GAO Releases Report on Poor Perfoming Nursing Homes

In 1998, CMS created the Special Focus Facility initiative or program designed to target or focus attention on improving the poorest performing facilities (performance defined by survey/compliance history).  Each state selects up to 15 of the poorest performing facilities until the program reaches its cap or maximum of 136 facilities.  The requirements from CMS to … Read more

Health Reform Implications for Institutional Providers

My last post covered CMS’ proposed rule affecting LTAcHs in fiscal year 2011 (October 1, 2010).  In this post I noted that CMS’ proposed rule included a disclaimer that  any impacts related to the PPACA (health reform) were not included and as a result, CMS would from time to time, release updates providing additional guidance.  … Read more

CMS Proposed Policy and Rate Changes for LTAcHs

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule for rates and other policy changes for FY 2011 (October 1, 2010) as applicable to Medicare inpatient stays within long-term acute care hospitals (LTAcH).  The entire rule can be found at http://www.federalregister.gov/inspection.aspx#special.  In their release, CMS noted that the proposed rule does … Read more

Stark, Health Care Reform and Updated Compliance Requirements

When the Patient Protection and Affordable Care Act (PPACA) became law, a provision within adds a new dimension to the rules on self-referral and refund requirements of overpayment (Medicare) contained within the Stark Law.  Specifically, the PPACA requires the Secretary of HHS to develop a new self-disclosure protocol whereby health care providers can disclose known (or found) … Read more

Part B Therapy Cuts Delayed to June 1

As a follow-up to a post from last week regarding pending cuts in Part B therapy rates, last evening the House passed a bill that the Senate had passed earlier in the day, included within is a provision to delay the pending cuts to the physician fee schedule until June 1.  The provision is tucked … Read more

Part B Therapy Rate Reductions Return

With Congress on recess, the temporary extension of the Part B therapy rate cuts ended on March 31.  As of today, with Congress still on “holiday”, the Part B therapy rate cuts remain in effect.  Best knowledge has it that Congress is working on another temporary extension that would retro to April 1 and last through April 30.  … Read more

Health Care Reform and Assisted Living

In a bit of an indirect manner, Assisted Living got a boost from health care reform, albeit in a typical governmental fashion.  With the Feds willing to use Medicaid as the vehicle for expanded coverage programs for underinsured (those within 150% of the poverty limit with high-deductible plans) and the uninsured, coupled with additional funding for Home … Read more

Health Care Reform Implications: Home Health Care

I’m a tad behind where I hoped to be in terms of getting these posts out.  Its been a bit  busy over the last ten days or so but headed into the Holiday weekend, a break in the schedule affords me the opportunity to “maybe” get caught up. Of all of the industry sectors touched by … Read more

Health Care Reform Implications: SNFs

The following is a summary of the major provisions in the recently passed health care reform bill.  Please note: I have not attempted to cover every nuance in detail but to provide a highlight for a point of reference.  If any reader has additional questions or wants additional insight on any particular provision, please let … Read more

Strategies for Accomplishing New Development or Major Capital Projects

One of the focal areas of my consulting practice/work is assisting health care organizations in accessing sources of funding (securing financing basically) for major projects and/or new development.  Given the state of the economy, most specifically the capital markets over the past eighteen months, getting funding for capital projects and/or development has been challenging, though … Read more