OIG: High Facility-Backed Discharges of Mentally Ill Residents From Nursing Homes ‘Raises Questions’ 

A majority of discharges of mentally ill patients from nursing homes are initiated by facilities due to dangerous behaviors, and perhaps many of these patients should never have been admitted in the first place given “the challenges” at nursing homes, according to the Office of Inspector General (OIG). OIG’s review issued Wednesday suggests that of […]

OIG Says Nursing Homes Among Top 6 Provider Types Tied to Medicaid Patient Neglect, Abuse Convictions

Nursing facilities were among six provider types with the most patient abuse and neglect convictions tied to Medicaid than other provider types in 2023, as a whopping 841 criminal and civil patient and abuse complaints related to the sector – topping all other categories – are still open to investigation. There are 238 open nursing […]

OIG Plans To Audit Nursing Home Survey Practices This Year – With Results Expected in 2025

The Office of the Inspector General (OIG) will be auditing nursing home survey practices this year with results expected in 2025, following concerns that third-party contractors may not have sufficient oversight in the space. OIG suggested closer scrutiny of the Centers for Medicare & Medicaid Services (CMS) regulatory practices when it came to surveys, given […]

OIG: Nursing Homes Hard-Pressed To Meet Resident Needs in Emergencies Due To Staffing

A staggering number of nursing homes reported challenges in meeting the care needs of their residents during public health emergencies and natural disasters due mostly to inadequate staffing, with transportation, communication and infection control and prevention also being among key areas hampering these efforts. This is according to the latest report issued Wednesday by the […]

CMS Makes More Nursing Home Performance, Ownership Data Public in Latest Transparency Push

Moving ahead with its reform initiatives to make nursing home ownership more transparent, the Centers for Medicare & Medicaid Services (CMS) on Wednesday began posting names of affiliated owners and aggregate data related to staffing and other metrics for ownership groups. The agency made the information available on Nursing Home Care Compare and data.cms.gov; consumers […]

OIG: Coding Mistake Leads to $22.5M in Medicare Overpayments to Doctors in Nursing Homes

Medicare overpaid physicians serving in facility settings during a two-year audit period – about $22.5 million more for over a million claims. That’s according to an audit conducted by the Office of the Inspector General (OIG) and published this week. Generally, Medicare pays practitioners for physician services separately – and a higher amount – compared […]

Arizona Bill Aims to Privatize the Survey Process for Nursing Homes 

As federal entities continue to call for significant changes to nursing home operators and oversight through surveys, Arizona appears to be the first state intent on outsourcing this crucial tool. The legislature in Arizona may let nursing homes and assisted living facilities be surveyed by a third party to conduct annual and complaint surveys – […]

CMS Proposal Marks Shift After Years of Skilled Nursing Frustration with Medicare Advantage Diversions

The Centers for Medicare & Medicaid Services (CMS) has decided to take action on transitions in care – specifically Medicare Advantage (MA) plans diverting care to home health instead of skilled nursing – after years of skilled nursing industry and consumer feedback. CMS last month took steps to address the trend with a proposed rule […]

OIG: Pandemic Data Shows Major Changes Needed in Nursing Home Staffing, Surveys, Infection Control

A federal watchdog agency is calling for “significant changes” to nursing home operations and oversight in light of new data on Covid-19 infection rates. The Department of Health and Human Services Office of Inspector General (OIG) calls on the Centers for Medicare & Medicaid Services (CMS) to take action in a report issued Thursday. More […]

OIG Launches Investigation into Skilled Nursing Residents With Potentially Preventable Hospitalizations

The Department of Health and Human Services’ (HHS) watchdog arm added a probe of skilled nursing residents who had potentially preventable hospitalizations in its list of priorities over the next year. The HHS Office of the Inspector General (OIG) recently announced an additional investigation as part of its 2022 work plan — specifically focusing its […]

Nursing Home Facility Discharges Need ‘Further Attention’, OIG Report Says

Nursing home-initiated discharges require a closer look as “inappropriate discharges” may be on the rise, according to a report released by the Office of the Inspector General (OIG) and U.S. Department of Health and Human Services (HHS). Overall, OIG isn’t aware of how many residents have experienced facility-initiated discharges from nursing homes, much less which […]

OIG to Probe Improper Nursing Home Discharges, Evictions

The federal government’s top health care watchdog last week announced a plan to investigate whether nursing homes are following rules around discharges, specifically citing media reports about improper evictions from facilities. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) added a probe of facility-initiated discharges to its formal work […]

OIG Expands Probes into Nursing Homes’ Response to COVID-19 Pandemic

The federal government’s top health care watchdog agency added a pair of new probes into the nation’s nursing homes to its already busy slate of long-term care investigations for the coming year. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) last week rolled out two long-term care investigations — […]

OIG Launches Multiple Investigations into Nursing Home Response to COVID-19

The Department of Health and Human Services’ (HHS) watchdog arm added multiple probes of nursing homes’ response to COVID-19 to its list of top 2020 priorities, with a particular focus on infection control. The HHS Office of the Inspector General (OIG) last Friday announced two coronavirus-related investigations as part of its ongoing 2020 Work Plan […]

Encore Rehabilitation, DOJ Reach $4M Settlement in False Claims Act Case

Encore Rehabilitation Services on Friday publicly agreed to pay $4 million to settle federal allegations that the contract rehab provider violated the False Claims Act. The Department of Justice had accused the Farmington Hills, Mich.-based rehab operator of “causing three Michigan skilled nursing facilities to submit false claims to Medicare for rehabilitation therapy services that […]

Ambulance Company Operator Given Prison Time, $750K Fine in Skilled Nursing Fraud Case

The operator of an ambulance company that primarily served nursing homes and other outpatient care sites has been sentenced to 30 months in federal prison after pleading guilty to defrauding Medicare and Medicaid. Joseph Valdie Kimble, the former operator of the Longview, Texas-based Tiger EMS, must also pay more than $750,000 in restitution to the […]