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Monday August 29, 2011
The Centers for Medicare and Medicaid Services has announced
it will cut Medicare payments to skilled nursing facilities by $3.9
billion next year to recover overpayments it made to companies that
inflated their costs. CMS says its newly recalibrated
classification system, known as "Resource Utilization Groups
Version 4," or RUG-IV, will eliminate skilled nursing facilities'
ability to bill for a higher level of care than they actually
provide to patients. According to a July 29 statement ...
http://money.msn.com/retirement/article.aspx?post=a6d41859-804e-49f4-9568-e4cf43be63b3
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Thursday August 11, 2011
Click on the link below to download the QIS documents:
QIS Brochure
April 2011
QIS
Checklist Final July 2011
QIS
Implementation Map April 2011
QIS
Memo Checklist Changes July 2011
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Monday August 8, 2011
The purpose of this letter is to ensure that States are
informed of the existing options and flexibilities regarding the
application of Medicaid liens, transfer of assets, and estate
recovery. Specifically, this letter is intended to advise States of
existing choices and options regarding spousal and domestic partner
protections related to liens, transfer of assets, and estate
recovery.
Same Sex Partners MCD Liens Transfers Estate Rec 06 11
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Friday August 5, 2011
A federal audit of Medicare hospice spending for nursing home
residents has revealed that spending has jumped nearly 70 percent
since 2005, as some for- profit hospices gained higher enrollment
and reimbursement rates at long-term- care facilities. The Office
of the Inspector General issued recommendations that the Centers
for Medicare and Medicaid Services reduce Medicaid payments for
hospice care provided in nursing facilities and closely monitor
hospice agencies.
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Wednesday August 3, 2011
Due to a recent event and in an effort to keep our customers
informed of risk management issues, we wanted to communicate
potential risk factors regarding mechanical lifts and slings.
There are numerous brands of lifts (Hoyer, Invacare, Reliant,
EZ-Access, etc.) There are also numerous brands of slings and in
most cases, each sling will contain a warning label that states to
utilize the sling only with the same brand of lift.
Therefore, please look at your lift program to determine if the
appropriate slings are being utilized with the appropriate
lifts. (Note: Some distributers may sell some slings as
universal slings but the warning labels may still have a disclaimer
to only utilize with the same brand of lift.) Also, each lift
manufacturer may have their own fit guide to determine how to
measure residents for the appropriate size of sling.
Therefore, if your facility has several different brands of lifts
then your staff may have to be knowledgeable of the different fit
guides to determine the appropriate size of sling. Also, your
staff should be knowledgeable on guidelines to determine what type
of sling should be utilized for the resident, i.e. bathing,
transfers, etc. Will your staff be able to answer questions
on how to measure residents for the appropriate fit of a sling for
each brand? Will your staff be able to communicate how they
assess a resident to determine which type sling is appropriate for
the resident? How will your facility be able to show how you
communicate to your staff the correct size sling and type of sling
for each resident?
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Tuesday August 2, 2011
Only the resident signed the arbitration provisions contained
in the admission agreement. Suit was filed before her death and
later amended to include wrongful death. Although currently on
appeal before the 11th circuit, the trial court ruled
that a personal representative of a resident's estate cannot be
compelled to arbitration. They opined that Alabama courts have
consistently held that wrongful death claims do not belong to a
decedent (Ala. Code ยง 6-5-462). As such, her wrongful death claim
belongs to the person representative because as a survival action,
the claim would have belonged to the decedent through her estate.
The outcome is currently pending on appeal but may have far
reaching results. Stay tuned.
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Tuesday August 2, 2011
The redesign of the federal Nursing Home Compare website, which
lets consumers file complaints more easily and compare facilities
based on quality measures, is complete.
www.medicare.gov/nhcompare/
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Tuesday August 2, 2011
A federal court in the Western District of Kentucky recently
provided much awaited clarification on one of many troubling
dilemmas faced by defendants, insurers and their attorneys
who are working to adhere to the requirements of Medicare Secondary
Payer ("MSP") law. Despite the challenges associated with
complying with MSP law, all of those involved in the settlement of
a claim that involves personal injury damages must be diligent to
avoid the post-settlement potential for liability to the Centers
for Medicare & Medicaid Services ("CMS").
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Tuesday August 2, 2011
A federal audit of Medicare hospice spending for nursing
home residents has revealed that spending has jumped nearly
70 percent since 2005, as some for- profit hospices gained
higher enrollment and reimbursement rates at long-term-care
facilities. The Office of the Inspector General issued
recommendations that the Centers for Medicare and Medicaid
Services reduce Medicaid payments for hospice care provided in
nursing facilities and closely monitor hospice agencies.
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Tuesday August 2, 2011
Inpatient rehab facilities will see a 2.2% payment rate increase
under the IRF Prospective Payment System in fiscal year 2012. The
system will also establish a new quality reporting system
authorized by the Affordable Care Act.
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Tuesday August 2, 2011
Shares of major skilled nursing facility operator stocks took
a nosedive Monday morning following Friday's announcement that
the Centers for Medicare & Medicaid Services are cutting
Medicare reimbursements to SNFs by 11.1%, starting Oct. 1.
Operators Sun Healthcare, Skilled Healthcare and Kindred Healthcare
lost more than a quarter of their market value on Monday, according
to published reports.