A report released recently released by the Office of Inspector General (OIG) at the US Department of Health titled: Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity has highlighted that hospice care fraud is a nationwide problem in the US. The report found that hospices do not always provide needed services to beneficiaries and sometimes provide poor quality care for Nursing home residents and other patients. When care is provided hospices’ inappropriate … [Read more...] about HHS Releases Report on Hospice Care Fraud in US
New CMS payment system for skilled nursing facilities reimburses providers for care not volume
CMS new Patient-Driven Payment Model (PDPM) will be implemented on Oct. 1, 2019. CMS finalized the Patient-Driven Payment Model for skilled nursing facilities (SNF), which will link Medicare payments to value and care, rather than volume/ fee-for-service care. The rule according to news reports “would reduce documentation standards around patient assessments, saving facilities approximately $2 billion over 10 years," and would "give a $975 million collective raise next year to post-acute care … [Read more...] about New CMS payment system for skilled nursing facilities reimburses providers for care not volume
Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Information Letter No. 18-07 - Addressed to Nursing Providers. Nursing Facility (NF) providers MUST ensure that a designated resident has a valid Daily Care service authorization reflected on the Medicaid Eligibility Service Authorization Verification (MESAV) at the significant steps in the submission and approval process for NF Specialized Services. The letter addresses how to minimize billing issues. NF staff must ensure all appropriate and necessary forms and assessment submissions have … [Read more...] about Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
Beginning on Jan. 1, 2019, physician assistants can now supervise cardiac and pulmonary rehabilitation programs under the Medicare program as well as provide and manage Hospice care for terminally ill Medicare patients. The extended medical privileges for physicians assistants could benefit Medicare beneficiaries who live in medically underserved and rural communities, where a PA might be the only available medical professional to provide some services, according to news reports. According to … [Read more...] about New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
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
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
Physician shortage in Texas spells major issues for aging population
43 US states have a higher proportion of primary care physicians to residents than Texas and 35 out 80 Texas counties have no doctors at all. According to news reports, there are not enough doctors in Texas, especially in certain rural stretches of South Texas. The shortage will require training — and retaining — more physicians in Texas but one main problem is that the state needs to add more residency slots for post-graduate medical training to remain competitive — a problem that has plagued … [Read more...] about Physician shortage in Texas spells major issues for aging population
The Future of Assisted Living Communities headed for change
As the number of elderly population requiring living facilites rises the new preferences of those older adults will drive changes to assisted living communities in the future, according to a new report on Assisted Living. The report identified 4 ways these communites could change in the future for elderly residents and their providers. The report, Real Trends. The Future of Real Estate in the U.S. identified technology, demographics and policy as some of the significant areas that will … [Read more...] about The Future of Assisted Living Communities headed for change
Health Care Providers See Millennials as Key to Nursing Shortage
Shortage of Nurses and nursing providers have increased as more of the population retires. Millennials, who fall between the birth years of 1982 to 2000 are the top age group that is becoming the largest group in the in-home care workforce. According to a new study published in the October edition of Health Affairs an average millennial is now 186% more likely to become a registered nurse (RN) compared to baby boomers who's generation are the ones most typically in the highest leadership … [Read more...] about Health Care Providers See Millennials as Key to Nursing Shortage
HHSC Requires Providers to Immediately Redo all Nurse Aide Registry Status Searches
Provider Letter No. 17-24 All Providers who used the Nurse Aide Registry(NAR) from June 14, 2017, through August 3, 2017 are now required by HHSC to recheck the status searches due to an error by contractor Pearson Vue which placed ineligible nurse aides on “Active” status and mailed these ineligible individuals an invalid certificate. This error also caused 50 inaccurate event-based emails to be sent to 19 individual candidates. If a search result now shows that a nurse aide is not in … [Read more...] about HHSC Requires Providers to Immediately Redo all Nurse Aide Registry Status Searches