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Long Term Care

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 →

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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CMS Clarifies Requirements for Minimum Data Set Discharge Assessments

On August 23, 2013, the Centers for Medicare & Medicaid Services (“CMS”) published a memorandum that addressed issues arising from incomplete, inaccurate and missing Minimum Data Set (“MDS”) Discharge Assessments that adversely affect Skilled Nursing Facilities (“SNFs”) and Nursing Facilities (“NFs”).  Under 42 C.F.R. §§ 483.20(g) and (f)(1), SNFs and NFs are required to provide an assessment that accurately reflects a resident’s status and to provide specific information relative to that assessment within seven days after its completion.  Within 14 days after the assessment is completed, it must be transmitted electronically to the CMS system. Continue Reading →

Automatic Sprinkler System Requirement Now in Effect for Long-Term Care Facilities

On August 13, 2013, all nursing facilities participating in the Medicare and Medicaid programs were required to be in compliance with the automatic sprinkler systems’ regulation that was published in a final rule on August 13, 2008. The regulation provided a five-year phase-in program to allow long-term care facilities (“Facilities”) to achieve compliance by the August 13, 2013 deadline. Continue Reading →

Notification of Facility Closure Changes to State Operations Manual

On August 2, 2013, the Centers for Medicare and Medicaid Services (“CMS”) issued an update to the State Operations Manual (“SOM”) regarding the process for notification of a facility closure.  The updates to the SOM are the result of a final rule published in the Federal Register on March 19, 2013 and can be found at 42 CFR 483.75(r) and (s).  CMS noted that the August 2nd update to the SOM may differ slightly when published in the online version of the SOM. Continue Reading →

CMS Clarifies Qualifying Stay in VA Hospital

One of the main admission requirements for a skilled stay in a skilled nursing facility (“SNF”) is a three-day qualifying stay in an inpatient hospital.  In response to a question discussed on a recent Open Door Forum, the Centers for Medicare & Medicaid Services (“CMS”) released a memorandum discussing if a stay in a Department of Veterans Affairs Hospital (“VA Hospital”) can count as a qualifying stay for Medicare purposes.    Continue Reading →

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