Articles and Blogs

On August 2, 2013, the Centers for Medicare and Medicaid Services (“CMS”) issued an update to the State Operations Manual (“SOM”) regarding the process for notification of a facility closure.  The updates to the SOM are the result of a final rule published in the Federal Register on March 19, 2013 and can be... READ MORE

One of the main admission requirements for a skilled stay in a skilled nursing facility (“SNF”) is a three-day qualifying stay in an inpatient hospital.  In response to a question discussed on a recent Open Door Forum, the Centers for Medicare & Medicaid Services (“CMS”) released a memorandum discussing if a stay in a... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has rated nursing facilities since 2009 for three areas of performance: Health Inspections, Staffing, and Quality Measures. From 2009 through 2011, more than 40% saw an improvement in overall rating, while only around 27% had a most recent rating that was lower than the first.  READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) issued a Survey and Certification Letter as a reminder of current regulations (42 C.F.R. 483.10(j)) delineating the rights of long term care (“LTC”) residents to receive family and non-family visitors.  The current guidelines grant broad discretion to the residents with respect to visitation.  Facilities must provide 24-hour... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final rule for fiscal year (“FY”) 2014 skilled nursing facility (“SNF”) prospective payment system (“PPS”) rates.  These rates will take effect October 1, the start of FY 2014.   READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently issued the final rule for hospice agreements with long-term care (“LTC”) providers.  The rule requires LTC facilities to have written agreements specifying the respective roles and responsibilities for the hospice and LTC provider for any arrangements for the provision of hospice care within the LTC facility.... READ MORE

On July 12, 2013, CMS issued S&C: 13-46-ALL regarding changes for State Survey Agency (“SA”) obtaining OCR information from providers seeking initial enrollment in the Medicare program or for providers undergoing a change of ownership (“CHOW”).  In the past, the SAs would send the provider an OCR clearance request with the initial Medicare enrollment packet. ... READ MORE

On June 27, 2013, CMS released the proposed home health prospective payment rule (the “PPS Rule”) for calendar year 2014.  While refinements to the ICD-9-CM and discussions of ICD-10-CM implementation are of interest, the most notable change to the PPS Rule for 2014 is CMS’s long-awaited proposal for rebasing home health payments.  Once it... READ MORE

Originally due last Fall, the Centers for Medicare & Medicaid Services (“CMS”) has published the Quality Assessment and Performance Improvement (“QAPI”) Provider Toolkit and Provider Resources for skilled nursing facilities (“SNFs”).  These items have been published on a new CMS website dedicated to helping SNFs develop and implement a QAPI program, as required by... READ MORE

Please find below the frequently asked questions (“FAQs”) the Centers for Medicare & Medicaid Services (“CMS”) recently released concerning therapy caps and advanced beneficiary notice of noncoverage (“ABNs”). READ MORE