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Northern District Federal Court Orders Presumptive Eligibility for Medicaid Applicants for Long Term Care Services

A recent ruling by Judge Gotschall in the United States District Court for the Northern District of Illinois, Eastern Division made it abundantly clear that the state has 90 days to bring its procedures for processing...more

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements - Part I

On Oct. 4, CMS published the biggest overhaul to federal long-term care regulations since 1991. The lengthy Final Rule reforms the requirements for long-term care facilities participating in Medicare and Medicaid. CMS...more

Impending Deadline: CMS Issues Proposed Rule Reform for Long Term Care Facilities – Part 4 of 4

On July 16, 2015, the Federal Register published Centers for Medicare and Medicaid Services' (CMS) proposed rule to reform the requirements for Long Term Care Facilities participating in Medicare and Medicaid. CMS will be...more

Impending Deadline: CMS Issues Proposed Rule Reform for Long Term Care Facilities – Part 3 of 4

On July 16, 2015, the Federal Register published Centers for Medicare and Medicaid Services’ (CMS) proposed rule to reform the requirements for Long Term Care Facilities participating in Medicare and Medicaid. CMS will be...more

CMS Issues Proposed Rule Reform for Long Term Care Facilities - Part 1 of 4

On July 13, 2015, CMS issued a proposed rule to reform the requirements for long term care facilities participating in Medicare and Medicaid. The 400-page proposed rule recommends the biggest overhaul to nursing home...more

Changes to CMS' Five-Star Ratings System Turn Up the Heat on Nursing Homes and Increase Risks for Psychotropic Use

On Feb. 20, 2015, the Centers for Medicare & Medicaid (CMS) unveiled Version 3.0 of its Nursing Home Compare, which updates the current 5-Star Quality Rating System to reflect higher performance standards. Because of these...more

HFS Issues Clarification on MMAI Program

On August 8, 2014, the Illinois Department of Healthcare and Family Services (HFS) issued a three-page memo to long term care nursing home providers clarifying several issues regarding participation in the Medicare/Medicaid...more

Proceed With Caution: Contracts Between Senior Communities And Placement Agencies May Not Violate The Anti-Kickback Statute

In This Issue: - Background of the Arrangement - The OIG’s Analysis: How the Senior Communities Reduced Their Risk - What Providers Should Know - Excerpt from Background of the Arrangement: The...more

Health Reform + Related Health Policy News - November 2013 - Issue 1

In This Issue: - Top News ..HHS Gives Mixed Messages Regarding Federal Health Care Program-Status of Qualified Health Care Plans (QHPs) ..HHS Issues Health Insurance Marketplace Enrollment Report...more

Failure To Maintain Automatic Sprinkler Systems In Nursing Homes Now Leads To Survey Citations And More

As of August 13, 2013, all nursing homes participating in Medicare or Medicaid must have automatic sprinkler systems installed throughout the building. CMS first established the sprinkler requirement in a final rule published...more

Updates To Need Determinations Show A General Decrease In Need For Health Care Facilities And Services In Illinois

On August 15, 2013, the Illinois Health Facilities and Services Review Board ("the Board") released updated inventories and need determinations for health service areas across the State. The new need determinations reveal a...more

Illinois Jury Found Nursing Home Liable For $28.1 Million In Whistleblower Case Alleging Substandard Care And Resident Abuse

An Illinois district court jury in United States v. Momence Meadows Nursing Center, Inc. recently issued a verdict on February 11, 2013 imposing $28.1 million in civil penalties on the operators of a nursing home. The nursing...more

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