CMS’ PDPM May Impact Clinical Protocols

Changes to Medicare reimbursements may affect your facility’s workflow. Read More »

CMS raises reimbursement by 1%, pushes VBP

With the Value-Based Purchasing program due to begin in 2019, CMS is pushing SNFs to get on board with performance baselines now. Read More »

PointClickCare, ABILITY Network partner on claims management

The tech companies will integrate software so providers can create, access and manage claims within the electronic health record.  Read More »

House passes AHCA bill by 4 votes

The promise of $8 billion for high-risk and pre-existing conditions pushed the bill in the GOP's favor. The bill now moves on to the Senate, where the margins for passage are predicted to be tougher. Read More »

CMS funds nursing home for prisoners

A Connecticut nursing home will receive federal funding to help pay for and provide care to the state’s aging inmates.  Read More »

Mass. proposes increased LTC funding

State legislators are rallying behind bills to increase wages for nursing home workers and Medicaid reimbursement levels for nursing homes and rehabilitation facilities.  Read More »

Re-examining CMS’ 5-star rating system

A new GAO report highlights why experts say the next addition to the Nursing Home Compare five-star ratings should be customer service. Read More »

The best of 2016

CMS mandates, dementia care strategies, cross-team collaboration and ageism culture change—We checked our web visits and social media stats to see which in-depth articles were the most popular among our readers in 2016. Did you miss any of these? Read More »

CMS issues final rule for cardiac bundled payments

CMS released its latest episodic care models Tuesday, including the 90-day bundles for heart and bypass patients. Read More »

CMS to test new ACO model for dual-eligibles

The pilot will let accountable care organizations manage the Medicaid claims for beneficiaries who receive both Medicare and Medicaid benefits. Read More »

OIG scrutinizes SNFs and therapy reimbursement

The office’s 2017 workplan targets rehabilitation, hospice and hyperbaric oxygen therapy services, in addition to SNF billing. Read More »

A Place For Mom joins effort to promote veterans’ LTC resources

A Place For Mom is partnering with a veterans resource organization to spread the word about the Veterans Aid and Attendance Pension, which can help pay the costs for assistance for those who qualify. Read More »

CMS finalizes site-neutral payment policies

The Centers for Medicare and Medicaid Services has finalized a rule that will change the way services are reimbursed in off-campus and on-campus settings. Read More »

Life Care Centers reaches $145M settlement

The nation’s largest private nursing home company will pay $145 million to settle claims it overcharged the government for therapy treatments.  Read More »

BPCI Model 3: Bonanza or boondoggle?

There’s an argument to be made for being an early adopter with Bundled Payments for Care Improvement (BPCI) Model 3, but there are also questions about how much participants will ultimately save. Read More »

DOJ shuts down $1B Miami nursing home fraud scheme

The largest-ever fraud case involved the owner of more than 30 skilled nursing facilities and two others accused of kickbacks and false billing, the Department of Justice indictment says. Read More »

Medicare proposes changes to primary care payment

The Centers for Medicare and Medicaid Services has proposed changes to the Physician Fee Schedule to change how Medicare pays for primary care with an emphasis on care management and behavioral health. 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 »

Challenges to EHR implementation

A new study on implementation of electronic health records (EHR) has identified several obstacles for doctors, chief among them poor user experience. 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 »

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 »

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 »

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 »

Proposed legislation aimed at comorbidity among Medicare beneficiaries

A U.S. Senate Working Group has outlined priorities for improving Medicare delivery to beneficiaries with multiple, complex chronic illnesses while reducing healthcare expenditures.  Read More »

FBI investigates hospice owner for overmedicating, Medicare fraud

The FBI is looking into claims the 34-year old accountant himself chose which home healthcare patients would be moved to hospice, recruited unqualified patients and charged the government for services not medically necessary. Read More »