Articles and Blogs

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 finances. READ MORE

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 Federal Social Security Administration... READ MORE

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 (the “Act”), is expected to... READ MORE

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.   READ MORE

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 severity (“S&S”) levels of... READ MORE

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 intends to initiate a... READ MORE

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. READ MORE

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 LSC K Tag requirements. ... READ MORE

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... READ MORE

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.   READ MORE