National reports by Human rights advocates say that nursing homes are overprescribing antipsychotics to patients. According to the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Yet advocacy groups reveal that misuse of drugs remains a major problem in nursing facilities. The findings outlined in a … [Read more...] about Elderly patients at risk at Nursing homes that overmedicate
CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
CMS is adding flexibility to their expansion of benefits by redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports and more. Hospice care and palliative care are considered as well as supplemental benefits down the road. Benefits will only be available to some of the participants of Medicare Advantage plans. These benefits will not be extended to original Medicare. Supplemental … [Read more...] about CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
Changes to HHSC-Approved Diagnostic Codes for Persons with Related Conditions List
Information Letter No. 18-04 This letter provides an annual update to the International Classification of Diseases, Tenth Revision (ICD-10) code set as of October 1, 2017, which includes new and revised ICD-10 diagnostic codes. Health and Human Services Commission (HHSC) has revised the HHSC-Approved Diagnostic Codes for Persons with Related Conditions. List of Invalid ICD-10 Related Conditions Codes: The following ICD-10 diagnoses codes are no longer valid and were deleted from the … [Read more...] about Changes to HHSC-Approved Diagnostic Codes for Persons with Related Conditions List
Nursing Facilities – Immediate Threat Violations
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
PPAT Notice For Draft Rule Amendments Regarding Abuse, Neglect & Exploitation
Texas Health and Human Services (HHS) implemented rules that address changes in the authority of the DFPS Adult Protective Services (APS) Provider division, as amended by SB 1880 and SB 760, 84th Legislative Session (2015). The changes give the APS Provider division the authority to investigate an allegation of abuse, neglect, or exploitation (ANE) of an adult or child who receives a service from a provider who contracts with HHSC to provide Medicaid waiver or Medicaid state plan services and … [Read more...] about PPAT Notice For Draft Rule Amendments Regarding Abuse, Neglect & Exploitation
