Applies to all Medicaid and/or Medicare certified nursing facilities Posted October 18, 2002 For more information contact Jerri Lynn Ward. A recent Survey and Certification Clarification memorandum (S&CC #02-07) published by the Texas Department of Human Services answers the question "Can private pay residents be included in samples done by surveyors during certification surveys?" The answer is yes. Section 2714.1 of the State Operations Manual, entitled "Application of … [Read more...] about Inclusion of Private Pay Residents in Survey Samples
Granny Get Your Scooter!
Medicare Reimbursement for Power Operated Vehicles For more information contact Jerri Lynn Ward. Posted October 31, 2002 Are Power Operated Vehicles Covered Under Medicare? Yes, but make sure a specialist orders the POV and thorough documentation exists to prove it is medically necessary. Under what Conditions Does Medicare Reimburse for the Cost of a Power Operated Vehicle? If medically necessary, Power Operated Vehicles (POVs), such as "Scooters," are covered under … [Read more...] about Granny Get Your Scooter!
HIPAA: What You Really Need to Know
For more information contact Jerri Lynn Ward. Posted November 13, 2002 Applicable to All Covered Entities The Privacy Rule under HIPAA requires that all covered entities be compliant by April 14, 2003. As of November 14, 2002 you have less than 6 months to make your facility, business, office or practice HIPAA compliant. HIPAA contains over 400 pages of legalese that the average healthcare provider has little time to read and analyze. The following is a short summary of those 400 … [Read more...] about HIPAA: What You Really Need to Know
ICF-MR’s and the Aftermath of Texas Home Management, Inc. vs. Peavy
For more information contact Jerri Lynn Ward. Applicable to ICF-MR's Posted March 25, 2003 The recent Texas Supreme Court Case, Texas Home Management, Inc. vs. Peavy has, again, proven the axiom, bad facts make bad law. In October 2002 the Texas Supreme Court held that an ICFMR might be liable for a murder committed by a resident, while he was on an unsupervised home visit. A facility owned and managed by Texas Home Management, Inc. ("THM") allowed a consumer with violent tendencies, … [Read more...] about ICF-MR’s and the Aftermath of Texas Home Management, Inc. vs. Peavy
Reporting Deaths to the Attorney General’s Office
By Jerri Lynn Ward, J. D. Garlo Ward P.C. www.garloward.com Posted February 12, 2004 Said the cunning Spider to the Fly, " Dear friend what can I do, To prove the warm affection I 've always felt for you? I have within my pantry, good store of all that's nice; I'm sure you're very welcome -- will you please to take a slice?" "Oh no, no," said the little Fly, "kind Sir, that cannot be, I've heard what's in your pantry, and I do not wish to see!" Alas, alas! how very soon this … [Read more...] about Reporting Deaths to the Attorney General’s Office
Barbarians At Your Door: Of the MFCU, the OIG and Formidable Alliances
By Jerri Lynn Ward, J.D., Garlo Ward, P.C. www.garloward.com Posted October 4, 2004 It was a time when reimbursements were cut to the bone, and when Providers were set upon by Regulators and Plaintiff's Personal Injury Lawyers. It was an age undreamed of— when out of Austin Texas a New Threat appeared! Let me tell you of the days when there appeared... Barbarians at your Door!!! In 2003, the Legislature, faced with a shortfall of revenue, delivered two successive and painful … [Read more...] about Barbarians At Your Door: Of the MFCU, the OIG and Formidable Alliances
Change in Survey Procedures When New Deficiencies Found on a Follow-Up Survey!
Posted June 15, 2000 Effective January 1, 2000, HCFA is continuing remedies when, on a follow-up survey, the deficiencies from the initial survey are determined corrected but new deficiencies are identified. Previously, this situation resulted in ending the previous action and a new action began. Now the entire period from the first survey until all deficiencies are corrected is considered the period of noncompliance, even though the deficiencies from the first survey are determined … [Read more...] about Change in Survey Procedures When New Deficiencies Found on a Follow-Up Survey!
Serious Effects of a DOPNA (Denial of Payment for New Admissions)
by Jerri Lynn Ward, Garlo Ward, P.C. Posted December 28, 2000 As many of you know, a common adverse action recommended by the Texas Department of Human Services is the Denial of Payment for New Admissions or DOPNA. Generally, this recommendation is accepted and imposed by the Health Care Financing Administration. In the past it was understood a facility would receive a refund for any payments denied for new admissions should the facility clear before the DOPNA went into effect. (Often … [Read more...] about Serious Effects of a DOPNA (Denial of Payment for New Admissions)
How To Save Money & Work With Your Attorney
Posted March 26, 2001 Adversarial matters in health care are unfortunately becoming more numerous and frequent, from patient or employee related claims or litigation to administrative law proceedings based upon facility investigations by government regulators. At Garlo Ward, P.C., we strive to assist our clients to address and resolve such legal matters in the most expeditious and cost-effective manner possible. For that reason, this article explores the ways in which clients can work closely … [Read more...] about How To Save Money & Work With Your Attorney
Interpretation of “Neglect” Under 242.133 of the Health & Safety Code
Posted June 27, 2001 In November of 2000, the Houston Court of Appeals (145th District) interpreted the meaning of "neglect" under the Health & Safety Code in Gonzales v. Methodist Retirement Communities, 33 S.W.3rd 882. Because the legislature did not define this term, the Court looked at common usage. Looking at dictionaries such as Webster's, the Court focused on terms such as "omit, disregard, and ignore." Thus, the Court concluded that the intent: "most likely meant in Section … [Read more...] about Interpretation of “Neglect” Under 242.133 of the Health & Safety Code