Articles and Blogs

The Medicare Payment Advisory Commission’s (“MedPAC”) recent Report to Congress included a chapter dedicated to skilled nursing facilities (“SNFs”), which MedPAC reports received $31 billion in Medicare reimbursement in 2011.  Recently, SNFs have been under pressure from repeated reimbursement cuts; however, MedPAC’s analysis states that SNF reimbursement is adequate.   READ MORE

The Medicare Payment Advisory Commission’s (“MedPAC”) March 25th Report to Congress outlines inefficiencies they believe exist in the post-acute world and lead to excessive Medicare payments to providers. MedPAC recommendations include Congress evaluate post-acute provider reimbursement and encourage use of the lowest cost mix of services necessary to achieve the best outcomes. READ MORE

The Centers for Medicare & Medicaid Services (“CMS”), in the March 8, 2013 Memorandum, issued new guidance specifying those tasks that can and cannot be delegated in skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”).  Physicians who improperly assign tasks to non-physician practitioners (“NPPs”) jeopardize the SNFs’ and NFs’ compliance with federal and state... READ MORE

The Centers for Medicare & Medicaid Services, in the March 8, 2013 S & C 13-16 NH, revised the Interpretative Guidelines for F-Tag 155 (“Advance Directives”) in Appendix PP of the State Operations Manual.  This memorandum updates S & C 12-47. READ MORE

According to the Centers for Medicare & Medicaid Services (“CMS”), since 1972, there have been in excess of 100 reports of Luer misconnections that have resulted in adverse events.  Recently, a patient’s blood pressure tubing was misconnected to an intravenous line in an ambulatory surgical center (“ASC”) that resulted in the patient’s death.  Generally,... READ MORE

Based on additional feedback, the Centers for Medicare & Medicaid Services (CMS) has revised the surveyor guidance issued in September 2012 on Naso-Gastric Tubes (NG Tubes) for F-Tag F322.  Since the NG Tube regulation, §483.25(g), was published, the use of NG Tubes has become increasingly rare in favor of other forms of enteral feeding... READ MORE

The Centers for Medicare & Medicaid Services (CMS) has unofficially announced it will not be enforcing the upcoming March 23rd compliance program requirements until final regulations are published.  As required under the Affordable Care Act, nursing facilities are required to have a compliance program in place by March 23, 2013.  Despite ambiguity in the actual statute,... READ MORE

In 2003, two fires in long-term care facilities resulted in 31 resident deaths. As a result of these two events, CMS analyzed the fire safety precautions in place in these facilities and determined that resident safety could be greatly improved by requiring that all long-term care facilities have automatic sprinkling systems installed throughout the... READ MORE

The Patient Protection and Affordable Care Act (PPACA) requires all skilled nursing facilities (SNFs) and nursing facilities (NFs) to have an effective compliance and ethics program in place by March 23, 2013.  Unfortunately, the Centers for Medicare & Medicaid Services (CMS) has failed to publish final regulations covering these programs, as required under PPACA, by... READ MORE

Under the Bundled Payments for Care Improvement initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. The Centers for Medicare & Medicaid Services (CMS) hopes these models may lead to higher quality and more coordinated care at a lower cost to Medicare.   READ MORE