Articles and Blogs

The Centers for Medicare & Medicaid Services (“CMS”) has recently instructed contractors to reopen certain claims that were previously denied for failure to meet the “face-to-face” requirements in certain circumstances and assuming all content requirements of the certification and the face-to-face documentation are otherwise met.  It came to CMS’ attention that certain claims were... READ MORE

On November 30, 2011, Daniel R. Levinson, Inspector General, appeared before the Special Committee on Aging, and testified regarding the Office of Inspector General’s (OIG) findings pertaining to the use of atypical antipsychotic drugs by nursing home residents. The OIG hired psychiatrists who are experts in treating elderly patients to review a sample of... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) announced yesterday the timeline for Round 2 competitive bidding for Durable Medical Equipment, Prosthetics, Orthotics and Suppliers (“DMEPOS”), with registration set to begin on December 5, 2011. According to the release from CMS, the 60-day bid window for Round 2 and the National Mail-Order Competition for Diabetic... READ MORE

In the next Centers for Medicare & Medicaid Services (CMS) Open Door Forum conference call, CMS will discuss the top regulatory issues skilled nursing providers face.  The monthly CMS Open Door Forum provides an opportunity for providers to listen to CMS discuss current topics, as well as participate in a Q&A session.  The next Open Door Forum is scheduled... READ MORE

The Elder Justice Act (EJA) was enacted as part of the Patient Protection and Affordable Care Act (PPACA) in March, 2010, and creates a duty for long-term care providers to swiftly report any reasonable suspicion of a crime committed against any individual who is a recipient of care from the facility, or face significant... READ MORE

The National Fire Protection Association (NFPA) has recently released the 2012 Edition of the Life Safety Code (LSC).  Currently, the Centers for Medicare & Medicaid Services (CMS) enforces the 2000 Edition of the LSC.  The updated LSC includes many changes for health facilities, and addresses cultural changes for nursing homes.  For instance, to move... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) just released a Survey & Certification Letter (S&C: 12-04-NH) to address a recent report of a nursing facility resident death due to a smoking accident.  A resident who was deemed appropriate to smoke unsupervised, but failing to wear a smoking apron, died as the result of... READ MORE

Change Request (CR) 6421 was recently revised to remove chiropractors from the list of providers who may order or refer for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).  All other information in the CR remained the same.  As you will recall, in CR 6421, the Centers for Medicare & Medicaid Services (CMS) started the expansion of claim editing to... READ MORE

The Occupational Safety and Health Administration (“OSHA”) has included nursing facilities in their Site-Specific Targeting 2011 (“SST-11”) Plan for facilities with high rates of injuries and illnesses experienced by workers.  The SST-11 selects individual facilities for inspection identified through the 2010 Data Initiative survey.  OSHA will target facilities with specific Days Away, Restricted, or... READ MORE

This past September, the Centers for Medicare & Medicaid Services (“CMS”) posted revised interpretive guidelines concerning the use of feeding tubes in nursing homes.  In late October, CMS retracted the Survey & Certification Letter detailing the revised changes so they could include instructions that pertain to the Quality Indicator Survey (“QIS”).  Further revised interpretive... READ MORE