Providers win pay rate case
Iowa — The state Supreme Court recently ruled in favor of nine nursing homes in a case dealing with how Medicaid reimbursement rates are set.
The Iowa Department of Human Services refers to nursing homes’ annual financial reports to set the per diem Medicaid rate. In 2008, DHS disallowed facilities from including certain Medicare Part A costs in their annual reports, leading to lower Medicaid pay.
An administrative law judge affirmed that these Part A costs should be included in annual reports. A district court reversed that decision, but an appeals court again sided with the providers. The Supreme Court ultimately decided in favor of the providers.
Inclusion of the costs in annual reports does not necessarily tie DHS to using those numbers in a strict way in setting Medicaid rates, due to the availability of an “offset” option the DHS can exercise, the high court noted.
Providers balk at video cameras in resident rooms
At the end of June, Attorney General Mike DeWine (R) announced that 131 nursing home cases were ongoing, up from 74 a year before. DeWine declared an aggressive campaign against poor nursing homes after closing a facility in Zanesville in June.
State investigators used surveillance cameras at the Zanesville facility, placing them in rooms with the consent of residents and their families, according to local reports. Nursing home staff did not know about the cameras.
This has created “paranoia” among providers, said Peter Van Runkle, executive director of the Ohio Health Care Association. The organization’s attorney has questioned whether investigators can legally use hidden cameras, and is concerned about potential privacy violations, according to The Columbus Dispatch.
State LTC website live
Connecticut — Residents can turn to a recently launched website, www.MyPlaceCT.org, to learn about long-term care options and careers.
My Place CT refers to the website and accompanying media campaign aimed at educating the public as Connecticut reshapes its long-term care system. In January, Gov. Dannel P. Malloy (D) announced the Strategic Plan to Rebalance Long-Term Services and Supports, which draws on about $86 million in combined federal and state funds.
My Place CT stresses the importance of finding the right setting to meet individual needs. The website includes resources on assessing needs, and finding, accessing and financing appropriate care.
The website is supported by federal dollars and is described as a “complement” to the state’s health exchange, set to open in October as part of the Affordable Care Act implementation.
Ban creates no-smoke zone
New York — Lawmakers have passed a bill to ban smoking within 15 feet of hospital and nursing home property lines.
The measure passed unanimously in the Assembly and only one member voted against it in the Senate. New York City already has a similar law on the books, and many healthcare providers have enacted voluntary policies banning smoking, the American Lung Association of the Northeast noted. The organization strongly supported the bill, which was sponsored by Assemblywoman Ellen Jaffee (D-Rockland) and Sen. Jack Martins (R-Mineola).
The law would take effect 90 days after being signed by Gov. Andrew Cuomo (D).
Veto means provider turmoil
South Carolina — Nursing homes are facing uncertainty following Gov. Nikki Haley’s (R) move to defund the state’s certificate of need program.
To open new facilities or make major equipment purchases, South Carolina nursing homes have had to obtain a certificate of need. However, Haley vetoed the $1.7 million CON appropriations bill at the end of June, effectively ending the program.
The director of the Department of Health and Environmental Control said providers will not face penalties for projects undertaken while the program is suspended. The DHEC also has sued the South Carolina Health Care Association, in a move to get judicial review of the program’s suspension.
Huge prison facility opens
California—An $839 million long-term care facility for prison inmates has opened in Stockton.
The California Correctional Health Care Facility includes 54 buildings on 1.2 million square feet. Ultimately, it will have about 1,720 beds. n
Medical capabilities include diagnostic and treatment centers, dialysis machines, and rooms with nurse-call buttons and hospital beds. Security features include an electrified fence, 11 guard towers and 24-hour patrols.