Articles and Blogs

Effective October 1, new PPS rules for fiscal year 2012 require nursing homes to diligently review claims prior to submission.  As previously discussed, significant cuts in SNF reimbursement are aimed mostly at therapy services.   SNFs submitting claims under the previous rules can expect high rates of denials and rejections.  Even facilities billing under the new... READ MORE

CMS has published a proposed regulation that would limit the ability of institutional pharmacies to offer pharmacist consultation services to facilities.  CMS believes that relationships between nursing homes and pharmacy suppliers could result in “recommendations that conflict with the best interests of nursing home residents.” The proposed regulation would require facilities to hire independent pharmacists to... READ MORE

CMS will host their monthly Skilled Nursing/LTC Open Door Forum on Thursday, October 20, from 2-3pm EST.  This call was originally scheduled on October 13.  The information to participate in the call is available here. The recent changes to MDS 3.0 and PPS are likely to be heavily discussed topics.    Should you have any questions, please contact: Todd Selby... READ MORE

Yesterday, CMS sent a new transmittal to the state survey agencies on the use of feeding tubes in nursing homes. In short, F321 has been combined into F322 and according the CMS the changes were made to provide nursing home surveyors with guidance to determine compliance with use of feeding tubes by nursing homes. ... READ MORE

CMS released a Survey & Certification letter today providing guidance for nursing homes that desire to utilize on-site gardens to provide fresh produce for residents. After numerous inquiries from facilities, CMS confirmed that residents can benefit from home-grown foods as long as food-borne illness dangers are mitigated to the greatest extent possible.  READ MORE

CMS recently published a Survey & Certification Memorandum (S&C:11-35-NH) detailing progress in the implementation of Section 6121 of the Affordable Care Act (ACA).  Section 6121 of the ACA mandates enhanced nurse aide training in nursing homes.  The enhanced training focuses on two areas: 1) how to care for residents with dementia, and 2) how... READ MORE

The US Office of Management and Budget has approved the revised Medicare Provider-Supplier Enrollment Applications, the CMS-855 forms.  These updates to the 2008 versions include multiple changes to comply with enhanced disclosure requirements. Such changes include:   READ MORE

The proposed agenda for today’s Home Health, Hospice & DME/Quality Open Door Forum is as follows: Hospice wage index final rule published; Hospice CR 7518 with FY 2012 updated rates and cap amount issued; Timeline for Hospice CAP changes; HHCAHPS Updates.  This is scheduled for Wednesday, August 17, 2011 from 2:00pm-3:00pm EST. Resistration for this... READ MORE

On July 29, 2011, CMS issued the following guidance for the use of video cameras in ICFs/MR: To ensure that clients’ rights are protected, the use of video cameras in the ICF/MR must be reviewed, approved and monitored by the Specially Constituted Committee (SCC) of the facility as constituted per 42 CFR 483.440(f)(3)(i-iii).  If... READ MORE

Earlier this week, we highlighted the implementation by Centers for Medicare & Medicaid Services (CMS) of enrollment revalidations and screening categories, and which categories CMS places certain long-term care providers. It is important for providers and suppliers to understand what each screening category (limited, moderate, or high) entails and be aware of any events... READ MORE