Report Suggests For-Profit Hospices Utilize Longer Periods of Service

Earlier this week, McKnight’s reported on a study from the Mount Sinai School of Medicine in New York relating to the length of stay at for-profit versus nonprofit hospice providers.  This study showed that, of the 600 Medicare certified hospices nationwide, for-profit hospices were more likely to have patients with a... Continue Reading →

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CMS Extends and Expands Home Health Enrollment Moratoria

Effective January 31, 2014, the Centers for Medicare & Medicaid Services (“CMS”) has issued a temporary moratoria for the enrollment of home health agencies in Fort Lauderdale, Florida; Detroit, Michigan; Dallas, Texas; and Houston, Texas.  CMS also announced it is extending the current enrollment moratoria in Chicago, Illinois and Miami,... Continue Reading →

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Daughter Not Liable for Mother’s Skilled Nursing Facility Expenses Because She Had No Authority Over Finances or Access to Mother’s Finances

The Indiana Court of Appeals (“Court”) ruled that a daughter who signed a skilled nursing facility admissions agreement as her mother’s “responsible party” was not liable for her mother’s unpaid skilled nursing facility bill because the daughter did not have authority over her mother’s finances or access to her mother’s... Continue Reading →

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Indiana Changing the Way Indiana Residents Will Obtain Medicaid Coverage Beginning June 1, 2014 – Some Indiana Residents Need to Establish Certain Trusts to Maintain Benefits

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On June 1, 2014, Indiana will change the way Indiana residents obtain Medicaid coverage in the age, blind or disabled categories.  Currently, when Indiana residents apply for Medicaid coverage, they are subject to state-specific restrictive criteria.   After June 1, 2014, Indiana residents will automatically be enrolled in Medicaid if the... Continue Reading →

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

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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... Continue Reading →

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CARES Act Introduced: Would Waive Three-Day Stay for Certain SNFs

The Creating Access to Rehabilitation for Every Senior Act of 2013 (“Bill”) was introduced this week by Representative James Renacci (R-OH) to the House.  This Bill proposes to waive the three-day qualifying stay requirement for admission to a skilled nursing facility (“SNF”) under Medicare.  ... Continue Reading →

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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... Continue Reading →

Medicare Administrative Contractors Announce Intent to Review Hospice Claims

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On October 30, two Medicare Administrative Contractors, Palmetto GBA and CGS, announced their intent to focus on certain hospice claims for patients located in Skilled Nursing Facilities (“SNFs”). Palmetto GBA announced that it has identified top providers with a large number of beneficiaries receiving hospice services in SNFs, and it... Continue Reading →

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Filial Responsibility Law (Part 2) – Another Tool for Nursing Homes to Get Paid – Son Liable for Parents’ $104,276 Nursing Home Bill Under North Dakota Law

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Recently, the North Dakota Supreme Court found a son liable for his parents’ $104,276 unpaid nursing home bill under North Dakota’s filial responsibility law.... Continue Reading →

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

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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... Continue Reading →