Articles and Blogs

An article in the New York Times discussed a growing trend away from the utilization of nursing facilities in favor of managed care and home care.  In light of reimbursement cuts from Medicare and Medicaid, the push to home health, managed care, and the Program of All-Inclusive Care for the Elderly (PACE) has received enthusiastic response from some... READ MORE

The Centers for Medicare & Medicaid Services (CMS) released updated guidance on Section 6501 of the Patient Protection and Affordable Care Act (PPACA) that requires state Medicaid agencies to terminate the participation of any individual or entity if such individual or entity is terminated under Medicare or any other state Medicaid plan.   READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) just released a Survey & Certification Letter (S&C: 12-04-NH) to address a recent report of a nursing facility resident death due to a smoking accident.  A resident who was deemed appropriate to smoke unsupervised, but failing to wear a smoking apron, died as the result of... READ MORE

Pursuant to Section 6111 of the Affordable Care Act enacted on March 23, 2010, and the final rule published on March 18, 2011 in the Federal Register, a nursing facility must be offered the opportunity to request an Independent Informal Dispute Resolution (IIDR) if the Centers for Medicare & Medicaid Services (CMS) imposes a... READ MORE

Yesterday, CMS sent a new transmittal to the state survey agencies on the use of feeding tubes in nursing homes. In short, F321 has been combined into F322 and according the CMS the changes were made to provide nursing home surveyors with guidance to determine compliance with use of feeding tubes by nursing homes. ... READ MORE

Earlier this week, we highlighted the implementation by Centers for Medicare & Medicaid Services (CMS) of enrollment revalidations and screening categories, and which categories CMS places certain long-term care providers. It is important for providers and suppliers to understand what each screening category (limited, moderate, or high) entails and be aware of any events... READ MORE

While Congress was able to present the President with a compromised solution to cut Federal spending and raise the Government’s debt ceiling earlier this month, all long-term care providers should anticipate future reimbursement changes.  Under the current law, the Budget Control Act of 2011t , Medicare and Medicaid are unchanged. However, the Act requires for... READ MORE

As record-breaking temperatures scorch the Midwest, long-term care providers are reminded to evaluate their emergency preparation plans. Proper planning can mitigate a situation from a potential disaster to a mere inconvenience. CMS provides a checklist, Emergency Preparedness for Every Emergency, for providers to use to evaluate their current emergency plans. Federal regulations at 42... READ MORE

Michigan’s Department of Community Health will enforce Michigan’s Medicaid Asset Recovery Act (MCL Sec. 400.112g) with efforts starting July 1, 2011.  Michigan may file claims in the probate estates of individuals age 55 or older who received Medicaid benefits that paid for long term care services after September 30, 2007.   Michigan’s claim would seek... READ MORE

Recently, the Indiana State Department of Administration, on behalf of Indiana’s Family and Social Services Administration (FSSA), posted a Request for Proposals to contract with multiple attorneys for Indiana Medicaid estate recovery.  The Request for Proposals is at http://www.in.gov/idoa/proc/bids/rfp-11-84/ .  It appears Indiana plans to get much more aggressive in Medicaid estate recovery, including... READ MORE