The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey and Certification letter updating the State Operations Manual (“SOM”) guidelines on surveys of deemed status long-term care (“LTC”) providers when the provider has been found to have a condition level instance of noncompliance, including immediate jeopardy (“IJ”), in a complaint survey. This change in policy only applies to “deemed status providers.” Deemed status is available when an approved accrediting organization (“AO”), separate from CMS, determines the provider is in compliance with Medicare conditions. This “deemed status” will largely exempt the provider from routine surveys by the State Agency (“SA”) but still requires the provider to comply with all applicable Medicare conditions. Nursing facilities are largely not eligible for deemed status; however, home health agencies (“HHAs”) and hospice and rehabilitation agencies are eligible.
Archive for the ‘Litigation and Risk Management’ Category
CMS Revises Policy as to Surveys to Be Conducted Following Complaint Investigations Resulting in Condition-Level Noncompliance
CMS Clarifies Delegation of Tasks by Physicians in Long-Term Care Facilities
The Centers for Medicare & Medicaid Services (“CMS”), in the March 8, 2013 Memorandum, issued new guidance specifying those tasks that can and cannot be delegated in skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”). Physicians who improperly assign tasks to non-physician practitioners (“NPPs”) jeopardize the SNFs’ and NFs’ compliance with federal and state regulations, which potentially affects the facilities’ reimbursement.
Sixth Circuit Determines Nursing Facility Must Prove Lack of Negligence with Missing Documents
In a suit brought against an Ohio nursing facility related to improper medication administration, the U.S. Court of Appeals for the Sixth Circuit allowed the use of res ipsa loquitur in finding a facility responsible for lapses in a resident’s medication regime. (more…)
FCC to Promote Expansion of High-Bandwidth Capacity to SNFs
The Federal Communications Commission (FCC) has just issued a release detailing the establishment of the Healthcare Connect Fund (the “Fund”) to reform and modernize its universal service program for health care. Recognizing the importance of high-speed data connectedness for quality patient care and burgeoning health care practices such as telemedicine, the FCC is expanding and reforming its existing Rural Health Care program. (more…)
CMS Distributes Free “Hand in Hand” Toolkit to Nursing Facilities
The Centers for Medicare & Medicaid Services (CMS) will soon be distributing a free toolkit to nursing facilities, CMS Regional Offices, and State Survey Agencies. Hand in Hand is a high quality training series for nursing homes that emphasizes person-centered care for persons with dementia, as well as the prevention of abuse. Section 6121 of the Affordable Care Act requires CMS to ensure that nurse aides receive regular training on caring for residents with dementia and on preventing abuse. Hand in Hand addresses the annual requirement for nurse aide training on these important topics.
More information is available on the Hand in Hand website.
Should you have any questions, please contact:
Todd Selby at 317.977.1440 or tselby@hallrender.com;
Brian Jent at 317.977.1402 or bjent@hallrender.com; or
David Bufford at 502.568.9368 or dbufford@hallrender.com,
or your regular Hall Render attorney.
CMS Extends “Extraordinary Circumstances” Hospice Exemption
While hospices are required to ensure that substantially all core hospice services, including nursing services, are performed by hospice employees, hospices have been permitted to utilize contracted staff members to supplement hospice employees during periods of peak patient loads or extraordinary circumstances.
The Centers for Medicare & Medicaid Services (CMS) agrees the nation-wide shortage of hospice nurses has proven to be an “extraordinary circumstance” for many hospices, and has adopted a policy to permit the exemption for individual hospices that can demonstrate the impact of the shortage on their ability to provide care. Originally set to expire September 30, 2012, the ongoing nursing shortage has caused this policy to extend to September 30, 2014. (more…)
OIG Publishes Findings of Nurse Aide Criminal History Investigation
As part of the Patient Protection and Affordable Care Act (PPACA), the Office of the Inspector General (OIG) was mandated to submit a report to Congress evaluating the Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long Term Care Facilities and Providers (commonly referred to as the “Background Check Program”, herein the “Program”). The OIG recently published the findings of the first year of this investigation, establishing a baseline figure for future years. (more…)
Study Reports SNF Providers Face Grim Reimbursement Future
The Alliance for Quality Nursing Home Care (AQNHC) released the results of a study conducted concerning the future of skilled nursing facility (SNF) reimbursement. While SNF providers have recently seen their reimbursement rates improve, the study report projects SNF providers are facing $65 billion in reimbursement cuts over the next ten years.
The reimbursement cuts, the cumulative result of several different federal budgetary actions and regulatory changes, would, as stated by Alan Rosenbloom, President of the AQNHC, bring “one of America’s most important health sectors to the brink of operational viability.” (more…)
Another Antipsychotic Measure Fails to Pass
In an on-going push to regulate the use of antipsychotic medications in nursing facilities, another piece of legislation has failed to pass Congress. The Senate did not pass a proposed regulation that would have standardized protocols for obtaining informed consent before administering antipsychotics for off-label use. (more…)
Nursing Facility Antipsychotic Legislation Fails to Clear Senate
Last Thursday, a proposed regulation aimed at curbing the high levels of “off-label” uses for antipsychotic medications failed to pass the Senate. This proposed legislation relates back to a report last November by Daniel R. Levinson, the U.S. Inspector General, that exposed the high levels of antipsychotic medications administered to nursing facility residents. That report stated a large percentage of antipsychotic medication usage was outside the Medicare reimbursement criteria.
Despite this setback, this issue will continue to be pushed. CMS continues to scrutinize resident medication regimes, and providers must develop alternative treatment plans to avoid the risk of more restrictive regulations in the future.
This proposed regulation will likely be before Congress again in the near future.
Should you have any questions, please contact:
Todd Selby at 317.977.1440 or tselby@hallrender.com;
Brian Jent at 317.977.1402 or bjent@hallrender.com; or
David Bufford at 502.568.9368 or dbufford@hallrender.com,
or your regular Hall Render attorney.
Topical Index
- Home Health (44)
- Hospice (40)
- Litigation and Risk Management (38)
- Long-Term Care (140)
- Medicaid/Medicare enrollment and regulatory compliance (70)