled nursing facilities remains scarce, but lenders say they will listen if operators present a convincing case for building.

Doctor admits kickback role in sending homeless people to nursing homes, hospitals

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A California physician received kickbacks from skilled nursing facilities as part of a large-scale scheme to defraud government health programs, authorities announced Friday. Ovid Mercene, M.D., pleaded guilty to the fraud and related tax charges in U.S. District Court.

Ask the care expert ... about hospice rules

Ask the care expert ... about hospice rules

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I heard the rules recently changed related to hospice. Do you know what will be included?

Chair-lift death might hit SNF

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A Colorado facility might have to pay punitive damages because a supervisor put the wrong safety clip on a lift that malfunctioned and led to a resident's death, a federal court recently ruled.

CMS clarifies Medicare payment rules for SNF to SNF ambulance transportation

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A skilled nursing facility discharging a Medicare Part A resident to another SNF is responsible for ambulance transportation fees, and no separate Part B claim should be made for that service, the Centers for Medicare & Medicaid stated in a recent memorandum.

SNF discharges tied to income

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The rate at which nursing home residents are hospitalized is linked to how well a state provides healthcare for low-income people, according to a report from The Commonwealth Fund. Minnesota was the top performer for its low percent of hospitalizations within a 30-day period, at 7%.

Close, specific hospital-SNF partnerships drive down readmission rates, researchers find

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A strong relationship between a hospital and a skilled nursing facility reduces the readmission rate among patients discharged to that SNF, according to recently published research.

Omnicare reaches $120 million settlement in whistleblower suit over SNF drug prices

Omnicare reaches $120 million settlement in whistleblower suit over SNF drug prices

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Omnicare, the nation's largest provider of long-term care pharmacy services, has agreed to pay $120 million to settle a False Claims Act lawsuit over Medicare Part A drug pricing, the company announced Wednesday. The settlement likely is one of the largest in a whistleblower case in which the government did not intervene, according to Frederick Morgan, one of Gale's attorneys at the firm Morgan Verkamp LLC.

SNFs with satisfied workers report fewer deficiencies, earn better marks from customers: report

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Skilled nursing facilities with a high rate of employee satisfaction also have fewer survey deficiencies and a higher Five-Star quality rating, according to research announced yesterday at the American Health Care Association annual meeting in Phoenix.

People don't 'get' me: Tips for the misunderstood long-term care provider

People don't 'get' me: Tips for the misunderstood long-term care provider

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Do you ever feel that people don't really "get" what you do as a long-term care provider? You might take heart from the fact that professionals in other fields also feel this way, according to a recent study. And you might be disturbed at how this lack of understanding affects job performance.

CMS 'arbitrarily' approved SNF Medicaid cuts in Pennsylvania, appeals court rules

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A group of nursing home operators has won a moral victory over the Centers for Medicare & Medicaid Services, with a federal appeals court saying the agency made Medicaid reimbursement cuts without considering the consequences, but without the court ordering financial relief.

Readmission fines target skilled care

Readmission fines target skilled care

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Skilled nursing operators often want the same treatment as hospitals. They might get their wish soon, though not necessarily in the way they hoped.

Limits on telehealth will stay, CMS says

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Medicare will stick with reimbursing only one telehealth visit per month for skilled nursing facility residents, according to a proposed rule from the Centers for Medicare & Medicaid Services.

Kindred teams with Omnicare, splits with skilled nursing pharmacy PharMerica

Kindred teams with Omnicare, splits with skilled nursing pharmacy PharMerica

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Major long-term care provider Kindred Healthcare will split with its current pharmacy partner, PharMerica, and team with the sector's largest pharmacy, Omnicare, at the end of 2013, according to documents filed with the Securities and Exchange Commission.

CMS updates SNF Medicare manual to implement sequestration cuts

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The Centers for Medicare & Medicaid Services has updated the online Medicare Provider Reimbursement Manual, modifying instructions related to the 2% reimbursement reductions resulting from sequestration.

Report on Medicare payments for poor care paints skewed picture, nursing home advocates say

Report on Medicare payments for poor care paints skewed picture, nursing home advocates say

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Skilled nursing facilities collected Medicare payments of $5.1 million in 2009 for care that did not satisfy government quality measures, according to a report released Thursday. Prominent nursing home advocates say they're taking the report seriously but counter that the Department of Health and Human Services Office of Inspector General (OIG) is presenting an incomplete picture.

AHCA praises bipartisan effort to repeal SNF therapy caps

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The American Health Care Association and National Center for Assisted Living came out in support of bipartisan legislation to permanently repeal Medicare Part B therapy caps for skilled nursing facilities. The legislation was introduced in both the House of Representatives and the Senate on Feb. 15.

SNF that kept prison inmates constituted 'immediate jeopardy' for residents, state says

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An Oklahoma nursing home was slapped with $168,000 in fines after taking in jailed inmates following a prison riot.

Administration proposal would ease Medicare coverage for SNF stays

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Federal health officials have agreed to changes in Medicare coverage rules that would make it easier for beneficiaries with chronic conditions to qualify for nursing home stays, outpatient therapy and home healthcare services, according to reports.

Turning a challenge into an opportunity

Turning a challenge into an opportunity

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Many nursing home administrators are not sleeping well these days. If it's any consolation, hospital administrators are probably catching even fewer winks.

Dear, sweet stubborn grandmother!

Dear, sweet stubborn grandmother!

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I love my grandma dearly. She's still going strong, living independently in a ranch-style house. But while her stubbornness may be the reason she lives such full and active lifestyle, it's also a trait that almost cost her big-time when she had a "health scare" a few years ago.

Medicare auditors can request twice as many SNF medical records

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Medicare recovery audit contractors (RACs) can now request twice as many resident medical records than previously allowed, according to the Centers for Medicare & Medicaid Services.

Skilled nursing groups slam MedPAC recommendations to revise payment system

Skilled nursing groups slam MedPAC recommendations to revise payment system

Leading provider groups are sharply critical of a Medicare advisory committee's recommendation that the Centers for Medicare & Medicaid Services should massively overhaul the skilled nursing facility reimbursement system and rates.

Providers say phased-in Medicare cuts would soften final payment rule damage, slow nursing home worker layoffs

Congress could stave off the predicted loss of 20,000 nursing home jobs by enacting a phased-in funding regulation over three years, according to one provider group.

CMS adds additional training session call on payment changes

CMS adds additional training session call on payment changes

Due to overwhelming interest from skilled nursing facility operators, the Centers for Medicare & Medicaid Services has added a training conference call on changes related to MDS 3.0 on Sept. 1.

Ambulance supplier's payment proposal could violate anti-kickback statute

One ambulance supplier's proposal to receive payments from skilled nursing facilities that use Medicaid transport services could overstep the bounds of an anti-kickback statute, according to an advisory opinion from the Department of Health and Human Services' Office of Inspector General.

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