OIG: CMS Should Take Action Against States with Poor SNF Survey Performance

Last week, the U.S. Department of Health and Human Services Office of the Inspector General (OIG), issued a report regarding the performance of contracted state agencies with respect to nursing home (SNF) compliance surveys. CMS contracts with state agencies, typically state departments of health or divisions thereto, to perform compliance/regulatory activities (surveys) in nursing homes. The report … Read more

Friday Feature: Regulatory Shake-Up – 20 States Revamp Assisted Living Laws in 2022 – 2023

TGIF! Greetings from the great white northland! ‘Tis January and Iowa Caucus time and of course, winter settles in. In the rapidly evolving landscape of Assisted Living, it is crucial for states to adapt and refine their regulations to ensure the safety and well-being of residents. Between July 2022 and July 2023, a total of … Read more

Final Independent Contractor Rule: Implications for Health Care

This morning, the Department of Labor issued a final rule interpreting who is and who is not, an independent contractor v. an employee. Contract work in health care has boomed since the pandemic, though even pre-pandemic, the use of contractors (physicians, nurses, therapists, etc.) was on the increase. The final rule is available here: 2024-00067 The … Read more

SNF Closure Risks Increasing

Two articles in my email caught my attention to start the week. Both have to do with SNF closure risks, one regarding rural facilities and the other regarding staffing challenges. Interesting enough, both cross the same issues for closure, approached however, somewhat differently. I’ve written about this subject for years now yet, attention has only become acute … Read more

COVID Assisted Living Claim in Virginia – Potentially Precedential

My work has me very attuned to litigation trends and in particular, COVID litigation. We are just beginning to see COVID litigation coming to a head with some interesting decisions. Within my firm (H2 Healthcare, LLC), is a practice focus headed by my wife. It involves clinical compliance and complex litigation support. She is considered one of, if … Read more

Wednesday Feature: Outlook for 2024

Happy Hump Day! I hope all readers, followers, and visitors had a great Christmas Holiday. This post will likely wrap-up 2023 for me as tomorrow, I begin a bit of travel to see some long-time friends and celebrate the New Year. I am not much for resolutions into the new year as I try to … Read more

Genesis and COVID Litigation – Interesting Update

Genesis is one of the country’s largest SNF and assisted living providers so naturally, it saw its share of COVID cases throughout the pandemic. Like other similar providers across the same industry, cases involving COVID infections are just now hitting the courts.  Back in October, I wrote about the advancement of litigation involving COVID.  There … Read more

Washington Post and Assisted Living (not so good) News

Yesterday, a story in the Washington Post highlighted a series of wandering cases where residents from an Assisted Living or Memory Care facility wandered and were later, found dead. Industry insiders knew this story was coming and yesterday, it dropped. In many ways, it is eerily similar to a PBS story a decade ago around poor care/neglect … Read more

Humana, United Health: Class Action Suits over AI use in Coverage Determination

It was only a matter of time before litigation came forward regarding the use of Artificial Intelligence (AI) in primarily, Medicare Advantage plans, where coverage denials/determinations are at issue. This week, a class action suit dropped in the U.S. Circuit Court of Western Kentucky against Humana. A link to the suit is here: https://www.scribd.com/document/692182281/Humana-AI-NaviHealth-MA-lawsuit In … Read more

Wednesday Feature: SNF Ownership Transparency

Happy Hump Day!  Only 12 more shopping days until Christmas! In mid-November, CMS issued a final rule titled: “Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts“. The final rule is … Read more