Long-Term Care

News & Analysis as of

Maintaining Privilege for Quality Assurance Performance Improvement (QAPI) Documents and Reports*

Introduction to QAPI - Pursuant to § 6201(c) of the Patient Protection and Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) have issued interim guidance governing the implementation of...more

5 Tips on Deciding Whether to Buy Long-Term Care Insurance

One of the most difficult decisions in long-term care planning is whether to purchase long-term care insurance (LTCI) and which of the wide variety of products to purchase. On the one hand LTCI premiums are high, they...more

Scorecard Ranks States on Long-Term Care Services

A new report ranks states on the quality and accessibility of their long-term care services and concludes there is a lot of room for improvement. The 2014 State Long-Term Services and Supports Scorecard finds that quality of...more

HUD Helps Clear Confusion in Loans to the Long Term Care Industry

Overview - New Guidance from HUD. By now, long term care project owners are very aware of the advantages of HUD-insured financing. However, HUD's program policies continue to challenge some providers who own and/or operate...more

HUD Issues New Handbook for Long Term Care Financing Under Section 232

On May 22, 2014, HUD published a new Handbook covering its Section 232 Healthcare Insurance Mortgage Program, which insures HUD-approved lenders against financial loss from mortgage loan defaults in loans to qualifying long...more

IPPS Proposed Rule: Read Once, Then Take an Aspirin

The Centers for Medicare and Medicaid Services (CMS) has set its sights on the quality of care during hospital inpatient stays and much, much more. On May 15, 2014, CMS published a proposed rule that would update Medicare...more

CMS Releases Proposed IPPS and LTCH Rule

On April 30, 2014, CMS released the much anticipated proposed Hospital Inpatient Prospective Payment System rule (“Proposed IPPS Rule”), which would apply to FY 2015 Medicare payments. For inpatient acute care hospitals, CMS...more

President Signs Medicare Physician Fee Schedule/SGR Patch with Numerous Health Policy Provisions

In This Issue: - One-Year Medicare Physician Fee Schedule Fix - Valuation of Services Under the Physician Fee Schedule - ICD-10 Delay; LTCH Moratorium to Become Effective Immediately - Skilled Nursing...more

New Approaches – and Increasing Oversight – for Medicaid Managed Long Term Services and Support

Approximately one-third of Medicaid spending, $136 billion, is on long-term services and supports (LTSS). While the majority of Medicaid LTSS takes place in institutional settings, such as nursing facilities and mental...more

Long Term Care Construction Opportunities

Based on the long term care projects with which we have recently been involved, there appears to be great opportunity for growth in the construction of long term care facilities. This is attributed to the ever-growing aging...more

Mitigating Successor Liability in Long Term Care Acquisitions

As in any business acquisition, purchasers in the long term care industry can encounter potential liability due to employment claims, seller violations of representations and warranties under the purchase agreement, tort...more

New Development Regarding Medicaid STAR+PLUS Network Provider Agreements for Texas Nursing Homes

Beginning this fall, Texas nursing home reimbursement will be converted to Medicaid Managed Care. In preparation for the Medicaid Managed Care rollout, Texas Managed Care Organizations ("MCOs") recently sent out network...more

Not Your Grandmother’s Nursing Home -- Boomers and Obamacare spur a transformation of the growing long-term care industry.

The modern nursing home was born from the Social Security Act, which conditioned payments in a way meant to eliminate state-run “almshouses” serving the elderly poor. Over the following decades, the long-term care sector was...more

MedPAC Recommends Reduction To Hospital Outpatient Department, LTCH Payment Rates, Increases To Inpatient Acure Care Hospital...

On January 16, the Medicare Payment Advisory Committee (MedPAC) unanimously voted to recommend that Congress direct the Secretary of Health and Human Services to...more

Key 2014 Dollar Limits for Medicaid Long-Term Care Coverage Released

The Centers for Medicare & Medicaid Services (CMS) has released the 2014 federal guidelines for how much money the spouses of institutionalized Medicaid recipients may keep and the limit on how much a home can be worth for...more

FLSA Care for the Caregivers: New DOL Rule Broadens Minimum Wage and Overtime Protections for Direct Care Workers

A final rule issued by the Department of Labor (“DOL”) is to erode significantly a longstanding exemption under the Fair Labor Standards Act (“FLSA”). For nearly 40 years, under the companionship services exemption, home care...more

Pennsylvania Commonwealth Court Holds Structured Settlement Annuity Is Transfer for Less Than Fair Market Value Under the Deficit...

The Pennsylvania Commonwealth Court’s recent decision in the matter of Sams v. Department of Public Welfare may significantly affect the structured settlement industry, and the settlement of lawsuits on behalf of certain...more

CMS to Begin Implementing 25 Percent Threshold for LTCHs

CMS, in its federal fiscal year (FFY) 2014 final rule, has allowed its five-year moratorium on the 25 percent threshold payment adjustment policy to expire. Following the lifting of this moratorium, LTCHs that admit more than...more

CMS Releases Final FFY 2014 IPPS Rule

CMS has released its final federal fiscal year (FFY) 2014 prospective payment system (PPS) rule for inpatient stays in acute care and long-term care hospitals (LTCHs). The rule projects a net increase in operating payments to...more

Important Terms for Long Term Disability and Other Important Factors to Consider

For people fortunate enough to have a policy of long term disability (“LTD”) benefits, they will typically need to refer to the specific wording of their policy before knowing what steps they have to take and what rights they...more

CMS Issues Final Rule Regarding Required Agreements Between Long Term Care Facilities and Hospices

Beginning August 26, 2013, skilled nursing facilities participating in Medicare and nursing facilities participating in Medicaid (collectively referred to as “long-term care facilities”) that choose to arrange for the...more

New Requirement for LTC Facilities That Arrange Hospice Services through a Medicare-Certified Hospice

Effective August 26, 2013, the Centers for Medicare & Medicaid Services require that a long-term care, or LTC, facility that chooses to arrange for the provision of hospice services through a Medicare-certified hospice must...more

CMS Rule Complicates Long-Term Care Facility and Hospice Relationships

Final rule aims to improve the quality and consistency of care between long-term care facilities and hospice providers but may increase conflict between facility and provider staff. ...more

Health Reform + Related Health Policy News - May 2013

In This Issue: - Top News ..HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation ..States Divided on Medicaid Expansion ..CMS Issues FY 2014 Proposed Rules for...more

Planning And Paying For Long-Term Care (Part 6 In A Series: Medicaid/Medical Assistance)

In Part 5, I discussed the issue of “excess” assets and the “spend-down” process in Medical Assistance. Apart from a couple’s exempt assets (house, one car, household furnishings, etc.), the remaining assets are “countable”...more

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