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On March 7, 2025, the Centers for Medicare & Medicaid Services (CMS) posted a memo dated March 10, 2025, that gives nursinghomes and surveyors more time to prepare for implementation of new rules and updates to allow surveyors to add extra attention and increase oversight in nursinghomes.
Medicaid managed care plans and the Children’s Health Insurance Program (CHIP) will be subject to new wait time standards and quality ratings requirements, the Centers for Medicare & Medicaid S | CMS defended implementing stronger rules over nursinghome staffing as well as explained its thoughts behind Medicaid access and managed care rules.
introduced new legislation this week that would provide for permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics. Butterfield, D-North Carolina, and Glenn Thompson, R-Pa., " WHY IT MATTERS. ON THE RECORD.
Joel Landau, founder and chairman of The Allure Group Nursinghomes have embraced technology, especially during the COVID-19 pandemic, to help seniors, staff, and clinicians better communicate with one another and for residents to stay in touch with loved ones. Nursinghomes are evolving. percent of U.S.
Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursinghomes. hours of nursing staff per resident per day, or 3.0 billion over 10 years. [4]
According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. However, CMS noted that for one data source, only 49.3%
The Centers for Medicare and Medicaid Services published a proposed rule that aims to promote transparency in the often opaque realm of nursinghome ownership.
Skilled nursing faciltiies will receive a higher Medicare pay bump in fiscal 2024 than proposed by the Centers for Medicare and Medicaid Services in April.
Nursinghomes, rehab providers and psychiatric hospitals urged the Centers for Medicare and Medicaid Services to account for economic conditions in fiscal 2024 rates
On Tuesday, Centers for Medicare and Medicaid Services expanded its Medicare telehealth coverage during the COVID-19 pandemic to enable more patients to get virtual care services from their providers. ON THE RECORD.
More > Tags: Centers for Medicare & Medicaid Services , Civil Penalties , CMS , Healthcare Providers , Long-Term Care , Long-Term Care Facilities , Medicare. For reference, the 2017 Guidance can be found here. The accompanying CMP Analytic Tool can be found here.)
Its compliance program guidance (CPG) has improved the efficiency and effectiveness of Medicare and many other federal programs. Last November, the OIG published industry-specific compliance guidance for 2024 for several healthcare subsectors, including nursinghomes and facilities.
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.
In 2023, nursinghomes have seen increased citations by surveyors for noncompliance tied to their pre-dispute, binding agreements for binding arbitration with their residents. The Arbitration Regulations revised the requirements for arbitration agreements when they are used by nursinghomes to resolve disputes with their residents.
The Centers for Medicare & Medicaid Services (CMS) has finalized a rule that will require more transparency into nursinghome ownership. | The Centers for Medicare & Medicaid Services has finalized a rule that will require more transparency into nursinghome ownership.
"The FCC COVID-19 Telehealth Program will enable Parker to reduce patient face-to-face encounters in the nursinghome and the possible impact of COVID-19, reduce PPE, and minimize staff burden." " Lorraine Breuer, Parker Jewish Institute for Health Care and Rehabilitation. ” MARKETPLACE.
Medicare and Medicaid certified facilities will be required to ensure that their employees are vaccinated for COVID-19, the Centers for Medicare & Medicaid Services (CMS) announced on September 9, 2021. The Interim Final Rule will apply to any healthcare facility receiving Medicare or Medicaid reimbursement.
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 nursinghome 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.
Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursinghome members of the health care compliance community. Medical Directors in NursingHomes 42 CFR 483.70(g)
A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.
Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursinghome mogul Phillip Esformes had reached a plea deal on pending conspiracy [.] Indest III, J.D.,
Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursinghome mogul Phillip Esformes had reached a plea deal on pending conspiracy [.] Indest III, J.D.,
spread between nursinghomes. These facilities, like most nursinghomes, are for-profit businesses that pad their margins by cutting labor costs. As in nursinghomes, homecare understaffing pre-dated , but was intensified by , the pandemic. Recall that the first COVID-19 outbreak in the U.S.
The Office of Inspector General (OIG) conducted an audit and found that selected nursinghomes may not have complied with federal requirements for infection prevention and control and emergency preparedness. Specifically, 28 of 39 nursinghomes they audited had possible deficiencies.
Using the ICPG to Maintain an Effective Compliance Program The Centers for Medicare & Medicaid Services (CMS) has issued participation requirements for nursing facilities in the Medicare and Medicaid programs (Requirements of Participation or ROPs). The ICP covers the areas listed below.
Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursinghome mogul Phillip Esformes had reached a plea deal on pending conspiracy [.] Indest III, J.D.,
On September 23, 2022, the Centers for Medicare & Medicaid Services (CMS) issued revised COVID-19 nursinghome visitation guidance. Nursinghomes should use the community transmission level metric, not the community level metric. Vaccination status was removed from the guidance.
They identified that 6,622 nursinghomes had been cited for infection prevention and control program deficiencies as of February 26, 2020, and Medicare.gov indicated that 24 nursinghomes were part of a nursinghome chain. The OIG’s audit found that 23 of the 24 nursinghomes had possible deficiencies.
Board Certified by The Florida Bar in Health Law On July 11, 2016, a federal appeals court stated that a bankruptcy judge did not have the authority to block government health officials from cutting off Medicare and Medicaid payments to a Florida nursinghome that was alleged to have violated patient-care regulations.
An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare program. The complaint alleged that the provider had engaged in conduct to defraud the Medicare program. to the United States.
On January 7, 2022, the Centers for Medicare & Medicaid Services (CMS) published a memorandum stating that nursinghome staff turnover and weekend staffing will be posted on the Medicare.gov Care Compare public website. The QSO memorandum can be accessed at: QSO-22-08-NH (cms.gov).
On November 3, 2022, the OIG released the results of a recent inspection of a nursinghome by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections).
The Centers for Medicare & Medicaid Services launched its enhanced NursingHome Five-Star Quality Rating System which integrates data nursinghomes report on their weekend staffing rates for nurses and information on annual turnover among nurses and administrators.
Board Certified by The Florida Bar in Health Law On June 15, 2022, the US Department of Justice (DOJ) announced it has sued three nursinghomes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” Indest III, J.D.,
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 nursinghomes that OIG previously excluded. As a result, OIG has excluded the nursinghomes and their owner.
The Centers for Medicare and Medicaid Services (CMS) began to allow for reimbursement for videoconferencing between healthcare provider and patient. According to CMS.gov , CMS is expanding access to telehealth services with Medicare. If they have COVID-19, they can continue in isolation and prevent the spread of the illness.
To make it easier for families and caregivers to evaluate the quality of nursinghomes, the Center for Medicare & Medicaid Services (CMS) regularly publishes data on its “ Care Compare ” website. Last month, CMS added additional metrics to how it scores the quality of nursinghomes. Staff Turnover.
On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.
A Maine nursinghome 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 nursinghome, so police took her to the facility. In the second case, the resident was hit and killed by a motor vehicle.
The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced that they will be enhancing their focus on potentially preventable hospitalizations of Medicare-eligible skilled nursing facility (SNF) residents. Audit resident care plans to ensure they are regularly followed and updated as needed.
Department of Health and Human Services found that most skilled nursing facilities (“nursinghomes”) 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.
The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursinghome residents’ rights to vote. On September 26, 2024, CMS issued a QSO Memo , “Compliance with Residents’ Rights requirement related to NursingHome Residents’ Right to Vote.” 42 CFR §483.10(b)(1)
The Centers for Medicare & Medicaid Services (CMS) has given surveyors new rules and updates to allow surveyors to assess and cite violations of the regulations on resident discharge and transfer. This includes a physicians order and a detailed explanation of why the facility can no longer meet the residents needs.
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