Articles and Blogs

The Elder Justice Act (EJA) was enacted as part of the Patient Protection and Affordable Care Act (PPACA) in March, 2010, and creates a duty for long-term care providers to swiftly report any reasonable suspicion of a crime committed against any individual who is a recipient of care from the facility, or face significant... READ MORE

The National Fire Protection Association (NFPA) has recently released the 2012 Edition of the Life Safety Code (LSC).  Currently, the Centers for Medicare & Medicaid Services (CMS) enforces the 2000 Edition of the LSC.  The updated LSC includes many changes for health facilities, and addresses cultural changes for nursing homes.  For instance, to move... 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

The Centers for Medicare & Medicaid Services (“CMS”) has released an updated Skilled Nursing Facility (“SNF”) Prospective Payment System (“PPS”) Factsheet.  The revised Factsheet includes background information and elements of the SNF PPS. Should you have any questions, please contact: Todd Selby at 317.977.1440 or tselby@hallrender.com; Brian Jent at 317.977.1402 or bjent@hallrender.com; or David Bufford at 502.568.9368 or dbufford@hallrender.com, or... 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

On October 5, 2011, the Office of Inspector General (OIG) published its proposed Work Plan for Fiscal Year 2012. As in the past, the Work Plan continues to identify compliance risk areas that subject Medicare and Medicaid providers to audit and enforcement initiatives. The 2012 Work Plan contains several new areas of focus by... READ MORE

Effective October 1, new PPS rules for fiscal year 2012 require nursing homes to diligently review claims prior to submission.  As previously discussed, significant cuts in SNF reimbursement are aimed mostly at therapy services.   SNFs submitting claims under the previous rules can expect high rates of denials and rejections.  Even facilities billing under the new... READ MORE

CMS has published a proposed regulation that would limit the ability of institutional pharmacies to offer pharmacist consultation services to facilities.  CMS believes that relationships between nursing homes and pharmacy suppliers could result in “recommendations that conflict with the best interests of nursing home residents.” The proposed regulation would require facilities to hire independent pharmacists to... READ MORE

CMS will host their monthly Skilled Nursing/LTC Open Door Forum on Thursday, October 20, from 2-3pm EST.  This call was originally scheduled on October 13.  The information to participate in the call is available here. The recent changes to MDS 3.0 and PPS are likely to be heavily discussed topics.    Should you have any questions, please contact: Todd Selby... READ MORE

CMS recently published a Survey & Certification Memorandum (S&C:11-35-NH) detailing progress in the implementation of Section 6121 of the Affordable Care Act (ACA).  Section 6121 of the ACA mandates enhanced nurse aide training in nursing homes.  The enhanced training focuses on two areas: 1) how to care for residents with dementia, and 2) how... READ MORE