Tag: Medicare

Long-term care providers showing progress in quality improvement activities

The Medicare Payment Advisory Commission’s latest report to Congress was submitted Friday with previously known recommendations for payment levels. Included in the report is a body of research indicating that long-term care providers are showing progress in quality improvement activities. Potentially avoidable hospital readmissions dropped 1% during the study period of 2011-2012, which is the first decline […]

Ask the expert: Beginning skilled therapy

Q: What day should a new admit to a skilled nursing facility begin the skilled therapy that is ordered by a physician if that resident is going to be Medicare Part A secondary to therapy? A:  Most of the time patients have other nursing skilled needs in addition to the therapy.  However, in order to be […]

New blood test can detect Alzheimer’s

A new blood test that predicts the onset of Alzheimer’s disease and mild dementia could lead to more effective management and even prevention of these conditions, according to research published in Nature Medicine. The study involved 525 participants who were over 70 years old. The participants gave blood samples throughout the trial period, and investigators […]

Adverse events occur during SNF stays

A recent study published by the Office of the Inspector General (OIG) found that over 20% of Medicare beneficiaries experience adverse events during their SNF stay. The study also found that an additional 11% experience temporary harm events during their SNF stay. The study estimated the national incidence rate, preventability, and cost of adverse events […]

Ask the expert: Part A to Part B billing

Q: When a Part A resident exhaust their Part A days and needs continued therapy under Part B, we have been writing the Part B POT and obtaining a signature by the MD. We have not billing for the Part B evaluation because it is a continuation of services. Is this correct?  Is there any CMS […]

2015 CMS updates provide increased quality and value for Medicare beneficiaries

The Centers for Medicare & Medicaid Services (CMS) has just released its 2015 proposal for payment and policy updates for Medicare Health and Drug plans. Beneficiaries can get greater protections, value, and care in the Medicare services they receive through the proposed policies. The 2015 Advance Notice and draft Call Letter takes steps to improve […]

Ask the Expert: Observation status

Q: A nursing home sends a SNF patient to the emergency room, after a fall.  A small scalp laceration is sutured, and a CT scan of the head shows no abnormality.  The patient is stable, and a decision is made by the treating physician, that the patient can return to the nursing home.  The patient’s primary […]

Ask the expert: Jimmo v. Sebelius settlement

Q: What is the most recent news in regard to the Jimmo v. Sebelius settlement? A: The Centers for Medicare & Medicaid Services (CMS) recently made a clarification to the Transmittal that details this settlement. The revisions in Transmittal 176 incorrectly indicated that skilled physical therapy services in the skilled nursing facility (SNF) setting must […]

AHCA finds long-term care services underfunded by Medicaid

The American Health Care Association (AHCA) released a report today demonstrating that the long term care services are significantly underfunded by Medicaid. The report estimates that the nation will have the highest Medicaid shortfall on record for 2013—over 7.7 billion dollars. On a daily basis, the shortfall is $24.26 per Medicaid patient. This shortfall is […]