Articles and Blogs

On March 4, 2020, the Quality, Safety & Oversight Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum entitled “Suspension of Survey Activities” (“QSO Memo”) to announce that it is suspending non-emergency inspections across the United States so that inspectors may focus on infectious diseases and abuse. CMS states this... READ MORE

Centers for Medicare & Medicaid Services (“CMS”) is revising its Nursing Home Compare Five-Star Quality Rating System to add a red alert icon to a skilled nursing facility’s profile if the facility has had a high-level abuse citation and/or repeat abuse citations. Changes to CMS Nursing Home Compare Website On October 7, 2019, CMS... READ MORE

On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE

As part of the Patient Protection and Affordable Care Act (PPACA), the Office of the Inspector General (OIG) was mandated to submit a report to Congress evaluating the Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long Term Care Facilities and Providers (commonly referred to as the “Background... READ MORE

On September 14, 2012, CMS published a Survey and Certification letter addressing “Hand in Hand: A Training Series for Nursing Homes.” This training is in response to Section 6121 of the Affordable Care Act, which requires that CMS ensure that nurse aides receive regular training on caring for residents with dementia and prevention of... READ MORE

The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities.  Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements.   READ MORE

Vermont Governor Peter Shumlin recently signed Vermont House Bill 413 into law.  The new law adds a new section to Vermont’s laws on abuse, neglect and exploitation of vulnerable adults residing in long term care facilities.  The new section allows Vermont’s Attorney General the right to pursue a civil action against individuals, nursing homes... READ MORE

The Centers for Medicare & Medicaid Services (CMS) just released a final rule requiring all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted... READ MORE

The Centers for Medicare & Medicaid Services (CMS) has pushed back the start of two anti-fraud programs to June due to provider concerns.  Two pilot programs, one that would require prior authorization for scooters and power wheelchairs and one allowing recovery audit contractors (RAC) to review claims prior to payment, were initially slated to begin January 1, 2012.   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