Archive | Long-Term Care

Obama Budget Contains Numerous Post-Acute Care Cuts

President Obama introduced his fiscal year (“FY”) 2015 budget yesterday, and there are many proposed cuts to post-acute care providers.  Some of the highlights include a number of bundled payment initiatives, a $100 co-pay for home health patients not discharged from a hospital and re-admission penalties for skilled nursing facilities (“SNFs”) with high hospital re-admissions.  This information was provided to the Hall Render Post-Acute Practice Group from John Williams, who leads Hall Render’s Federal Advocacy Practice Group from the firm’s office in Washington, D.C.  Continue Reading →

Proposed SGR Legislation Includes Significant Impact on Long-Term Care Hospitals

Last night the House passed, as part of the Ryan-Murray budget, a three-month patch to the Sustainable Growth Rate (“SGR”) formula that includes policy changes that significantly impact long-term care hospitals (“LTCHs”). The current SGR patch expires December 31, and this proposed legislation, titled the Pathway for SGR Reform Act of 2013 (the “Act”), is expected to pass the Senate shortly.  Continue Reading →

CMS Revises Citation Guidelines for Facilities Working Towards Sprinkler Compliance

The Centers for Medicare & Medicaid Services (“CMS”) just released a revision to their August Survey and Certification letter concerning the August 13, 2013 deadline for the installation of automatic sprinkler systems in nursing facilities. Originally, facilities that did not meet the deadline were subject to deficiencies at scope and severity (“S&S”) levels of D, E or F. Recognizing that some facilities are still in the process of compliance, CMS has enumerated 10 protections that, if in place, may permit the deficiency citation to be reduced to an S&S level of C. Continue Reading →

CMS Deletes Certain Citations Under §483.70(a), Associated Tag F-454

Effective October 25, 2013, CMS deleted citations for tag F-454 under 42 C.F.R. §483.70(a) pertaining to Physical Environment—Life Safety From Fire.  CMS noted, because these requirements are covered under the Life Safety Code (“LSC”), there was a duplication of findings and, therefore, only needed to be cited under the appropriate LSC K Tag requirements.  This change will benefit providers in that survey deficiencies will be more accurately and more appropriately cited for alleged LSC violations. Continue Reading →

CMS Issues Guidance on Survey and Certification Activities During Government Shutdown

Executive Summary

On October 1, 2013, the Centers for Medicare & Medicaid Services (“CMS”) released a Survey and Certification Letter (“S&C Letter”) that identified how the governmental shutdown (“Shutdown”) will affect state survey agency (“SA”) functions for all providers and suppliers.  The S&C Letter delineates what SA functions are essential to ensure the protection of Medicare and Medicaid beneficiaries against immediate dangers to life and health and to prevent providers and suppliers from experiencing harm that would threaten their ability to provide vital health care services to Medicare and Medicaid beneficiaries.   Continue Reading →

Revised RAI Manual Effective October 1

The most recent revisions to the Resident Assessment Instrument (“RAI”) User’s Manual became effective yesterday for all assessments with an assessment date on or after October 1.  The significant portion of the revisions addresses changes to therapy coding and swallowing and nutrition.   Continue Reading →

Bill Introduced to Remove Hospital Stay Requirement for SNFs

Prior to the government shutdown, Representative Jim McDermott of Washington introduced a bill that would end the hospital inpatient requirement for skilled nursing facility (“SNF”) coverage.  Currently, a beneficiary must complete a three-day inpatient hospital stay before qualifying for an SNF stay.  The proposed bill would eliminate the hospital stay requirement so long as a physician or other qualified professional certified the need for skilled services.  Continue Reading →

Preliminary Impact of Government Shutdown on LTC Providers–UPDATE

The Centers for Medicare & Medicaid Services (“CMS”) issued a Survey & Certification Memo (“S&C Letter”) to state agencies detailing the result of the governmental shutdown on long-term care providers as it relates to surveys.  As of this writing, the S&C Letter has not been published or otherwise made publicly available, and the below information has not been independently confirmed.  This information should not be relied upon until verification is available and is being provided for informational purposes only.  Please see the update below.   Continue Reading →

Expansion of IIDR

Beginning October 1, 2013, a skilled nursing facility (“SNF”), a nursing facility (“NF”) or a dually-certified SNF/NF will be permitted to request an independent informal dispute resolution (“IIDR”) for all federal deficiencies cited on its standard or complaint survey (CMS-2567) that are subject to the imposition, collection and escrow of civil money penalties (“CMPs”) by the Centers for Medicare & Medicaid Services.  Currently, only SNFs, NFs and SNF/NFs with federal deficiencies cited at a “G” or higher level (actual harm or immediate jeopardy) are subject to the CMP collection and escrow process and are permitted to request an IIDR.  After October 1, 2013, the opportunity to request an IIDR will be afforded to all affected facilities.

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