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?
Calls in Texas for Medicaid Expansion
Health care advocates gathered at the Texas Capitol calling for the expansion of Medicaid citing the number of uninsured Texans. The participants called for a state-wide ballot to amend the Texas Constitution regarding the issue. There are a bill and a Senate Joint Resolution supporting such a measure: At the rally, state Sen. Nathan Johnson, D-Dallas, said Texas should follow the lead of other states in expanding Medicaid. Johnson said it’s time that Texas lawmakers looked … [Read more...] about Calls in Texas for Medicaid Expansion
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
Administration Considering Pulling Medicare Coverage from Some Drugs to Encourage Negotation of Price
In an effort to give insurers leverage for negotiation, Trump is advocating pulling protections guaranteeing Medicare coverage: Pharmaceutical companies that raise the cost of certain drugs risk losing protections that guarantee Medicare coverage, part of a Trump administration proposal to give insurers leverage to negotiate lower prices. The U.S. Centers for Medicare and Medicaid Services on Monday proposed exceptions to six protected classes of treatments for illnesses … [Read more...] about Administration Considering Pulling Medicare Coverage from Some Drugs to Encourage Negotation of Price
Newly Adopted Rules for ALF’s, DAHS’s, ICFs/IID, NF’s and Pediatric Extended Care Centers
Texas HHSC has adopted one new rule and several amendments to rules in the Texas Administrative Code, implementing legislation from HB 2025 passed in 2017. The rules were effective on October 28, 2018, but HHSC is giving Alf's, DAHS facilities and NF's until May 1, 2019 to develop and implement the policies related to Alzheimer's training. Enforcement on the other rule changes will be enforced now. The provider letter announcing this can be found here. The Texas Secretary of State has … [Read more...] about Newly Adopted Rules for ALF’s, DAHS’s, ICFs/IID, NF’s and Pediatric Extended Care Centers
Pre-Claim Review for Home Health Agencies Back on the Table
In 2016, CMS rolled out a pre-claim review demonstration which was stopped by stakeholders with the aid of Congress. The initiative was to require that claims be sent in earlier in the claims process. CMS has revived the initiative with some modifications. Policy experts believe that stakeholders will not be able to stop the new version of the pre-claim review. The April 2018 report of the Government Accountability Office was probably the death knell for the efforts of opponents. … [Read more...] about Pre-Claim Review for Home Health Agencies Back on the Table
Pay Bumps for Physical Therapists
McKnight's News is reporting that long-term-care physical therapists working through home health and hospitals are getting larger raises. This is based on data from the Hospital & Healthcare Compensation Service. According to McKnight's: Providers should “ be creative in offering incentives for your rehab employees to stay with you beyond the typical raises,” said Rosanne Zabka, director of reports for H&HCS. Options include offering perks such as extra days off, … [Read more...] about Pay Bumps for Physical Therapists
