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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The Year of Hope

The Year of Hope

The Year of Hope

The Year of Hope

Could this be the year of hope that the healthcare industry has been waiting for?

Operators of skilled nursing facilities have seen their patient census fall, new construction come to a virtual halt and CMS pressures continue to mount. They look to this year for some positive movement.

The financial markets continuing to exhibit uncertainty around interest rates, volatile markets and an ever growing number of baby boomers retiring has left lenders, developers and operators asking if this new administration would provide the industry with favorable news.

It is clear from the first days of this administration that things will not operate in Washington as they...

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Drug Resistant Bugs Winning the War

Drug Resistant Bugs Winning the War

Drug Resistant Bugs Winning the War

Drug Resistant Bugs Winning the War

Most epidemiologists would admit that drug resistant bugs are winning the war in the acute and post acute setting.

Nursing facilities are in the forefront of the battle where environmental services and housekeeping are constantly under pressure the defeat the enemy and eliminate the germs from their facilities. From 2008 to 2012 the number of citations under F-tag 4412 rule from the Centers for Medicare and Medicaid Services (CMS) has doubled. Leading one to believe that infection control has not been a top priority in nursing facilities. Limited resources and staff turnover are certainly contributing factors.

Accordin...

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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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Talk So Your Doctor Will Listen

Talk So Your Doctor Will Listen

Talk So Your Doctor Will Listen

Talk So Your Doctor Will Listen

Patients need to talk so your doctor will listen.When there is little or no dialogue between doctor and patient it is much more likely that the patient will leave the office frustrated and the chances of a missed diagnosis will be substantially greater. Studies have shown that doctors listen to their patients for on average for 23 seconds before they cut them off. The feeling of not being listened that patients have expressed is probably a correct one.

There are some strategies that may help you maximize your doctors visits.

Make a human connection, ask the doctors “How the day is going”? before telling him your medical ...

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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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Collaboration Improves Treatment

Treatment

Treatment

Collaboration Improves Treatment

Collaboration between Dental and medical providers improves patient care for the elderly. The elderly often suffer with complex medical issues that are magnified by dental conditions. Recent research suggests that coordination between dentists and physicians helps improve patient care and produces better outcomes.

A collaborative model that involves community based physicians and dentists have increased access to care, improve health outcomes, and reduce disease and the cost of care associated with those living with chronic disease.

Collaborative models have been developed to look at a range of chronic conditions such as diabetes, heart disease, hea...

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Strokes, Spot the Signs and Act

Strokes, Spot the Signs and Act

Strokes, Spot the Signs and Act

Strokes, Spot the Signs and Act

It is important for everyone to recognize the signs of a stroke and to act quickly. The loss of blood flow to the brain only gives the victim minutes to react. Lifesaving treatment can reduce damage to the brain and reduce recovery time.

Symptoms may occur suddenly. Recognizing them and getting help fast might save the life of a loved one or at minimum reduce the risk of long term disability. Here are the things to look for.

F Face. Check the persons ability to smile. Is it uneven? Does one side droop? Is there numbness?

A Arms. Can they raise both arms. Does one arm drift downward? Is there weakness or numbness?

S Speech...

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The Definition of the Term Hospitals

The Definition of the Term Hospital

A hospital is defined as a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a heart attack. A district hospital typically is the major health care facility in its region, with large numbers of beds for intensive care and additional beds for patients who need long-term care. Specialised hospitals include trauma centres, rehabilitation hospitals, children’s hospitals, seniors’ (geriatric) hospitals, and hospitals ...

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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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Current Events Latest Health News

Current Events

It’s hard to keep up with Atlanta urologist Brian Hill.

He spends his 14-hour days moving quickly between the waiting room –“Hi, I’m Brian, nice to meet you” — the operating room — “We all good here?” — and the recovery area, where a typical conversation might involve telling his elderly patient she is beautiful while giving her daughter a high five.
“Bladder looked perfect, she did good, so that’s awesome,” he tells them.
“We just love Dr. Hill,” the patient says from her wheelchair as she leaves for home.
The feeling is mutual.
Current Events

Current Events

“I love medicine. Medicine is great,” Hill says with a big smile...
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Subacute Care

Sub Acute Care

Subacute Care:

Subacute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery.[1][2] In medical terms, care for acute health conditions is the opposite from chronic care, or longer term care. Subacute care

Sub Acute care services are generally delivered by teams of health care professionals from a range of medical and surgical specialties. Sub Acute care may require a stay in a hospital emergency department, ambulatory surgery center, urgent care centre or other short-term stay facility, along with the assistance of diagnostic services, surgery,...

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Long Term Care

Long term care:

Long term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods.It is common for long-term care to provide custodial and non-skilled care, such as assisting with normal daily tasks like dressing, feeding, using the bathroom.[1] Increasingly, long-term care involves providing a level of medical care that requires the expertise of skilled practitioners to address the multiple chronic conditions associated with older populations. Long-term care can be provided at home, in the community, in assisted living facilities or in nursing homes...

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