OIG: 46% of Medicare Patients in LTACs Experience Harm

Almost half of Medicare patients experience either adverse events or temporary harm events inside the walls of a long-term care hospital (LTCH) according to a November report from the Department of Health and Human Services (HHS). The Office of Inspector General (OIG) found that 21% of Medicare patients in LTCHs — also known as long-term […]

OIG Touts Nearly $3B in Medicare, Medicaid Fraud Recoveries in Fiscal 2018

The Department of Health and Human Services’ top fraud watchdog recovered nearly $3 billion from providers in fiscal 2018, a figure that included more than $18 million in improper payments at nursing homes. The HHS Office of the Inspector General (OIG) touted its $2.91 billion haul in its most recent semiannual report to Congress, released […]

Federal Lawmakers Grill CMS, HHS Over Nursing Home Safety

Representatives from the federal agencies that oversee skilled nursing agencies faced pointed questions from lawmakers on Capitol Hill on Thursday morning, with many expressing frustration with recurring resident safety issues. “We do this over and over again, but yet one-third of Medicare residents have experienced harm,” Rep. Diana DeGette, a Colorado Democrat, said during a […]

OIG Wants to Revise Anti-Kickback Rules to Ease Care Coordination

As the federal government increasingly emphasizes care coordination among players across the health care continuum, the industry’s top watchdog signaled that it could soon overhaul its anti-kickback regulations to help providers avoid pitfalls. The Department of Health and Human Services’ Office of the Inspector General (OIG) this week published a call to providers, asking for […]

OIG Targets Hospice Services in Skilled Nursing Facilities, Recommends Cuts

When the Department of Health and Human Services’ (HHS) top watchdog arm issued an overall warning about the state of hospice care earlier this summer, skilled nursing facilities were specifically singled out as areas for improvement. The HHS Office of the Inspector General (OIG) accused hospices of using residents in nursing homes to artificially inflate […]

OIG: More Than 60% of Therapy Claims Don’t Meet Medicare Requirements

More than 60% of outpatient therapy claims filed over a six-month period didn’t meet Medicare’s requirements — a figure that has a key government watchdog agency concerned. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) looked at a representative sample of 300 Medicare therapy claims filed in the final […]

Democrats Ask CMS to Halt Skilled Nursing Regulatory Rollback

A group of 12 Democratic U.S. senators slammed the Centers for Medicare & Medicaid Services in a letter sent last week, claiming that its leadership’s decision to ease regulatory restrictions on nursing homes has put seniors in danger. “We write with deep concern over a string of actions by the Centers for Medicare & Medicaid […]

Care Coordination in ACOs Might Not Actually Drive Savings

Accountable care organizations (ACOs) are built on a basic premise: By working together, providers across the health care continuum can save Medicare money and boost quality. But the largest share of the savings may simply come from shifting patients out of skilled nursing and home health settings, a new study suggests — and not on […]

CMS Delays Enforcement of Smoking Rules, Other Phase 2 Requirements

Skilled nursing operators can breathe a little easier as the second phase of the new Requirements for Participation takes effect this week: The Centers for Medicare & Medicaid Services (CMS) has delayed penalties for several of the new requirements. For the next 18 months, CMS won’t take enforcement action — in the form of civil […]

Nursing Home Complaints Up 33%, Some States Slow to Respond

Nursing home complaints handled by state authorities rose by one third between 2011 and 2015 — even as occupancy at skilled nursing facilities declined slightly. In addition, a handful of states accounted for the majority of late investigations, according to a new data brief from the Department of Health and Human Services’ (HHS) Office of the […]

Kansas Failed to Follow Up on Half of Skilled Nursing Deficiencies

Officials in the state of Kansas frequently took skilled nursing facilities at their word when following up on plans to fix certain deficiencies — a violation of federal requirements for SNFs that participate in Medicare and Medicaid. The Kansas Department for Aging and Disability Services only verified SNFs’ strategies to correct deficiencies 52% of the […]

ACOs Saved $1 Billion, Reduced SNF Spending

With three years of data for accountable care organizations (ACOs), the shared savings program from the Centers for Medicare & Medicaid Services (CMS) has demonstrated the potential to cut down on care costs. And the savings are frequently coming from skilled nursing facility (SNF) care, according to a recent report from the Office of Inspector General […]