Medicare/Medicaid

Whistleblower: hospice provider rigged documentation to raise census

A civil lawsuit filed by a whistleblower claims Caris Healthcare, which provides hospice services in five states, deliberately documented any illness that could be considered terminal in order to keep its hospice beds occupied. Read More »

MedPAC launches plan for new payment system

The Medicare Payment Advisory Commission (MedPAC) submits it recommendations to Congress for how to establish a unified, cross-setting post-acute care payment system. The plan would redistribute payments among types of stays, making profits more uniform and hopefully reducing unnecessary services and admission preferences.  Read More »

House Republicans propose healthcare system overhaul

Republicans from the U.S. House of Representatives announced a healthcare reform proposal that would challenge parts of the Affordable Care Act but retain some of the Act’s more popular provisions. Read More »

Unified PAC payment feasible, MedPAC says

The Medicare Payment Advisory Commission (MedPAC) has issued its annual report on refinements to Medicare payment systems and on issues affecting the medicare program Read More »

CMS gives hospitals extension to meet new fire safety codes

The Centers for Medicare & Medicaid Services announced it will not begin surveying for compliance with the 2012 fire safety codes until November. The July 5 ruling still applies when considering which code chapters facilities must comply with.  Read More »

GAO report: Provider Medicare appeals still in logjam

Despite efforts to ease the backlog of appeals, no relief is in sight for the backlog of appeals from facilities that choose to appeal Medicare claims denials and deficiency citations. Read More »

Medicare could cover comprehensive Alzheimer’s care plan

Congressional subcommittees have proposed changes to the Social Security Act to cover an initial care plan for Medicare beneficiaries newly diagnosed with Alzheimer’s disease and related dementias to help them understand the disease and treatment options. Read More »

How chart audits affect your reimbursement

The pressure is on for skilled nursing facilities: Compliance for CMS reimbursement means proper charting, documentation of therapy minutes and shaking out those RUGs. Read More »

Getting stiff

Getting that handy touchpad laptop made life seem easier, but it wasn't so great for her hand's range of motion, says SNF resident blogger Kathleen Mears. Read More »

CMS to Allow ACOs to Join Forthcoming CPC+ Model

The Centers for Medicare & Medicaid Services (CMS) has opened up its new Comprehensive Primary Care Plus (CPC+) initiative to 1,500 eligible primary care practices currently in the Medicare Shared Savings Program (MSSP). Read More »

Extreme honesty: Medical errors and full disclosure

Mistakes and “near misses” can and will happen. But, how a facility discloses an error can affect everything from the CMS response to the family’s reaction. Read More »

“We are the solution,” industry execs tell Congress

A two-day AHCA/NCAL congressional briefing brings 450 long-term interests to Capitol Hill. Read More »

Couples become more similar as they age

New research suggests people who have been in relationships for decades are more likely to age to become more like each other mentally, physically and emotionally. That means doctors need to monitor the health of their patient--and their patient’s partner. Read More »

The fate of your stars: CMS and the new quality measures

As the opening keynote at the Memory Care Forum in Philadelphia, NASL policy guru Cynthia Morton discusses what’s coming next from CMS on long-term care quality measures and how that data might affect your five-star quality rating. Read More »

Crusading to protect the elderly

Are the new Justice Department Elder Justice Task Forces a smokescreen to cut costs? Long-Term Living's politics and policy reporter, Robert Gatty, examines the forces at play in the new initiatives. Read More »

Hospice experience inspires woman to become a hospice nurse

A woman decides to become a hospice nurse based on her personal experience with hospice care for her teenage son. Read More »

DOJ to South Dakota: Stop sticking people with disabilities in SNFs

The Department of Justice is cracking down on South Dakota, accusing the state of putting people with disabilities in nursing homes unecessarily rather than providing community-based services. Read More »

CMS adds quality measures to 5-star rating system

The Centers for Medicare & Medicaid Services adds six new quality measures to the Nursing Home Compare system, including data on short-stay residents' trips to the emergency room. Read More »

Are you ready for PBJ transactions?

With the new CMS reporting requirements looming, skilled nursing facilities are gearing up for the mandatory Payroll-Based Journal data transactions for direct-care workers. Read More »

CMS proposes payment boost, new reporting system for hospice

Hospice may see a 2 percent increase in reimbursements in 2017, but new reporting requirements could go into effect as well, according to a new CMS proposal. Read More »

Fast food threatens to steal LTC workforce in Texas

Texas has one of the highest turnover rates for nursing home employees. The facilities are having trouble staying competitive with Wendy’s or McDonald’s, which can offer hourly workers a job with better pay and less stress.  Read More »

Rocking the drug reimbursement boat

Medicare is trying a new way of calculating the reimbursement for certain drugs, including expensive drugs to treat cancer. After barely a month, the pilot has riled physicians on both sides of the issue. Read More »

CMS payment model could change primary care for up to 25M Medicare beneficiaries

The Centers for Medicare and Medicaid Services (CMS) will test a new payment model that encourages doctors to focus on health outcomes rather than volume of visits or tests. Read More »

DOJ: substandard nursing home care will not be tolerated

The Department of Justice announced the launch of 10 regional interagency task forces designed to protect seniors in nursing homes by holding operators accountable for the quality of care they provide. Read More »

CMS imposes fines of more than $278k for Woodbriar Health Center

The Centers for Medicare & Medicaid Services has imposed steep fines and threatened to terminate Woodbriar Health Center from its programs if serious problems are not resolved by next week. Read More »

Innovation program to reduce nursing home hospitalizations

The Center for Innovation has invested more than $30 million for Indiana University’s project to reduce avoidable hospitalizations for nursing home residents by providing higher levels of care on site. Read More »

Calif. nursing home population growing younger

From 1994 to 2014, the population of California nursing home residents under age 65 increased by nearly 40 percent. So, too, did the number of reported problems directly related to the resident population mix.   Read More »

Fla. passes LTC wait-list prioritization law

The new law will require the state’s Department of Elderly Affairs to sort and prioritize those who are receiving long-term care services and those who are waiting for consideration. Read More »