News & Analysis as of

Skilled Nursing Facility

6 Key Takeaways for Providers on BPCI-Advanced (Value-Based Medicare Payment)

by Foley & Lardner LLP on

Despite some initial difficulty in gaining momentum, the use of value-based payment methodologies will likely increase across all provider niches. This change is partly a function of cost savings driven by margin compression...more

Trump Administration’s Proposed FY 2019 Budget Targets Medicare, Medicaid for Savings, Seeks (Again) to Repeal/Replace ACA

by Reed Smith on

The Trump Administration has released its fiscal year (FY) 2019 budget proposal, which includes extensive health policy provisions. While most of the President’s policy proposals for Department of Health and Human Services...more

What Happens When a Nursing Home Closes?

A nursing home closure can be traumatic for residents who are forced to move. While there may not be much that can be done to prevent a closure, residents do have some rights....more

Unanimous Defense Verdict for Home Healthcare Provider

Jones, Skelton & Hochuli, PLC is pleased to announce Partner Donn Alexander and Associate Cory Tyszka obtained a unanimous defense verdict in a home healthcare matter. This case involved allegations of abuse, neglect, and...more

CMS releases updated resource documents for Hospice Quality Reporting Program

by Bricker & Eckler LLP on

On February 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released updated resource documents regarding the requirements and notable information for the Hospice Quality Reporting Program (HQRP). ...more

Home Health Care Patients With Chronic Conditions Are Having Trouble Getting Medicare

Medicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of...more

Court Vacates $350 Million FCA Jury Verdict under Escobar

by Weiner Brodsky Kider PC on

In an action brought by a relator under the False Claims Act, the U.S. District Court for the Middle District of Florida vacated a $350 million jury verdict, finding that the relator failed to provide proof that either the...more

Nursing Facility Discounts Approved in OIG Advisory Opinion 17-08

by Baker Ober Health Law on

The OIG created an opening for nursing facility discounts to private payors when it approved a startup company's proposal to create a network of nursing facilities willing to offer discounts on the daily rates charged to...more

Post-Acute Care Providers Ponder Role in BPCI Advanced

by Baker Ober Health Law on

As CMS's approach to Alternative Payment Models continues to evolve, most recently with the release of BPCI Advanced, post-acute care providers may be left scratching their heads as they try to determine where they fit. An...more

“Traps, Zaps, and Zingers:” District Court Overturns $350 Million False Claims Act Jury Verdict for Want of Materiality

On January 11, 2018, the United States District Court for the Middle District of Florida set aside a nearly $350 million False Claims Act (FCA) jury verdict rendered in February 2017 against a group of fifty-three skilled...more

Court Overturns $350 Million Judgment in FCA Case: Materiality, Scienter, and Causation Standards Preclude Liability by “Zaps,...

by Reed Smith on

A Florida federal court issued a blistering opinion vacating a $350 million judgment in a False Claims Act (FCA) case, and granting the defendants’ motion for judgment as a matter of law. In doing so, the court joined a...more

Middle District of Florida Vacates Massive Verdict Due to Plaintiff’s Failure to Prove Materiality and Scienter

In United States ex rel. Angela Ruckh v. Salus Rehabilitation, LLC, et. al., No. 8:11-CV-1303-T-23TBM (M.D. Fla. Jan. 11, 2018), the Middle District of Florida vacated a jury award totaling nearly $350 million because the...more

Florida Court Tosses $350 Million False Claims Act Verdict Under Escobar’s Materiality Standard

by King & Spalding on

On January 11, 2018, a Florida Federal court vacated a $350 million jury verdict against Salus Rehabilitation—an operator of specialized nursing facilities—in a non-intervened case under the Federal False Claims Act (FCA) and...more

Day 4 Notes on the 2018 JP Morgan Healthcare Conference

San Francisco (January 11, 2018) – The final day of the 2018 JP Morgan Healthcare Conference gave us food for thought about the topic of healthcare navigation, as well as updates on the home health sector. Post-acute has...more

New CMS Guidance Regarding Health Care Texting and Involuntary Discharges

by Benesch on

The Centers for Medicare and Medicaid Services (CMS) periodically provides guidance to the State Survey Agency Directors which outlines areas of emphasis or important concerns for the health care industry. Two (2) recent...more

Hospice compliance: OIG Work Plan, Quality reporting

by Bricker & Eckler LLP on

Hospices may wish to align their 2018 compliance initiatives with the Office of Inspector General (OIG) Work Plan. The OIG Work Plan sets forth various projects including audits and evaluations that are underway or planned to...more

Medicare Launches Hospice Compare Website

Patients looking for hospice care can now get help from Medicare’s website. The agency’s new Hospice Compare site allows patients to evaluate hospice providers according to several criteria. The site is a good start, but...more

Medicare's Part B Premium Will Be Unchanged in 2018, But Many Will Pay More. Got That?

The announcement of the 2018 Medicare premium is good news for some beneficiaries and bad news for many others. The good news is that the standard monthly Part B premium, which about 30 percent of Medicare beneficiaries pay,...more

DOJ Bows Out of ManorCare FCA Case

by Bass, Berry & Sims PLC on

After years of investigation and litigation, and on the eve of a highly anticipated trial, the government abandoned its FCA case against ManorCare, the nation’s second-largest operator of skilled nursing homes and assisted...more

Unreliable Expert Collapses DOJ-Led False Claims Act Case

by Holland & Knight LLP on

False Claims Act cases often turn into battles of the experts. But only rarely does that battle turn into a rout. It did last week in a case out of the Eastern District of Virginia, United States ex rel. Ribik v. HCR...more

Senior Housing Transactions in 2017

by Williams Mullen on

Through the first three quarters of 2017, the market has continued to see steady deal flow in senior housing, with some sluggishness over the summer months. The dollar value of senior housing transactions for the first half...more

Florida Administrative Law Judge Invalidates Governor’s Executive Order Mandating Generators for Senior Housing Facilities

Last week, an Administrative Law Judge ruled against the governor and state agencies regulating senior housing communities, finding that the controversial emergency order did not address a true emergency and as written was...more

Shorts on Long Term Care - October 2017 - News for the NC LTC Community

by Poyner Spruill LLP on

The Citation of Immediate Jeopardy Deficiencies Against Nursing Facilities: Unforeseen Consequences - There are no words more feared by a skilled nursing facility Administrator during an annual recertification survey or...more

The Citation of Immediate Jeopardy Deficiencies Against Nursing Facilities: Unforeseen Consequences

by Poyner Spruill LLP on

There are no words more feared by a skilled nursing facility Administrator during an annual recertification survey or complaint survey than these from a surveyor—“we’re citing you for an Immediate Jeopardy.” Those words set...more

Nursing Home Costs Rise Sharply in 2017

The median cost of a private nursing home room in the United States has increased to $97,455 a year, up 5.5 percent from 2016, according to Genworth's 2017 Cost of Care survey, which the insurer conducts annually. Genworth...more

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