Hall Render

AUGUST 21, 2023

Nursing homes are critical in providing residents with care, comfort and dignity. Nursing homes need to navigate this delicate terrain with care, sensitivity and a commitment to creating a safe and respectful environment for all residents.

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The Health Law Firm Blog

OCTOBER 5, 2023

Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

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Healthcare Compliance Blog

APRIL 18, 2022

A certified nurse’s aide (CNA) who was working in an Oklahoma nursing home has pled guilty to stealing money from a resident. Our office will not tolerate the financial exploitation of our beloved nursing home residents, no matter how large or small the amount.”.

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Healthcare Compliance Blog

MAY 25, 2022

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has excluded a Louisiana man from participation in federal healthcare programs due to his ownership interest in seven Louisiana nursing homes that OIG previously excluded. As a result, OIG has excluded the nursing homes and their owner.

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Healthcare Compliance Blog

JANUARY 18, 2022

On January 7, 2022, the Centers for Medicare & Medicaid Services (CMS) published a memorandum stating that nursing home staff turnover and weekend staffing will be posted on the Medicare.gov Care Compare public website. The QSO memorandum can be accessed at: QSO-22-08-NH (cms.gov).

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The Health Law Firm Blog

JULY 11, 2022

Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

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Healthcare Law Blog

AUGUST 25, 2023

On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) announced updates to the Medicaid overpayment self-disclosure program, which now includes an abbreviated process for reporting and explaining overpayments that are considered routine or transactional in nature and have been already voided and adjusted.

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Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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McBrayer Law Blog

OCTOBER 18, 2021

More > Tags: Centers for Medicare & Medicaid Services , Civil Penalties , CMS , Healthcare Providers , Long-Term Care , Long-Term Care Facilities , Medicare. For reference, the 2017 Guidance can be found here. The accompanying CMP Analytic Tool can be found here.)

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Hall Render

JUNE 30, 2022

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the quality of care and quality of life for residents. Hall Render blog posts and articles are intended for informational purposes only.

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Healthcare Compliance Blog

FEBRUARY 8, 2022

The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursing home residents. The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta.

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Healthcare Compliance Blog

MARCH 7, 2022

After an investigation into Colorado’s care for people with disabilities who reside in nursing homes, the Department of Justice (DOJ) concluded that the state unnecessarily segregates people with physical disabilities in nursing facilities. Interview residents to ensure that all safe discharge planning needs have been met.

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Health Law RX

SEPTEMBER 16, 2022

AHCA is sending out postcards to existing Florida Medicaid providers (Providers) alerting them to upcoming changes in the Florida Medicaid program. Providers are urged to sign into their account on the Florida Medicaid portal immediately. Medicaid Certified School Match Program Fee Schedule. Check your mailboxes.

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Healthcare Law Blog

DECEMBER 7, 2022

Leveraging Oversight to Better Protect Nursing Homes – In the introduction to this Semiannual Report, Grimm indicated that “providing quality and safety of care in the more than 15,000 Medicare- and Medicaid-certified nursing homes nationwide” is a “top priority” moving forward. FOOTNOTES. [1]

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Hall Render

MAY 2, 2023

For this alert, “nursing homes” refers to skilled nursing facilities (often known as “SNFs”). In 2020, CMS revised the nursing home infection control regulations at 42 CFR § 483.80 Additionally, this information is now publicly available on CMS’s COVID Nursing Home Data Website.

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Hall Render

JULY 5, 2023

When a patient is discharged from acute care, it is important that the acute care provider deliver accurate and appropriate patient information related to a patient’s treatment and condition in order to decrease the risk of readmission or an adverse event at the skilled nursing providers and home health agencies.

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Healthcare Law Blog

OCTOBER 27, 2022

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program.

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MedTrainer

JANUARY 30, 2024

In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them. Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes.

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Hall Render

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that calls for minimum staffing standards in long-term care facilities (“nursing homes”). Nursing homes would need to provide residents with a minimum of 0.55 HPRD for RNs and 2.45

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MedTrainer

SEPTEMBER 20, 2023

Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies. There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud. Accreditation.

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Provider Trust

AUGUST 9, 2023

Through collaborative efforts with partners such as the Department of Justice (DOJ), Medicaid Fraud Control Units (MFCUs), and various federal, state, and local law enforcement agencies, the OIG employs a comprehensive and data-driven approach to detect, investigate, and prosecute instances of fraud.

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Provider Trust

JULY 17, 2023

Their guidance aims to improve a number of potential risks within the healthcare space by improving care at nursing homes and strengthening the program integrity in managed care. OIG pointed to the increased instances of patient neglect abuse as well as the need for oversight within nursing homes.

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Healthcare Law Blog

DECEMBER 1, 2023

HHS-OIG conducted investigations resulting in 661 criminal actions against individuals related to Medicare and Medicaid, as well as 726 civil actions, including false claims, unjust-enrichment lawsuits, and civil monetary penalty settlements. Enhancing program integrity in noninstitutional care settings, such as home health and hospice care.

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Healthcare Law Blog

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 billion was spent on LTSS. This represents 13.2% of LTSS spending. [5]

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Healthcare Law Blog

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited proposal to establish new federal minimum staffing standards for long-term care facilities. [1] Nurse Aide (NA) HPRD (the “2.45 Nurse Aide (NA) HPRD (the “2.45 55 RN hours per resident per day (the “.55 55 RN HPRD”); and At least 2.45

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Health Law Attorney

JANUARY 13, 2022

The Centers for Medicare and Medicaid Services (“ CMS ”) has also taken recent action to implement a COVID-19 vaccine mandate. In November 2021, CMS issued an Interim Final Rule (“ IFR ”) that would require facilities receiving Medicare and Medicaid funding to ensure that their staff are vaccinated against COVID-19.

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Hall Render

JANUARY 11, 2022

Facing further confusion from skilled nursing facilities and families amidst the current spike in COVID cases in the United States, the Centers for Medicare & Medicaid Services (“CMS”) released additional best practices and addressed more issues that skilled nursing providers should follow as they encounter certain visitation scenarios.

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Hall Render

JANUARY 18, 2022

Amidst a nationwide nursing and skilled nursing facility staffing crisis, the Centers for Medicare & Medicaid Services (“CMS”) announced that additional information regarding nursing home staff numbers will be added to the January 2022 CMS Care Compare website. Weekend Staff.

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Healthcare Compliance Blog

MAY 18, 2022

The program is funded by the Centers for Medicare & Medicaid Services (CMS), and will establish a Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions (Center for Excellence).

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Hall Render

SEPTEMBER 22, 2023

CMS’s proposed nursing home staffing requirements will have a big impact on the industry. According to a KFF report , fewer than 1 in 5 nursing homes will meet the new requirements. The program will use Medicaid dollars to provide housing subsidies and tenant services.

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Healthcare Compliance Blog

JANUARY 10, 2022

A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursing home. He then used the debit card to make unlawful and unauthorized use of the victim’s funds or assets, which exceeded $500 within a six-month period.

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New Jersey Healthcare Blog

NOVEMBER 8, 2022

In October 2022, Centers for Medicare & Medicaid Services (CMS) made some significant changes to the Special Focus Facility (SFF) program that raise the bar for completion of the program and that increases enforcement actions for nursing homes that fail to demonstrate improvement. See 42 U.S.C. §§ 1819(f)(8), 1919(f)(1).

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Hall Render

DECEMBER 8, 2023

Skilled Nursing News reported that one of the unintended consequences of the SNF minimum staffing proposal may be less utilization of nursing homes, as residents may be shifted to assisted living and home and community-based services, with a boost from expanded Medicaid waivers.

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Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 With Medicaid, the challenges are equally formidable.

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Hall Render

FEBRUARY 27, 2023

Health Care Fraud Actions Medicaid. The Medicaid program was a target in 2022. DOJ recovered $260 million from a pharmaceutical company for its underpayment of rebates to the Medicaid program by improperly designating one product as a new drug. Hall Render blog posts and articles are intended for informational purposes only.

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Healthcare Law Blog

DECEMBER 19, 2022

In 2021, COVID-19 immunization rates among nursing home staff quickly rose due to federal vaccine mandates for healthcare workers and long-term care facilities participating in the Federal Pharmacy Partnership for Long-Term Care Program. viii] Who We Help – Nursing Homes | qioprogram.org. pdf (federalregister.gov).

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Hall Render

DECEMBER 20, 2023

Medicaid funding changes are also accelerating the move from nursing homes to home and community-based services. Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot give legal advice outside of an attorney-client relationship.

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