Articles and Blogs

Reimbursement under the new Patient Driven Payment Model, staff background checks, infection control programs, facility-initiated transfer or discharge of a resident and the use of psychotropic drugs are several new skilled nursing facility (“SNF”) areas of audit and focus of Department of Health and Human Services Office of Inspector General (“OIG”). OIG publishes updates... READ MORE

On April 8, 2021, the Quality, Safety & Oversight Group at Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum entitled “Updates to Long-Term Care (LTC) Emergency Regulatory Waivers Issued in Response to COVID-19” (“Blanket Waiver Update Memo”) that announced the termination of several blanket waivers for skilled nursing facilities (“SNFs”) related to resident... READ MORE

On March 13, 2020, the Quality, Safety & Oversight Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a second revision of a memorandum entitled “Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (“COVID-19”) in nursing homes (REVISED)” (“QSO Memo”) that announced recommendations for skilled nursing facilities (“SNFs”) regarding restricting visitors, transfers... READ MORE

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). Hall Render published an overview of Final Regulations components as well as Parts 1,... READ MORE

Review of the New Home Health Conditions of Participation – Patient Rights (part 2). This is the fifth article in a series discussing CMS’s Final Revised Home Health Conditions of Participation (“Final CoPs”). With the release of the Final CoPs, CMS is finalizing the significant changes they proposed to make to the home health... READ MORE

On August 25, 2014, CMS issued a survey transmittal regarding the need for nursing homes to complete a discharge assessment when a resident transfers from a SNF and/or NF certified bed to a non-certified bed in the same facility.  CMS issued this transmittal to reinforce to facilities that discharge assessments are critical to ensure the... READ MORE

On August 23, 2013, the Centers for Medicare & Medicaid Services (“CMS”) published a memorandum that addressed issues arising from incomplete, inaccurate and missing Minimum Data Set (“MDS”) Discharge Assessments that adversely affect Skilled Nursing Facilities (“SNFs”) and Nursing Facilities (“NFs”).  Under 42 C.F.R. §§ 483.20(g) and (f)(1), SNFs and NFs are required to... READ MORE

The United States Bankruptcy Court for the Eastern District of Kentucky held that the wife of a nursing home resident was contractually bound through a nursing home admissions agreement to apply for Medicaid benefits on behalf of her husband and who failed to do so, could not discharge the amount due to the nursing... READ MORE

The Centers for Medicare & Medicaid Services (CMS) has published a transmittal detailing changes for coding hospice discharges, which will provide greater clarity as to why the patient has been discharged from hospice care.   READ MORE

As previously discussed, hospice providers are required to have a hospice physician or nurse practitioner perform a face-to-face encounter with each hospice patient whose total length of stay is anticipated to reach the third benefit period.  This encounter must be performed no more than thirty days prior to the third benefit period recertification, and... READ MORE