Healthcare, Senior Living, Economics
A complex area for providers, especially with respect to their compliance programs, are the concepts of fraud and abuse. Central to current requirements for compliance programs, all post-acute providers are REQUIRED to have compliance programs that, Include policies and procedures to define, test for, and mitigate any issues pertaining to fraud and abuse. In this … Read more
TGIF! This week has been very busy with lots of data and lots of economic news. We got a new report from the BLS on inflation. We got earnings reports from Home Depot, Target, and yesterday, Wal Mart indicating what we saw from the Conference Board – consumers are slowing their spending. I called the … Read more
While mergers and acquisitions are generally down, affiliations, closings in some cases, and sponsorship changes in non-profit senior living and care are at a record pace. Back in July, I wrote about the disconnect between acquisitions and the merger/affiliation changes occurring among non-profits. That post is here: https://rhislop3.com/2023/07/24/senior-living-and-care-ma-two-worlds/ A news release from Ziegler Investment Banking, … Read more
Even after all of the years that I have been in health care and particularly, post-acute care, I still field a good number of questions regarding Hospice, the benefit under Medicare, how payments work, and what the generalized payment amounts are. Having started a few hospices in my career, I can attest that done right, … Read more
On November 1, CMS issued the final PPS rule for Home Health (2024). The majority of provisions within this rule, especially those related to payment, take effect on January 1, 2024. The Final Rule as published is available for download here: Home Health 2024 Final Rule In July I wrote a post on the proposed … Read more
An issue that has been tied to AI (artificial intelligence) and specifically, to Medicare Advantage plans, involves coverage denials. I wrote about this in a post earlier this year at https://rhislop3.com/2023/05/01/medicare-advantage-part-d-final-rule/ Coverage denials have been a fairly hot topic around Medicare Advantage plans. The core of the issue is that Medicare Advantage plans are required … Read more
TGIF! On a calendar year basis, we are into the home stretch for 2023. It’s generally about now that I start looking at how 2024 is shaping up. What trends are there to watch? What do markets look like now, socially and economically? What does policy and politics tell us about the year to come? … Read more
Seema Verma, former CMS head, spoke out yesterday regarding the proposed staffing mandate (hours and type of staff, per resident per day) proposed rule, indicating her opinion that the approach was flawed. A recap article on her comments is here: https://www.mcknights.com/news/former-cms-chief-verma-regulators-over-their-skis-with-staffing-mandate/?utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_MLT_DAILYUPDATE_110223&hmEmail=IjP1GPaY%2BJ2uvsLxTJ79bVeRWY7ycbnr&sha256email=aa4cb7c695037c31a216b9562788596b6fcd012145d566f31440b6fcd139c8a9 Regular readers know that I have covered various topics on healthcare staffing, particularly as … Read more
A new week and lots of data/info. coming on a variety of fronts. Today’s post is less about one thing and more about a few things, a bit of smorgasbord to start the week. State by State SNF Data/CLA: Back at the start of the month, I wrote a post on the state of the SNF … Read more
Ten days ago, I wrote a post about COVID litigation and how it was not only mounting but also morphing in terms of scope. Cases were predominantly focused on responsibility for infections at the senior living end such as, my ‘family member’ caught COVID at XYZ Manor and died, so therefore XYZ Manor is responsible … Read more