Healthcare, Senior Living, Economics
I know I sound redundant but clearly, the message is still not permeating through the industry (except for readers here). The Department of Justice and the OIG for the Department of Health are scrutinizing SNFs, their therapy billings, and the use of therapy contractors. Why? It is all due to a known and now routinely … Read more
With the hospice market (in most areas) fairly well saturated and the core (source) demand from traditional referral sources “flat”, growing census is a challenge for agencies. Some agencies have experienced referral growth but alas, length of stay has shortened. Others have experienced erosion as, while improper, the “skilled to death phenomenon” erodes days and … Read more
As is customary in late fall, the Office of the Inspector General (OIG) of the Department of Health and Human Services released its Fiscal Year work plan. As a reminder or preface, the work plan is the summary of investigations and focal areas the OIG plans to undertake in the upcoming fiscal year and beyond … Read more
In mid-October, the Justice Department announced a $38 million settlement with the SNF chain Extendicare, resolving a series of Medicare False Claims Act violations. The violations involved improper billing for services supposedly provided, provided unnecessarily, or for care that was substandard. This series of violations included allegations of inappropriately billed therapy services; care billed for … Read more
Readers, followers (Twitter, etc.) and folks who have attended one or more of my industry conference presentations know that I routinely harp on the “risk/reward” relationship between SNFs and therapy companies (the contract therapy provides). Last year at LeadingAge’s annual conference in Dallas, the principals from Theracore Management Group and me did a full session … Read more
Yesterday, CMS confirmed the details of an earlier published proposed rule (May) set for publication on August 22, 2014 (final rule) regarding FY 2015 hospice payments. Anyone wishing a copy of the Federal Register text, please contact me as provided on this site (either via comment or contact info. in Author page). As is always the case … Read more
Just ahead of the Fourth of July holiday, CMS released its proposed home health rule changes for FY 2015. As common, the proposal includes rate changes/modifications and clarifications and adjustments to Conditions of Participation. The proposed rule continues a path for CMS and the industry of rate reduction/rate rebasing and movement toward greater emphasis on … Read more
I don’t write a lot on compliance issues. Given the scope of my firm’s practice in this area, maybe I should. My practice focus is more strategic, policy, research and corporate development while compliance is the purview of another Sr. Partner and it is our largest practice area (by full disclosure, this practice area is … Read more
In news just released, Kindred (the post-acute, skilled, rehab and LTAcH behemoth) has made two separate offers to purchase control of Gentiva, the latest a $14 per share offer consisting of half cash, half stock ($7 and $7). An earlier offer of $13 per share was rejected and it appears the $14 offer will see … Read more
Below is a link to an article from Bloomberg Business Week regarding the Hospice industry and the Medicare Choices Program. My last post covered the elements of this CMS demonstration project. The link comes from the original piece written by Charles Elmore and published in the Palm Beach Post this weekend. Readers will note my … Read more