Nursing Homes

News & Analysis as of

CMS Proposes Sweeping Changes for Nursing Home Oversight

On July 16, 2015, the Center for Medicare and Medicaid Services (“CMS”) published a Proposed Rule with new standards that will have a sweeping effect on the long-term care industry. This new Rule is the first comprehensive...more

Washington Healthcare Update

This Week: CMS Releases Guidance on Fast Track Process for 1115 Waivers for Medicaid and CHIP... Healthcare.gov CEO Sends Letter to State Insurance Commissioners Concerning 2016 Premium Decisions... Medicare Board of Trustees...more

OSHA Stepping Up Scrutiny of Hospitals and Inpatient Health Care Facilities

On June 25, 2015, the Occupational Safety and Health Administration (OSHA) published a Memorandum to its Compliance Officers expanding its enforcement policy regarding workplace hazards facing employees in the health care...more

CMS Proposes Significant Revisions to Requirements that Long Term Care Facilities Must Meet to Participate in Medicare and...

On July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a proposed rule to revise the requirements that skilled nursing facilities and nursing homes must satisfy to participate...more

CMS Proposes Significant Revisions to Requirements that Long Term Care Facilities Must Meet to Participate in Medicare and...

On July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a proposed rule to revise the requirements that skilled nursing facilities and nursing homes must satisfy to participate...more

CMS Proposes Significant Revisions to Requirements that Long Term Care Facilities Must Meet to Participate in Medicare and...

On July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a proposed rule to revise the requirements that skilled nursing facilities and nursing homes must satisfy to participate...more

2015 Florida Legislative Post-Session Report

Carlton Fields Jorden Burt’s Government Law and Consulting Practice Group released its 2015 Florida Legislative Post-Session Report detailing significant bills that passed during the 2015 Regular Session of the Florida...more

Beware! Long Term Care Class Actions are Coming

Long term care providers beware, class action suits are coming. Due to allegations of chronic understaffing, long term care providers are beginning to face massive class action lawsuits nationwide. The trend began in 2010,...more

Time to Revisit Your Physician Relationships

On June 9, 2015, the Department of Health and Human Services, Office of Inspector General issued a new Fraud Alert entitled "Physician Compensation Arrangements May Result in Significant Liability" (Alert) in the wake of 12...more

Comprehensive Proposed New Rules Announced for Long-Term Care Facilities

"Far reaching," "massive in scope," and "sweeping," are just a few of the terms that have been used to describe a 403-page proposed rule for Medicare and Medicaid nursing homes, which was released Monday (July 12) by the U.S....more

OSHA Announces Major Focus on Healthcare Industry

In late June, the Occupational Safety & Health Administration (OSHA) announced a major initiative that will intensify and expand the agency’s enforcement resources in the healthcare industry, with a focus on several common...more

Proposed Rule Creates Challenges for Managed Long-Term Services and Supports

On June 1, 2015, the US Centers for Medicare & Medicaid Services (“CMS”) published its proposed rule on Medicaid managed care (CMS-2390-P). As noted in our three earlier advisories, which provided an overview of the proposed...more

Government’s Objections to Non-Intervened FCA Settlement Are Unreasonable – Now What?

Recently, South Carolina U.S. District Judge Joseph Anderson, Jr. issued an opinion in which he struggled with how to handle a non-intervened qui tam brought under the Federal False Claims Act (FCA). In his opinion, Judge...more

Health Law Wire: OMIG Standards for PRI Audits Held Arbitrary and Capricious (7/15)

The Office of the Medicaid Inspector General (OMIG) was recently given a set-back in its on-going audits of nursing home case mix submissions. These audits focus on “Patient Review Instruments” (PRIs) which form the basis of...more

Recent OIG Audits of Home Health and Hospice Surveys May Signal Increased Scrutiny on Worker Qualifications

Recent audits by the Department of Health and Human Services Office of Inspector General (“OIG”) conclude that state survey agencies in a number of states and a leading national accrediting agency serving the home health and...more

Miami Nursing Home To Pay Record $17M in Whistleblower Suit

A Miami-based nursing home network agreed Tuesday to pay a record $17 million to settle a False Claims Act suit brought by its former CFO, accusing it of running a kickback scheme. The case is United States of America et al...more

EEOC Sues Green Manor Rest Home to Enforce Conciliation Agreement

Nursing Home Failed to Comply With Agreement Settling Disability Bias Charge, Federal Agency Says - WILMINGTON, N.C. - A Parkton, N.C., nursing home violated a settlement agreement stemming from a disability...more

Fired Nurse Loses Whistleblower Suit over Suspected Drug Use

A federal appeals court recently affirmed the dismissal of a whistleblower-retaliation suit against a Maine nursing home, holding that the plaintiff employee failed to prove that she was fired for telling her supervisor she...more

Department of Justice Takes Active Role in Lawsuit Against Nursing Home Chain

For the past six years, the Ohio-based nursing home chain HCR ManorCare has been embroiled in a whistleblower lawsuit featuring allegations that the company systematically overbilled Medicare and often put its residents...more

NJ Court says no double recovery for alleged injuries in Nursing Home

On post trial motions, based on recent decisions of the NJ Appellate Division, a private plaintiff cannot assert a cause of action against a nursing home for failure to comply with statutes, rules and regulations, but only...more

Long-Term Care Legislation in Florida - Regulatory Compliance Impacts Retirement Communities, ALFs and Nursing Homes

Long-term care companies in Florida need to dust off their regulatory compliance plans to see if updates are needed in light of several bills that passed during the regular legislative session of 2015. If they are signed by...more

Spring Vacations: Which arguments are winning on appeals from arbitration so far in 2015?

Today I present a collection of recent state and federal appellate court decisions that vacate or un-vacate arbitration awards. The seven opinions below emphasize how difficult it is to prove that an arbitrator exceeded his...more

CMS Call: National Partnership to Improve Dementia Care and QAPI (June 16)

On June 16, CMS is holding a call on the National Partnership to Improve Dementia Care and Quality Assurance and Performance Improvement (QAPI). The target audience for the call is consumer and advocacy groups, nursing home...more

Minnesota Session Ends With Governor Threatening Veto

The Minnesota legislature concluded its business last evening with Governor Mark Dayton threatening to veto a $17 billion public education funding bill – a threat he carried through with earlier today. The governor issued the...more

Cost of Private Nursing Home Room Now Averaging $91,250

The median cost of a private nursing home room in the United States has increased 4.2 percent to $91,250 a year, according to the 2015 edition of a Cost of Care survey that the insurer Genworth has conducted for the past 12...more

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