Articles and Blogs

On July 22, 2016, the Center for Clinical Standards and Quality/Survey & Certification Group released a memorandum that revised Chapter 7 of the State Operations Manual (“SOM”) and provided guidance on its policy to immediately impose federal remedies when a deficiency of a certain type is cited. The remedies are in addition to a... READ MORE

On August 5, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released a Survey and Certification Memo (“S&C Memo”) on protecting resident privacy and prohibiting abuse-related photographs and recordings by nursing home staff.¹  Recent news stories have reported nursing home staff taking unauthorized photographs or video recordings of nursing home residents, sometimes in... READ MORE

On June 3, 2016, CMS released a memorandum that answered questions regarding the agency’s criteria for selection of enforcement remedies for long-term care facilities with deficiencies. The document reported data on enforcement actions taken by the agency when a nursing home is not in compliance with the Medicare and Medicaid requirements of 42 C.F.R.... READ MORE

On Friday, March 18, 2016, CMS released a memo entitled “Payroll-Based Journal (PBJ) – Implementation of required electronic submission of Staffing Data for Long Term Care (LTC) Facilities.” The memo reminds LTC providers that the mandatory PBJ submission period begins July 1, 2016. The memo also contains information on how to register for PBJ reporting and... READ MORE

On Thursday, October 29, 2015, CMS issued the pre-publication copy of the final home health PPS rule for CY 2016 (“the Rule”).  The Rule adopts most of the proposals from July but makes a few key changes. Rates, Payments and Home Health Spending Although CMS makes several key changes to the final rule, CMS... READ MORE

On August 21, 2015, the Court of Appeals for the D.C. Circuit (the “Court”) issued a ruling in Home Care Association of America v. David Weil, also known as the “companionship services lawsuit.” Unfortunately, it is more bad news for the home care industry. The Court ruled that the Department of Labor (“DOL”) has... READ MORE

Introduction CMS has proposed a comprehensive revision of the requirements for participation for long-term care facilities (the “Requirements”) for the first time since 1991.  The proposed regulations reflect the significant changes in technology, resident care and facility demographics since 1991.  CMS states the proposed regulations are designed to optimize resident safety, reflect current professional... READ MORE

Value-Based Purchasing Comes to Home Care On Monday, July 6, CMS issued the pre-publication copy of the proposed FY 2016 Home Health PPS Rule (the “Proposed Rule”).  The Proposed Rule will impose further cuts to home health reimbursement.  This is done in part through a continued application of the Affordable Care Act rebasing, which... READ MORE

On March 13, 2015, the Medicare Payment Advisory Commission (“MedPAC”) released its annual report to Congress (“Report”). The Report contains MedPAC’s recommendation for improvements to Medicare payments to providers as well as recommendations on controls to help combat fraud and waste. As usual, MedPAC has concerns about home health and hospice and makes a... READ MORE

Subject to various exceptions, a covered skilled nursing facility (“SNF”) stay must initiate within 30 days of a qualifying hospital stay.  In some cases where it is medically predictable that an individual will require a covered level of SNF care within a determinable time frame, that same individual may also have a need for a covered... READ MORE