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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.
My commitment to this work has led me to build innovative programs both in the community and in skilled nursing facilities, designed to provide more and better-focused care to our frail elderly. According to Bureau of Labor Statistics data 1 , the number of workers employed at nursing care facilities nationwide has declined by 15%—from 1.59
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 HPRD from nurse aids (NAs). [2]
The Centers for Medicare and Medicaid Services published a proposed rule that aims to promote transparency in the often opaque realm of nursinghome ownership.
A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursinghome residents, but which were never provided. Additionally, it is necessary that the billing office ensures that no double billing occurs by the nursinghome and any consultant.
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 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.
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.
Fundamental Rights in Healthcare Organizations Nursinghomes can be challenging places to work, with staff citing workforce shortages and time pressures as the key sources of stress. Research reveals that staff who self-report that they have abused a nursinghome resident characterize themselves as emotionally exhausted.
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.)
The Centers for Medicare and Medicaid Services relaxed requirements around reimbursements early in the pandemic, contributing to the upswing in countrywide telehealth visits. " WHY IT MATTERS. Since then, multiple groups have pushed the agency to make such changes permanent. ON THE RECORD.
Last November, the OIG published industry-specific compliance guidance for 2024 for several healthcare subsectors, including nursinghomes and facilities. More specifically, the 2024 guidance for nursing facilities focuses on several areas.
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.
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.
An Oklahoma nurse aide pleaded guilty to abusing a nursinghome resident and was placed on a deferred sentence probation for three years under the supervision of the Oklahoma Department of Corrections. toward the cost of the investigation to the Office of the Attorney General Medicaid Fraud Control Unit (MFCU), $300.00
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.
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.
In recent months, there has been a lot of attention on decisions made during the height of the COVID-19 pandemic in New York State in regard to nursinghomes. Nursinghome operators themselves have faced suspicion in regard to such readmissions. Such funds will be used to support the NursingHome Quality Pool.
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.
According to court documents and evidence presented at trial, the psychologist caused the submission of fraudulent Medicare claims from July 2016 through June 2019 for psychotherapy services purportedly provided to nursinghome residents in Chicago and surrounding areas.
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.
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. The revision provides updated guidance for face coverings and masks during visits.
A certified nurse’s aide (CNA) who was working in an Oklahoma nursinghome has pled guilty to stealing money from a resident. Our office will not tolerate the financial exploitation of our beloved nursinghome residents, no matter how large or small the amount.”.
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 evidence at the trial showed that the CNA performed an improper, one-person lift of a nursinghome resident which resulted in severe and painful injuries to the resident. I want to thank the Medicaid Fraud Control Unit for thoroughly investigating this crime and successfully pursuing justice.
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. Ratings are updated quarterly.
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).
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.
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.
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. Why is this?
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.
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)
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.,
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.,
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.
Nursinghomes, rehab providers and psychiatric hospitals urged the Centers for Medicare and Medicaid Services to account for economic conditions in fiscal 2024 rates
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)
An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.?Under The post NursingHome Provider to Pay over $5.5M
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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