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.
Posts Tagged ‘medicaid’
CMS Clarifies Delegation of Tasks by Physicians in Long-Term Care Facilities
Authored By: Todd J. Selby
Internet-Based PECOS Improvements Increase Access to Information
Authored By: Todd J. Selby
The Centers for Medicare & Medicaid Services (CMS) implemented changes to Internet-based PECOS to allow providers easier access to information. The following enhancements are now available: (more…)
Study Reports SNF Providers Face Grim Reimbursement Future
Authored By: David W. Bufford
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…)
OIG Report Finds Extensive Misuse of Antipsychotics in Nursing Facilities
Authored By: David W. Bufford
The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities. Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements. (more…)
Reducing Avoidable Hospitalizations for Nursing Facility Residents
Authored By: Todd J. Selby
As a means of improving care to residents residing in Medicare/Medicaid nursing facilities, CMS announced on March 15, 2012 an initiative to help reduce avoidable hospitalizations. Organizations interested in participating in this initiative must submit an application to CMS by June 14, 2012.
The goal of the initiative is to improve care for residents of nursing facilities by helping avoid costly and avoidable hospitalizations by funding organizations who would partner with nursing facilities to provide enhanced on-site services to nursing facility residents. CMS will commit up to $128 million to support this initiative. The initiative will be a collaboration between the CMS Medicare-Medicaid Coordination Office and the Center for Medicare and Medicaid Innovation as created by the Affordable Care Act.
Organizations eligible to participate in the initiative include physician practices, care management organizations, and other public and not-for-profit entities. Eligible organizations will propose its own evidence-based intervention and improvement strategy. The organization will have staff on-site at nursing facilities to provide preventive services and will provide coordination and communication among providers. CMS is hopeful that the initiative will help reduce hospital re-admissions of nursing facility residents. It has been estimated that 45% of hospital admissions of nursing facility residents could have been avoided. It is estimated that 314,000 admissions could have been avoided which cost the Medicare program $2.6 billion in 2005.
More information on how to apply for this initiative can be found here or by searching for CFDA 93.621 at www.Grants.gov . The eligible organizaion must include letters of support from the State Medicaid Director and State Survey and Certification Director, and letters of intent from at least 15 nursing facility partners. Notices of Intent are due by April 30, 2012.
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.
New York Times Article Discusses Move to Managed Home Care
Authored By: David W. Bufford
An article in the New York Times discussed a growing trend away from the utilization of nursing facilities in favor of managed care and home care. In light of reimbursement cuts from Medicare and Medicaid, the push to home health, managed care, and the Program of All-Inclusive Care for the Elderly (PACE) has received enthusiastic response from some patients and providers alike.
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 Clarifies Guidance on PPACA Mandatory Medicaid Terminations
Authored By: David W. Bufford
The Centers for Medicare & Medicaid Services (CMS) released updated guidance on Section 6501 of the Patient Protection and Affordable Care Act (PPACA) that requires state Medicaid agencies to terminate the participation of any individual or entity if such individual or entity is terminated under Medicare or any other state Medicaid plan. (more…)
CMS Revisits Smoking Safety in Long Term Care Facilities
Authored By: David W. Bufford
The Centers for Medicare & Medicaid Services (“CMS”) just released a Survey & Certification Letter (S&C: 12-04-NH) to address a recent report of a nursing facility resident death due to a smoking accident. A resident who was deemed appropriate to smoke unsupervised, but failing to wear a smoking apron, died as the result of injuries she sustained while smoking unsupervised outside a facility. CMS published the Letter to review the current regulations and Guidance to Surveyors at 42 CFR 483.25(h), and tag F323, Accidents and Supervision.
CMS restated that survey agencies must do all they can to remind and encourage nursing homes with residents who smoke to take reasonable precautions to ensure the safety of residents to the maximum extent possible. The above regulation Guidance describes appropriate precautions such as smoking only in designated areas, supervising residents whose assessment and plans of care indicate a need for supervised smoking, and limiting the accessibility of matches and lighters by residents who need supervision when smoking. (more…)
Topical Index
- Home Health (44)
- Hospice (40)
- Litigation and Risk Management (38)
- Long-Term Care (140)
- Medicaid/Medicare enrollment and regulatory compliance (70)