Healthcare Compliance Blog

MAY 25, 2022

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has excluded a Louisiana man from participation in federal healthcare programs due to his ownership interest in seven Louisiana nursing homes that OIG previously excluded. As a result, OIG has excluded the nursing homes and their owner.

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Healthcare Law Blog

OCTOBER 27, 2022

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program.

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Healthcare Compliance Blog

JUNE 8, 2022

A Maine nursing home with a history of federal fines was listed as a special focus facility (SFF) after two residents wandered off in separate incidents last year. They were one mile from the nursing home, so police took her to the facility. In the second case, the resident was hit and killed by a motor vehicle.

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Hall Render

OCTOBER 28, 2024

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursing home residents’ rights to vote. On September 26, 2024, CMS issued a QSO Memo , “Compliance with Residents’ Rights requirement related to Nursing Home Residents’ Right to Vote.” 42 CFR §483.10(b)(1)

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Hall Render

NOVEMBER 21, 2024

Department of Health and Human Services found that most skilled nursing facilities (“nursing homes”) in Massachusetts that it surveyed are not correctly complying with life safety requirements or emergency preparedness requirements. The Office of Inspector General (“OIG”) of the U.S.

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Hall Render

SEPTEMBER 28, 2023

Department of Health and Human Services found that most skilled nursing facilities (“nursing homes”) in Georgia that it surveyed are not correctly complying with life safety requirements or emergency preparedness requirements. The Office of Inspector General (“OIG”) of the U.S.

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The Health Law Firm Blog

OCTOBER 5, 2023

Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

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The Health Law Firm Blog

JULY 11, 2022

Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

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Healthcare Compliance Blog

FEBRUARY 8, 2022

The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursing home residents. The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta.

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Hall Render

OCTOBER 10, 2023

As nursing homes look for funds to allow them to improve care and train nursing home staff, Centers for Medicare & Medicaid Services (“CMS”) released QSO-23-23-NH (“CMS Memo”), which reopens and recasts the Civil Money Penalty Reinvestment Program (“CMPRP”).

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Healthcare Law Blog

DECEMBER 7, 2022

Leveraging Oversight to Better Protect Nursing Homes – In the introduction to this Semiannual Report, Grimm indicated that “providing quality and safety of care in the more than 15,000 Medicare- and Medicaid-certified nursing homes nationwide” is a “top priority” moving forward.

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Hall Render

NOVEMBER 6, 2024

The COVID data reporting through the National Healthcare Safety Network (“NHSN”) was first required of nursing homes in May 2020 through an interim final rule. CMS took regulatory action through the Calendar Year 2022 Home Health Prospective Payment System rule to extend those requirements through December 31, 2024.

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Hall Render

AUGUST 21, 2023

Nursing homes are critical in providing residents with care, comfort and dignity. Nursing homes need to navigate this delicate terrain with care, sensitivity and a commitment to creating a safe and respectful environment for all residents.

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Hall Render

JUNE 30, 2022

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the quality of care and quality of life for residents. Hall Render blog posts and articles are intended for informational purposes only.

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MedTrainer

SEPTEMBER 20, 2023

Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies. There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud. Accreditation.

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MedTrainer

AUGUST 8, 2024

As of March 2024, over 67 million in the United States are Medicare beneficiaries. Medicare is the single largest payer for healthcare services in the United States. In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Here’s what you need to know.

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Healthcare Law Blog

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited proposal to establish new federal minimum staffing standards for long-term care facilities. [1] Nurse Aide (NA) HPRD (the “2.45 Nurse Aide (NA) HPRD (the “2.45 55 RN hours per resident per day (the “.55 55 RN HPRD”); and At least 2.45

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Healthcare Compliance Blog

APRIL 14, 2022

The Office of Inspector General (OIG) released their findings of an audit they conducted to determine if hospital admissions of Indiana skilled nursing facility (SNF) residents who are enrolled in both Medicare and Medicaid (dually eligible beneficiaries) were potentially avoidable, and if level-of-care requirements for Medicare were met.

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Hall Render

MAY 2, 2023

For this alert, “nursing homes” refers to skilled nursing facilities (often known as “SNFs”). In 2020, CMS revised the nursing home infection control regulations at 42 CFR § 483.80 Additionally, this information is now publicly available on CMS’s COVID Nursing Home Data Website.

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Hall Render

JANUARY 11, 2022

Facing further confusion from skilled nursing facilities and families amidst the current spike in COVID cases in the United States, the Centers for Medicare & Medicaid Services (“CMS”) released additional best practices and addressed more issues that skilled nursing providers should follow as they encounter certain visitation scenarios.

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Hall Render

JULY 5, 2023

When a patient is discharged from acute care, it is important that the acute care provider deliver accurate and appropriate patient information related to a patient’s treatment and condition in order to decrease the risk of readmission or an adverse event at the skilled nursing providers and home health agencies.

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MedTrainer

JANUARY 30, 2024

In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them. Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes.

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Healthcare Compliance Blog

JANUARY 24, 2022

The Medicaid Fraud Division also prioritizes the physical and financial security of residents who reside in Massachusetts nursing homes. Cases include: In September 2021, a certified nurse’s aide was charged with sexually assaulting two elderly nursing home residents at a Massachusetts nursing home while he worked the night shift.

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Healthcare Compliance Blog

MAY 18, 2022

The program is funded by the Centers for Medicare & Medicaid Services (CMS), and will establish a Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions (Center for Excellence).

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Health Law Attorney

JANUARY 13, 2022

The Centers for Medicare and Medicaid Services (“ CMS ”) has also taken recent action to implement a COVID-19 vaccine mandate. In November 2021, CMS issued an Interim Final Rule (“ IFR ”) that would require facilities receiving Medicare and Medicaid funding to ensure that their staff are vaccinated against COVID-19.

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Hall Render

APRIL 11, 2022

Last week, CMS proposed increases in Medicare rates for certain health care services, and Florida’s governor signed legislation that ensures patients of hospitals and health care facilities are allowed to have visitors. In other news, a large committee of experts issued a report on the nursing home industry that was less than flattering.

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Provider Trust

AUGUST 9, 2023

Leveraging Oversight To Protect Nursing Home Residents Better Enhancing the quality of care in nursing homes remains paramount to OIG. Through years of oversight, they have discovered various obstacles and weaknesses within nursing home facilities.

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Hall Render

OCTOBER 27, 2023

According to a recent study , physician-owned hospitals treated some of the most expensive Medicare beneficiaries at significantly lower costs compared to traditional hospitals, despite serving similar patient populations. In the broader nursing home industry, 19% meet such minimum staffing benchmarks.

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Provider Trust

JULY 17, 2023

Their guidance aims to improve a number of potential risks within the healthcare space by improving care at nursing homes and strengthening the program integrity in managed care. OIG pointed to the increased instances of patient neglect abuse as well as the need for oversight within nursing homes.

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Pharmacy Law Blog

FEBRUARY 13, 2018

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Prior to her guilty plea, she was accused of Medicare fraud and Anti-Kickback Statute violations allegedly through paying patients. By George F. Indest III, J.D.,

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Hall Render

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that calls for minimum staffing standards in long-term care facilities (“nursing homes”). Nursing homes would need to provide residents with a minimum of 0.55 HPRD for RNs and 2.45

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Hall Render

DECEMBER 6, 2024

A study by Oregon Health & Science University found increased housing and food insecurity among Medicaid and Medicare recipients during the COVID-19 pandemic, which also correlated with poorer health outcomes. Hall Render blog posts and articles are intended for informational purposes only. health care costs by $38B annually.

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Healthcare Law Blog

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 As individuals continue to live longer beyond retirement and the U.S.

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Healthcare Law Blog

DECEMBER 1, 2023

HHS-OIG conducted investigations resulting in 661 criminal actions against individuals related to Medicare and Medicaid, as well as 726 civil actions, including false claims, unjust-enrichment lawsuits, and civil monetary penalty settlements. Enhancing program integrity in noninstitutional care settings, such as home health and hospice care.

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Hall Render

JANUARY 18, 2022

Amidst a nationwide nursing and skilled nursing facility staffing crisis, the Centers for Medicare & Medicaid Services (“CMS”) announced that additional information regarding nursing home staff numbers will be added to the January 2022 CMS Care Compare website. Weekend Staff.

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MedTrainer

JANUARY 10, 2024

Centers for Medicare and Medicaid Services (CMS) requires nursing homes and ambulatory surgery centers (ASCs) to have an individual who is qualified by experience and training to serve as an infection control preventionist. Evaluate your current infection control and prevention plan.

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Healthcare Law Blog

JULY 5, 2022

On June 29, 2022, the Centers for Medicare and Medicaid Services (CMS) announced it issued significant changes to surveyor guidance for Long Term Care (LTC) facility health, quality and safety standards. [1] 1] Fact Sheet: Updated Guidance for Nursing Home Resident Health and Safety | CMS. [2]

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