Nursing Homes

News & Analysis as of

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

We Don’t Need No Intervention: Qui Tam Relator in Omnicare Wins Big Without DOJ

The United States Department of Justice (DOJ) recently announced the settlement of two qui tam whistleblower lawsuits against Omnicare Inc., the largest nursing home pharmaceutical and pharmacy services vendor in the nation....more

Omnicare Settles Two Qui Tam Cases Alleging “Swapping” Kickbacks to Nursing Homes

The pharmacy provider agrees to pay US$124 million to resolve allegations of below-cost discounts. On June 25, the Department of Justice (DOJ) announced that it had settled with Omnicare, Inc. in two matters alleging...more

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

Managing Regulatory Risk in Nursing Home-Hospice Arrangements

Challenges of Nursing Home-Hospice Arrangements. As a nursing home resident's life expectation sunsets, transfer of the resident from the restorative care of a skilled nursing facility (SNF) to the palliative care of a...more

New Ohio Sex Offender Requirements for Long Term Care Facilities

Nursing homes, residential care facilities and county homes (“Homes”) in Ohio will soon have additional requirements related to the admission of a registered sex offender. House Bill 483, the Mid-Biennium Budget Review bill...more

CMS Survey Guidance and Amendment to SOM Advance Copy of Revised F371; Interpretive Guidance and Procedures for Sanitary...

On May 20 the Centers for Medicare & Medicaid Services (CMS) issued S&C 14-34-NH devoted to the topic of egg preparation in skilled nursing facilities (SNFs). Lest one think that this is an odd or random topic, it is relevant...more

Tennessee CON Report - May 2014

In this Report: - I. May 2014—Tennessee Certificate of Need Meeting - A. Emergency Certificate of Need Review - B. Certificate of Need Review - C. General Counsel’s Report - II....more

Mississippi CON Report - May 2014

In this Report: - I. April 2014 – Mississippi Certificate of Need Meeting - II. Certificate of Need Program Report – Filings/Reports Since March 2014 - A. Letters of Intent to Change Ownership - B....more

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