Tag: skilled nursing facilities

CMS Releases Proposed Rule Featuring Payment Updates for 2014

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule that would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for 2014 and would revise and rebase the SNF market basket. This proposed rule also includes a proposed policy for reporting the SNF market […]

FDA warns of potential infection risks tied to mattresses

In an April notice, the Food and Drug Administration (FDA) is alerting health care providers, health care facility staff, and caregivers that damaged or worn covers for medical bed mattresses can allow blood and body fluids to penetrate medical bed mattresses, posing a risk of infection to patients. The FDA is providing recommendations for reducing […]

Ask the expert: Medicare coverage

Q: A resident in a SNF has not used her Medicare benefit since 2005. She was receiving rehab therapy 5x week prior to qualifying for a hospital stay. Are we allowed to skill her upon re-admission? A: Your question cannot be answered without more information.  Did the beneficiary ever go 60 days without receiving skilled […]

CMS releases fact sheet on Jimmo v. Sebelius settlement

As MDS 3.0 Insider previously reported, a settlement in the Medicare Improvement Standard case, Jimmo v. Sebelius, was approved on January 24, 2013. Now CMS has released fact sheet that gives an overview of the settlement and some background information. Glenda Jimmo of Lincoln, Vt., was the lead plaintiff in a class-action suit filed after […]

Digging in deeper: MedPAC report’s SNF findings

On March 15, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress. In the report, MedPAC addresses the SNF PPS in Chapter 8. MedPAC states that most indicators of payment adequacy for SNFs are positive. Here are some findings published in the report: Access to SNF services remains stable for most beneficiaries. […]

Ask the expert: Care plans

Q: We are having a large debate about care planning in our facility. Some people believe the basis of the care plan is to identify the resident’s care problems and plan actions, implement steps to care for those problems, and establish assessment dates, and then put MDS into the care plan. On the other side […]

Latest MedPAC report contains four reform recommendations for post-acute care

On March 15, the Medicare Payment Advisory Commission (MedPAC) issued its March 2013 Report to the Congress on Medicare payment policy. The report provides recommendations to increase the efficiency of Medicare by finding ways to provide high-quality care for Medicare beneficiaries at lower costs to the program. In this report, MedPAC recommends no update in […]

Ask the expert: 100-day benefit periods

Q: Can a long term dialysis patient, who was in a skilled facility for rehab and then discharged home, have a new 100-day benefit period if she was not in a SNF or in the hospital for at least 60 consecutive days, even though she did continue to receive dialysis while at home? A: If […]

Historic Jimmo v. Sebelius settlement approved

A settlement in the Medicare Improvement Standard case, Jimmo v. Sebelius, was approved on January 24, 2013, marking a huge step forward for thousands of beneficiaries nationwide, according to the Center for Medicare Advocacy. Glenda Jimmo of Lincoln, Vt., was the lead plaintiff in a class-action suit filed after Medicare denied her coverage for nurses […]

Ask the expert: Benefit periods

Q: A Medicare member benefits exhausted, but has been receiving a regular dose of insulin in the morning and night. Member went to the hospital, and is now returning to a facility, where she is a long-term resident. Would she regenerate a new benefit for Part A coverage? It has been more than 60 days […]