Nursing Homes

News & Analysis as of

Alabama CON Report - November 2014

In This Report: - I. Certificate of Need Program - II. Reviewability Determinations and Pending Reviewability Determinations Excerpt from Certificate of Need Program: A. AL2014-030, Redstone...more

OIG's 2015 Work Plan Highlights Departmental Priorities

Each year the Department of Health and Human Services, Office of the Inspector General (OIG) issues its Work Plan to identify for the provider community the key fraud and abuse issues on which it will focus on in the coming...more

The Game Plan for Health Care Enforcement: Office of Inspector General Releases 2015 Work Plan

The Office of Inspector General (“OIG”) within the federal Department of Health and Human Services (“HHS”) is charged with protecting the integrity of HHS programs by combating fraud, abuse and waste. On Halloween of 2014,...more

Nursing Home and Healthcare Facilities Tasked With Keeping it Safe

On October 1, 2014 Maryland Senate Bill 483 (Chapter 513) went into effect. The Act requires that certain sized nursing homes and health care facilities assign to a committee the task of assessment of workplace safety issues...more

Arbitration Agreements in Nursing Home Admission Agreements

In response to increasing runaway verdicts with large awards for punitive damages, many nursing homes are including arbitration clauses in their admission agreements. The U.S. Supreme Court’s decision in Marmet Health Care...more

Catch Me If You Can: Fake Doctor’s Application Voids Coverage for Himself But Not for Innocent Co-Insureds

Written like a blockbuster Hollywood film, the U.S. District Court in South Carolina, in Evanston Insurance Company v. Agape Senior Primary Care, et al., 2014 WL 5365679, issued a ruling October 21, 2014, in which it held...more

Blog: Litigation Round-Up: Some Recent Drug & Device Settlements, Investigations, Inquiries

Settlements - Pharmaceutical company Organon Inc. agreed to pay $31 million to settle federal and state allegations that it underpaid Medicaid drug rebates, provided kickbacks to nursing home pharmacy companies,...more

Changes Coming to Nursing Home Compare

The Centers for Medicare and Medicaid Services (“CMS”) has announced that the Nursing Home Compare Five Star Quality Rating System will soon undergo some changes. The rating system has experienced recent criticism for relying...more

Seventh Circuit Reaffirms Worthlessness of Worthless Services Cases

In August the Seventh Circuit expressed its view that so-called “worthless services” cases don’t state a claim under the False Claims Act. Last Friday the court reaffirmed its view by refusing to rehear the case en banc....more

Hairdresser Pushes on to ADA Trial

A hairdresser in a nursing home had restrictions on pushing and lifting after a hysterectomy. Previously, plaintiff pushed wheelchair-bound residents to and from the beauty shop two days a week. When plaintiff notified the...more

Health Headlines: Also in the News - October 2014 #2

CMS Announces Changes to the Nursing Home Quality Rating System – On October 6, 2014, CMS announced upcoming changes to the nursing home five-star quality rating system. The changes include revising the scoring methodology...more

Life Care Centers Seeks Sixth Circuit Review of Decision Allowing Statistical Sampling/Extrapolation in FCA Case

Last week, we posted about U.S. District Court Judge Harry Mattice’s September 29th ruling that government attorneys could extrapolate from a small sample of patient admissions to over 50,000 patient admissions (and over...more

Certificates of Insurance: What’s in Your Portfolio?

On September 24, 2014, a New Jersey appellate court decided Selective Ins. Co. v. Hospicomm, Inc., 2014 WL 4722776 (N.J. Super., September 24, 2014). The dispute in that case arose out of a nursing home construction project...more

Prepare for Changes to CMS’ Five Star Quality Rating System for Nursing Homes

Choosing a nursing home can be a daunting task for consumers who often have myriad questions regarding the quality of care available at the nursing homes in their areas. To help answer these questions, CMS has created the...more

Illinois Supreme Court Holds Improper Venue Not a Jurisdictional Defect in Administrative Review

A unanimous Illinois Supreme Court recently decided Slepicka v. The Illinois Department of Public Health. The Court defined proper venue for an action under state law for judicial review of an administrative decision, and...more

CMS Announces Changes to Five-Star Quality Rating System for Nursing Homes

On October 6, the Centers for Medicare and Medicaid Services (CMS) announced plans to expand and bolster Medicare’s Five-Star Quality Rating System (Five-Star System) for nursing homes, provided to the public on the Nursing...more

Federal Judge Rules to Allow Extrapolation on More Than 50,000 Claims in FCA Case

Last week, a Tennessee federal district court judge ruled that government attorneys can extrapolate from a small sample of billing statements to over 50,000 claims submitted by Life Care Centers of America, Inc. (a nursing...more

Risks of Over-Medicating Residents and Potential Liability Under the FCA

According to the Complaint, Country Villa Watsonville East Nursing Center (now Watsonville Nursing Center) and Country Villa Watsonville West Nursing and Rehabilitation Center (now Watsonville Post-Acute Center) “persistently...more

House Passes Bill Requiring Post-Acute Providers to Collect Patient Assessment Data

The House recently passed its version of The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (H.R. 4994/S. 2553), which would require various post-acute providers, including inpatient rehabilitation...more

Hospital Options for Unused Long Term Care Beds - Corridors Newsletter Fall 2014

A number of hospitals in North Carolina have skilled nursing beds in their bed inventory. According to the Proposed 2015 State Medical Facilities Plan (SMFP), 1,652 of the 45,724 (or approximately 4 percent) of the licensed...more

Alabama CON Report - August 2014

In This Report: - I. SHPDA Administrative Report - A. For Informational Purposes Only - II. Certificate of Need Program - A. Reconsideration on Home Health Batched Applications - B....more

Nursing Home Abuse and Neglect Compliance Trails Federal Requirements

The Department of Health and Human Services Officer of Inspector General (“OIG”) released a report this month titled, “Nursing Facilities’ Compliance with Federal Regulations for Reporting Allegations of Abuse and Neglect.”...more

Health Law Wire: OIG Report on Nursing Home Compliance with Federal Regulations for Reporting Allegations of Abuse or Neglect...

The Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services released a report and recommendations for nursing facilities to develop and implement written policies related to reporting...more

A Flood by Any Other Name is Still a Flood – or Why Losses Caused by Flood Are Subject to Flood Sublimits

In New Sea Crest Healthcare Center, LLC v. Lexington Ins. Co., No. 12-CV 6414(RJD)(RLM), 2014 WL 2879839 (E.D.N.Y. June 24, 2014), the insureds suffered losses to nursing homes in two locations as a result of Hurricane Sandy....more

Tennessee CON Report - July 2014

In This Report: - I. July 2014—Tennessee Certificate of Need Meeting - A. Certificate of Need Review - B. General Counsel’s Report - II. Certificate of Need Program Report—Filings Since June...more

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