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 →

CMS Issues Guidance on Survey and Certification Activities During Government Shutdown

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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... 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 →

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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.  ... Continue Reading →

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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... Continue Reading →

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Expansion of IIDR

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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... Continue Reading →

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House Bill Proposes Bundled Payments and Readmission Penalties for Nursing Homes

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The House of Representatives recently proposed legislation that would bundle payments for post-acute care services and create penalties for readmissions to Medicare-certified nursing homes. The proposed legislation would also reduce the annual market basket index for Skilled Nursing Services.... Continue Reading →

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CMS Clarifies Requirements for Minimum Data Set Discharge Assessments

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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... Continue Reading →

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