Category Government Policy

Work Place Shortage-PHI Launches Campaign

Work Place Shortage-PHI Launches Campaign

Work Place Shortage-PHI Launches Campaign

Work Place Shortage-PHI Launches Campaign

Work place shortage-PHI (Paraprofessional Health Institute) launches Campaign to solve this nation wide problem. PHI has instituted a new educational program to address the growing shortage of qualified health care works at a time when the need is growing, as the population ages.

The new campaign raises 60 Caregiver issues and strives to develop 60 new ideas to strengthen the direct care workforce. Their goal is to inspire policy makers, workers and long term leaders to recognize issues and then find solutions.

PHI has pledged to work closely with nursing facility operators to deal with multiple reasons for...

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Patient Access to Non-Approved Drugs

Patient Access to Non-Approved Drugs

Patient Access to Non-Approved Drugs

Patient Access to Non-Approved Drugs

The new administration has expressed support for permitting patients to access non-approved drugs when they have a terminal diagnosis. Vice President Pence met with advocates of “Right to Try” legislation this week. The group advocates legislation in support of letting terminally ill patients to try drugs that have reached the third FDA approval phase.

The Vice President expressed the administrations support for the Right to Try law, which designed to give terminally ill patients hope by giving them access to experimental drugs that have already met FDA safety standards...

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Medicaid Block Grants Partially Replace AFC

Medicaid Block Grants Partially Replace ACA

Medicaid Block Grants Partially Replace ACA

Medicaid Block Grants Partially Replace ACA

Medicaid block grants may be used by the Trump administration to replace the Affordable Care Act. Block grants have been used to provide funds for housing in the past as well as for certain educational programs. The belief has always been the block grants will move money closer to the people who need it, and put it under the control of local governments who better understand the people they serve and their specific program needs.

The administration also believes that Medicaid block grants will significantly reduce fraud, waste and abuse...

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LTC Immigration Policy

LTC Immigration Policy

LTC Immigration Policy

LTC Immigration Policy

LTC immigration policy is crucial for the entire health care sector.

The long term and post acute sectors have traditionally had staffing shortages. Semi skilled foreign workers have been used to fill empty slots, for certified nursing assistants, registered nurses.

The healthcare industry must be careful not to over react to the recent temporary executive order blocking refugees from seven countries from entering the United States. The order is temporary and it will not have a long term effect on the staffing of facilities. Currently these countries do not supply the majority of immigrant works for healthcare.

Political beliefs aside the indust...

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New Antibiotic Federal Requirements

New Antibiotic Federal Requirements

New Antibiotic Federal Requirements

New Antibiotic Federal Requirements

New antibiotic federal requirements go into effect in November 2o17. The federal government is requiring skilled nursing facilities and post acute care facilities to implement new systems into their infection control programs to combat antibiotic resistance. This new requirement was part of a series of provisions the Centers for Medicare and Medicaid Services (CMS) issued this past October. These new requirements are a condition of participation in Medicare and Medicaid for long term care and post acute care facilities.

These new CMS requirements call for facilities to designate an infection preventions by November 2019...

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Supreme Court Pick Good for Healthcare

Supreme Court Pick Good for Healthcare

Supreme Court Pick Good for Healthcare

Supreme Court Pick Good for Healthcare

President Trump’s nomination for Supreme Court, good for Healthcare. Judge Gorsuch has a history of looking at what he sees as over regulation and a lack of specificity. This could bring some serious regulatory relief to the healthcare industry.

He currently sits on the U.S. Court of Appeals for the Tenth Circuit where he has expressed concerns over how federal agencies produce regulations and then how they interpret them. The Centers for Medicare and Medicaid Services has not escaped his frustration and concern.

In a recent case Judge Gorsuch, where CMS attempted to recapture Medicare reimbursement from a provid...

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Nursing Facility Liability Costs on the Rise

Nursing Facility

Nursing Facility

Skilled Nursing Facility Liability Costs on the Rise

Skilled Nursing facility liability costs rise by $2,300 per bed in 2017 according to a report recently issued Aon Global Consulting/American Health Care Association predicts that a skilled facility with 100 beds will pay $235,000 for its liability insurance in 2017.

The report surveyed 31 different providers representing 224,000 skilled nursing facility beds. Those included in the survey included skilled nursing, subacute, assisted living, home health and independent living.

Loss rates have increased to 6% after remaining stable for three (3) years at 5%...

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Patient Satisfaction Part of Quality

Patient Satisfaction

Patient Satisfaction

Patient Satisfaction

Patient satisfaction as part of quality measurements may be the next frontier. In a hospital setting this might seem pretty straightforward, asking patients how they are feeling, how their treatment is going, how is the staff performing and is your doctor explaining your care and answering your questions seems reasonable. Even in the post acute or subacute setting this seems relatively to accomplish.

The Government Accountability Office recently concluded that adding resident satisfaction ratings to Nursing Home Compare, would be a more direct measure of nursing facility patient care. The American Health Care Association has supported this concept a...

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Nursing Facility Fraud a Focus

Nursing Facility Fraud a Focus

Nursing Facility Fraud a Focus

Nursing Facility Fraud a Focus

The new Trump administration is expected to keep nursing facility fraud a focus of the Department of Justice according to sources in the administration.

They are even expected to preserve several Obama policies. Fraud investigation and the eventual prosecution of more individuals will be initiatives continued under the new administration.

The issue of holding individuals liable for corporate wrongdoing has received support from both sides of the isle to date. The new Attorney General nominee Senator Jeff Sessions, (R-AL) is a former prosecutor who has generally been tough on white-collar crime.

Post acute care facilities with pro...

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Reducing Hospital Readmissions

Reducing hospital readmissions is a challenge for the entire healthcare continuum. It is all too common and it is costly and in many cases avoidable. Skilled nursing facilities and subacute facilities are not currently being hit with financial penalties for hospital readmissions. The Centers for Medicare and Medicaid Services (CMS) will change this policy in October of this year. Currently hospitals bear the brunt of these financial penalties for readmissions, as they are the facilities partner it is in everyone’s best interest to reduce the readmissions whenever and wherever possible.

This is an opportunity for hospitals and skilled facilities to develop a new and better model, which shou...

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CMS Final Rules Issued

Final Rules Issued

Final Rules Issued

Final Rules Issued

The final rules have been issued by the Centers for Medicare and Medicaid Services (CMS) for long term and subacute providers. Providers feel that the new rules are impossible to meet in the time frame provided.

The issue is not that the patient care centered changes are not appropriate or even long over due. The issue for the providers is the timeline and the work force requirements. Under the current timeline for implementation the providers believe that they are being set up for failure. The regulations and the timeline fail to recognize the difficult workforce environment, the lack of specific guidelines and resources to implement them...

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Rule Regarding Wellness Programs

Rule Regarding Wellness Programs

Rule Regarding Wellness Programs

Rule Regarding Wellness Programs

The U.S. District Court for the District of Columbia ruled that AARP failed to show that the rule could caused “irreparable harm” to employees.

Employers can now offer workers and their spouse’s incentives to participate in wellness programs. This follows the Equal Employment Opportunity Commission issuing final rules permitting employers and providers of medical information to set financial rewards-penalties- of up to 30 percent of the cost of the company’s health insurance plan.

Although these penalties and incentives could cost employee’s hundreds or thousands of dollars, the court ruled that these programs are vo...

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Representative Price is Right

Representative Price is Right

Representative Price is Right

Representative Price is right

Long term and subacute providers believe that Representative Price is right for their ringing endorsement. President Trump’s choice to lead the Department of Health and Human Resources is a fellow provider with a unique understanding of this segment of healthcare.

The feeling is that Rep. Tom price (R-Ga), a former practicing orthopedic surgeon and fellow provider, will bring a more sympathetic and pragmatic eye to healthcare administration. Providers have found the Price to be supportive of long term and subacute sectors and that he understands the role these two levels of care provide for patients.

Price’s understanding of the pat...

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Legal Pot Usage growing

Legal Pot Usage Growing

Pot Usage Growing

Pot Usage Growing

Twenty nine state (29) now permit the legal medicinal use of pot. Pot Usage is growing nationally.

Voters in California, Massachusetts, Nevada and Maine all approved recreational use of marijuana on election day. Voters in Florida, Arkansas, North Dakota and Montana gave the thumbs up for the medicinal use of pot, singling a real change in the countries views on the use of pot. Voters in Arizona rejected the expanded use of pot for recreational purposes.

Even though marijuana is still considered an illegal drug by the federal authorities...

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Annual Wellness Visit

Annual Wellness Visit

Annual Wellness Visit

Annual Wellness Visit

Medicare (CMS) has made higher quality healthcare possible with the advent of the “Annual Wellness Visit”. It is now possible to provide these visits to your Medicare patients every year under the new CMS guidelines.

This Annual Wellness Visit should not be mistaken for the annual physical that Medicare offers to its participants. The Annual Wellness Visit takes approximately 45 minutes to an hour to complete. The Annual Wellness Visit is not a physical and in fact is not performed by the physician. A member of the practice other than the physician who is trained is supposed to perform the visit...

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Emergency Room Surprise Billing

Emergency Room Surprise Billing

Emergency Room Surprise Billing

Emergency Room Surprise Billing

For most people a visit to an emergency room carries sufficient stress. As many as twenty percent (20%) of emergency room patients receive additional trauma in the form of an unanticipated medical bill– in more than a few cases for thousands of dollars.
Patients who are forced to use the emergency services in a hospital, even one that is within their insurance network have a twenty percent (20%) of seeing an out-of-network ER doctor who may bill them for his services according to the New England Journal of Medicine.
The article was based on a sample size of over 2...

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Skilled Nursing Payment Changes

Skilled Nursing Payment Changes

Skilled Nursing Payment Changes

Skilled Nursing Payment Changes Recommended.

CMS is recommending nursing payment changes. The Medicare Payment Advisory Commission (MedPac) is recommending changes to the federal fiscal year prospective payment system (PPS) for skilled nursing facilities (SNF’s).

MedPac members during its December meeting recommended the suspension of PPS updates for 2018 and 2019, as well as recommending a revision in the existing PPS. The members requested that the Department of Health and Human Services secretary revise the prospective payment system for skilled nursing facilities so that the new system would more closely align itself with real costs associated with provid...

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CMS Requires Staff Competencies

CMS Requires Staff Competency

CMS Requires Staff Competency

CMS Requires Staff Competencies for Participation

CMS requires staff competencies for participation. This past September, the Centers for Medicare and Medicaid Services (CMS) as part of a new set of regulations is now requiring staff competency for participation. These new regulations are the first major updates for skilled nursing facilities since 1991.

The implementation for these new regulations is supposed to be phased in over the next three years. A notable exception is the language that has been modified regarding staffing levels and staffing competency. Normally competency would be defined based on a combination of credentials and experience...

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CMS to Pay for Care Coordination

CMS to Pay for Care Coordination

CMS to Pay for Care Coordination

CMS to Pay More for Care Coordination

CMS to pay for more care coordination. Doctors in 2017 will be paid more for care coordination, disease prevention and mental/behavioral health care services.

Under the final physician fee schedule the Centers for Medicare and Medicaid Services has allocated an additional $140 million on these services. It is estimated that fees for these services could reach $4 billion, according to CMS Acting Administrator Andy Slavitt. Clinicians will be paid more for coordinating patient care and spending more time managing their patients beyond the office visit. CMS is recognizing in their payment codes primary care, care management

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EHR Usage Below Expectations

Electronic health Records

Electronic Health Records

Electronic Health Records Usage Slow

The adoption of electronic health records (EHR) in nursing facilities, subacute facilities, assisted living facilities and other senior living sites has not met federal or state health department expectations.

Vendors have been working over time to develop EHR’s that they expect to be the cornerstone of health care going forward. Despite their efforts to develop new bells and whistles, new features and efficiencies the provider community has been reticent to adopt the EHR.

Providers have three real issues with developing the EHR in their facilities, money, time and resources...

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Centers for Medicare & Medicaid Services

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children’s Health Insurance Program (SCHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilit...

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