Based on the OIG Audit Report: Financial Impact of Clustering Therapy Services During MDS Assessment Look-Back Periods for Texas Medicaid Residents of Long-Term Care Nursing Facilities, Texas HHS has issued a provider letter for Nursing facilities outlining best practices: ? Resident functional declines that do not warrant a significant change in status assessment (SCSA) should be clearly documented in the clinical record to support therapy evaluation and treatment orders. ? … [Read more...] about Nursing Facility Rehabilitation Services & Best Practices Provider Letter–Texas
Texas HHS Provider Letters for July 2019
HHS released three provider letters in July, 2019. The are as follows: On July 3, 2019 HHS released PL 19-16 regarding Responsibility for Records after a Management Change. The letter applies to Assisted Living Facility (ALF), Day Activity and Health Services (DAHS) Facility, Home and Community Support Services Agency, (HCSSA), Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions (ICF/IID), Nursing Facility (NF), and Prescribed Pediatric … [Read more...] about Texas HHS Provider Letters for July 2019
Rural Health Care in the News
Two interesting articles have been recently published. One deals with the closing of the hospital in rural Milam County, Texas. This has caused residents to travel further for care and has disincentivized some to seek needed care. Days after the two hospitals in Milam County abruptly shuttered in December, Renee Mueck started feeling stomach pain so sharp she couldn’t drive herself to the nearest hospital about 40 minutes away. Mueck, 60, said her husband drove her to a hospital … [Read more...] about Rural Health Care in the News
CMS Allows Arbitration Agreements in Nursing Homes, Delays Phase 3 ROP’s
The CMS has issued a final rule to allow pre-dispute arbitration agreements under the condition that the residents' receipt of care is not conditioned on signing them. Providers must inform residents or their representatives that they do not have to sign the agreement. The purpose of the rule is to: The CMS proposal supports patients and their caregivers by removing the ban on binding arbitration agreements while requiring nursing homes to ensure residents have the ability to choose … [Read more...] about CMS Allows Arbitration Agreements in Nursing Homes, Delays Phase 3 ROP’s
Nursing Home Staffing Levels Lower than Reported?
Modern Healthcare magazine is reporting that the results of a study published in Health Affairs are indicating that staffing levels are "often lower than reported" and "below what CMS expects." One area of special concern is staffing of RN's: "The numbers were most stark for RNs, where 91% of the organizations met expectations less than 60% of the time. Almost all facilities are required to have at least one RN on site for at least eight hours every day. But nearly 4% of … [Read more...] about Nursing Home Staffing Levels Lower than Reported?
Comprehensive Review of Nursing Home Regulations Planned?
Administrator Seema Verma has directed CMS to undergo a comprehensive reive of nursing home regulations, guidance and processes: Administrator Seema Verma said that the goal is to bolster safety and quality in SNFs across the country. “This is not business as usual — we are pushing beyond the status quo,” she wrote in a blog post Monday. “CMS’ approach to oversight of nursing homes is constantly evolving,” she added. “Just as we’re unleashing innovative strategies and technologies in other … [Read more...] about Comprehensive Review of Nursing Home Regulations Planned?
Hospital Re-Admissions and the Elderly
The New York Times is writing about the ACA's Hospital Readmissions Reduction Program and the question of whether or not this is causing increased mortality among older patients. This should be of increased interest to nursing facilities since the refusal of readmission after a nursing home sends a resident to the hospital and subsequent death of the resident when returned to the facility may increase scrutiny of the nursing home rather than the correctness of a hospital refusing … [Read more...] about Hospital Re-Admissions and the Elderly
Use of Marijuana in Nursing Homes? Obstacles to Medical Marijuana Weaken.
A nursing home in the Bronx began a cannabis program in 2016 and is having good results: The Hebrew Home at Riverdale, in the Bronx, first launched its “innovative” new cannabis program in 2016. With it, the facility provided educational sessions and a fact sheet on the often-misunderstood drug to both residents and their family members. About 10 residents have participated so far, and they have reported that cannabis has helped to lessen the severity of chronic pain and reduce opioid … [Read more...] about Use of Marijuana in Nursing Homes? Obstacles to Medical Marijuana Weaken.
Texas HHS Provider Letters
Three provider letters have been released by Texas HHS since December 10, 2018: Acceptable Documentation for a Criminal History Check (replacing old letters), released on January 1, 2019, describes the documentation that Alf's, DAH, HCSSA ICF/IID, NF, and PPECC may use to show that a criminal history check has been conducted, as well that the provider reviewed the results and determined that there was no impediment for employment. It also details what is not acceptable documentation and what … [Read more...] about Texas HHS Provider Letters
Immediate Jeopardy Decision Upheld by 7th Circuit Court of Appeals
The 7th Circuit upheld a finding of Immediate Jeopardy regarding sexual encounters between residents with dementia. The facility in question had a "policy of intervening in sexual encounters only when “outward signs” of non-consent were displayed, according to court documents." CMS determined that this was not adequate to protect residents and fined the facility for $83,000. The appeal by the facility argued that the residents have a right to have consensual intimate relationships, … [Read more...] about Immediate Jeopardy Decision Upheld by 7th Circuit Court of Appeals