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
Trump appears to continue his drive to implement the block grant approach to decrease costs for skilled nursing through Medicaid, though it is unclear whether he will do it through spending caps or stricter requirements for block grants: Trump sent providers reeling shortly after his inauguration when he made a first run at instituting the block grant approach. Healthcare providers and consumers banded together to beat back the contentious effort. It is believed that this time, … [Read more...] about Trump May Sidestep House to Rein in Spending for Skilled Nursing
A plan is being formulated by the Trump Administration in the event the lawsuit by states to strike down is successful: The Trump administration is formulating a backup plan to ensure that Obamacare customers can still get insurance if a state-driven lawsuit is successful in striking down the 2010 health law. Seema Verma, administrator for the Centers for Medicare and Medicaid Services, declined to give details of those plans or who might be covered, but the fact that planning is underway … [Read more...] about Backup Plan in the Event Obamacare Struck Down
Provider Letter No. 17-18 - (Replaces PL 14-13). The examples in this letter are not all inclusive. Many other possible scenarios are reportable. The law requires an owner or employee of a NF who has cause to believe that the physical or mental health or welfare of a resident has been or may be adversely affected by abuse, neglect or exploitation. Attachements included instruct guidance to NFs on resident-to-resident incidents, including sexual activity, and on how to determine whether NFs must … [Read more...] about Abuse, Neglect, Exploitation, Misappropriation of Resident Property, and Other Incidents that Must Be Reported to DADS
Provider Letter No. 17-19 - The Texas Department of Aging and Disability Services (DADS) amended existing rules in 40 TAC Chapter 18, Nursing Facility Administrators (NFAs). These changes were initiated to:• clarify when a NFA may request an informal review;• update the time frame for requesting a formal hearing; and• amend the list of violations that lead to sanctions.There are amendments to 40 TAC §18.52, 40 TAC §18.53 & 40 TAC §18.54.You may access the amended rules for Chapter 18 … [Read more...] about New Rule Amendments in Texas Administrative Code (TAC) for NFA’s
An essential element of an effective health care compliance plan is the internal investigations policy. Actions by employees, acting in the course and scope of their employment, can subject corporations to civil and criminal liability. Detecting, investigating and remedying such situations are crucial given the regulatory environment under which health care companies operate. The conduct of the investigation itself can exacerbate the situation. Employees subjected to discipline may … [Read more...] about Risk Reduction and the Internal Investigation Policy
The following information was obtained from the October 25 issue of the Texas Register. Proposed Rules The Texas Medical Board proposed to amend §192.1, Definitions, which would add language providing that the administration of certain local anesthesia, peripheral nerve blocks, or both in a total dosage amount that exceeds 50 percent of the recommended maximum safe dosage per outpatient visit is a Level II service. See the Texas Register for details. Withdrawn Rules The Texas Medical … [Read more...] about TX Register Updates: Level II Service, ACA Reqs.
Don't forget the September 23, 2013 deadline to comply with the HIPAA mega rule. Focus on the following: Business Associate Agreements Updating "Notice of Privacy Practices" Adding privacy and security changes to policies and procedures Revising your security breach protocol Encrypting as much as possible Educating staff about the new requirements Also, please note that breaches by your business associates and their subcontractors are your responsibility under the new rules. … [Read more...] about HIPAA Alert!!
http://youtu.be/aZNMNvHJYgc At the conclusion of the onsite review, the HHSC-OIG nurse reviewer must hold an exit conference with the nursing staff. The Administrator, DON, charge nurse and other leadership of the facility should attend in order to gain a full understanding of the findings by the nurse reviewer. The nurse reviewer is mandated to provide “formal written notification of all MDS validation findings during the exit process.” You will receive a “List of … [Read more...] about RUG Reviews: The Exit Conference
http://www.youtube.com/watch?v=gAJV7FsoXkg During the exit interview of a RUG review, you will be asked to sign and initial documents. It is very important that you understand what you are initialing or signing. Carefully review the document that you are asked to sign and ask questions if you don’t understand it before you sign or initial. These documents create a record that may become relevant in a Reconsideration or Appeal. Let us discuss the details by first reviewing the … [Read more...] about RUG Reviews: Signing Documents Provided by the Reviewers