PL 18-03-NF - This guidance for Nursing providers was issued by HHSC to address licensure violations and when violations counts as one of the three violations forming the basis for the license revocation that is required by §19.2107 in 40 Texas Administrative Code Chapter 19. b) Except as provided by subsection (d) of this section, the executive commissioner revokes a license if DADS finds that: (1) the license holder has committed three violations in §19.601(b) or (c) of this chapter … [Read more...] about Nursing Facilities – Immediate Threat Violations
HHS OIG Releases Report Regarding Group Homes and Critical Incident Reporting
This January, the Office of Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS) in conjunction with the Administration for Community Living (ACL) and the Office for Civil Rights (OCR) at HHS issued a report which detailed that "health and safety policies and procedures were not being followed. Failure to comply with these policies and procedures left group home beneficiaries at risk of serious harm. These are not isolated incidents but a systemic problem – 49 … [Read more...] about HHS OIG Releases Report Regarding Group Homes and Critical Incident Reporting
Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Information Letter No. 18-02 -Nursing Facility providers often make two common mistakes that usually result in denial of authorization requests or Health and Human Services Commission (HHSC) Preadmission Screening and Resident Review (PASRR) NF specialized services or assessments. To avoid this error, DADS has published this letter to help avoid these errors. The two most common reasons HHSC denies authorization requests for PASRR specialized services and assessments are: 1. NF staff … [Read more...] about Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Cost Report Training Information For Service Providers
Information Letter No. 18-01 - Cost report training is required every other year for the odd-year cost report in order for the preparer to be qualified to complete both that odd-year cost report and the following even-year cost report. Upon successful completion of either an Initial or Refresher Cost Report Training webinar, preparers who have previously completed cost report training for that same program will be awarded credit for completing the webinar and will be able to submit a 2017 cost … [Read more...] about Cost Report Training Information For Service Providers
Medicare program’s penalty protocols for Nursing homes change under Trump Administration
In 2016, the nursing home industry requested the change in the Medicare program's penalty protocols and now, according to reports, a new policy from the Trump administration will roll back fines against nursing homes cited for mistreatment or neglect. The New York Times research found that nearly 6,500 nursing homes in the U.S. have received at least one citation for a serious violation since 2013 and about two-thirds of those have been fined by Medicare.According to this New York Times excerpt … [Read more...] about Medicare program’s penalty protocols for Nursing homes change under Trump Administration
Texas to receive $25 Billion in Medicaid Funding after Approval of the 1115 Demonstration Waiver
According to The Office of Texas Government news release, the Texas Health and Human Services Commission and the Centers for Medicare and Medicaid Services have reached an agreement to continue a critical part of the state’s Medicaid program over the next five years.The approval of the 1115 Demonstration Waiver will allow the state to continue expanding managed care to Medicaid clients while also preserving supplemental payments to hospitals and other critical Medicaid providers. According to … [Read more...] about Texas to receive $25 Billion in Medicaid Funding after Approval of the 1115 Demonstration Waiver
Enforcement of Obama-era nursing home standards and enforcement remedies halted by CMS
CMS halts enforcement of some standards required by nursing homes that would enhance safety procedures for patients. In this notice: Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare posted late last month, the CMS announced an 18-month moratorium on enforcement remedies in some nursing home regulation that was finalized last year.Memorandum Summary from CMS Inlcuded:Temporary moratorium on imposing certain enforcement remedies for specific Phase 2 … [Read more...] about Enforcement of Obama-era nursing home standards and enforcement remedies halted by CMS
Extensions of Eligibility and Individual Plan of Care Authorizations for Individuals in CLASS and DBMD Impacted by Hurricane Harvey
Information Letter No. 17-25 – The information letter informs residents that were affected by Hurricane Harvey that The Texas Health and Human Services Commission can implement extensions of eligibility and individual plan of care authorizations on a case-by-case basis. An extension can be requested by a CLASS case management agency, CLASS direct service agency or DBMD program provider.The extension is for individuals that had permanent residence in a county declared a federal disaster area … [Read more...] about Extensions of Eligibility and Individual Plan of Care Authorizations for Individuals in CLASS and DBMD Impacted by Hurricane Harvey
Texas Register Update Concerning Delivery System Reform Incentive Payment (DSRIP) program.
The Texas Health and Human Services Commission (HHSC) adopts new Division 7, concerning DSRIP Program Demonstration Years 7-8, and within the new division (Review Texas Register for programs).The following information was obtained from the Novemeber 24 issue of the Texas Register.The Centers for Medicare & Medicaid Services (CMS) approved Texas' request for a new Medicaiddemonstration waiver entitled "Texas Healthcare Transformation and Quality Improvement Program" in accordance with §1115 … [Read more...] about Texas Register Update Concerning Delivery System Reform Incentive Payment (DSRIP) program.
CMS Finalizes Policies that Reduce Provider Burden, Lower Prescription Prices
The Centers for Medicare & Medicaid Services (CMS) issued a final rule this month for the 2018 Physician Fee Schedule and final rule with comment period for the Quality Payment Program (QPP). According to a news release by CMS, Seema Verma, Administrator of CMS explained that:“These rules move the agency in a new direction and begin to ease that burden by strengthening the patient-doctor relationship, empowering patients to realize the value of their care over volume of tests, and … [Read more...] about CMS Finalizes Policies that Reduce Provider Burden, Lower Prescription Prices