Wednesday Feature: Massachusetts Nursing Home Residents Set to Transition to Community Living with $1 Billion Settlement

Happy Hump Day! Last week, the Lieutenant Governor of Massachusetts, Kim Driscoll, announced the settlement of a class action lawsuit filed against the state by six disabled nursing home residents. The suit was filed in 2022 alleging that the state underfunded community-based care options, trapping them in nursing homes despite their wishes to return to … Read more

CMS Final SNF Staffing Rule Released

Late yesterday, CMS released the draft of the Final Rule consistently defined as the “staffing mandate rule”. Earlier in the day, I wrote a post about the final staffing rule and the final Medicaid access rule. At the time, CMS had only notified everyone about the final rule(s) contents via a press release. The actual … Read more

Regulation Monday: SNF Staffing Mandate and Medicaid Access Rule

Just announced this morning, CMS has finalized two hotly debated proposed rules into final rules. The final rules involve the SNF staffing mandate proposed last year and the Medicaid Access Rule, requiring 80% of payments for Medicaid HCBS programs go to compensation for direct care workers. The Medicaid Rule follows the original proposed rule while … Read more

Challenges Persist in Staffing for U.S. Life Plan Communities and Skilled Nursing Facilities

Monday, Fitch Ratings dropped a Non-Rating Commentary about staffing challenges in Life Plan and SNF organizations. Per the release, “Though growing for some time, payrolls for U.S. life plan communities (LPCs) and skilled nursing facilities (SNFs) are still well off the pace needed to reach a full post-pandemic recovery.” Bureau of Labor Statistics (BLS) data … Read more

Friday Feature: An End to Arbitration Clauses?

TGIF! It’s been a long week with the eclipse and lots of economic news plus all the stuff going on in the Middle East. My inbox is flooded so weekend reading will need to include a lot of parsing and pitching. On Tuesday in the Senate, a bill was introduced by Senators Blumenthal (CT) and … Read more

Recent HIPAA Right of Access Settlements Highlight Ongoing Enforcement Efforts

SNFs this one is for you! Yesterday’s post on billing fraud was too. It almost feels as if this second week of April has a compliance theme while last week, the focus was on CMS Proposed Rules. Assuredly, Wednesday will bring some different news as March CPI data drops. This news came last week via … Read more

Medicare, DOJ, Fraud and the Eclipse?

Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more

Reducing MDRO Prevalence in Healthcare Facilities: The Impact of Chlorhexidine Bathing and Nasal Decolonization on Hospitalizations

I’m sure the first reaction to this title is, it’s an April Fool’s joke. This is not that. I know, I don’t really write on any deep clinical topics, for various reasons. First, I’m not qualified clinically (I read to stay B.S. proof and to help my wife’s work – clinical compliance). Second, my only … Read more

CMS Releases 2025 PPS Proposed Rule for SNFs

It’s that time of year again where CMS begins to drop various rule proposals for updates to provider groups under PPS. From Hospitals, to SNFs, to Home Health and Hospice, each industry segment will see a proposed series of rate and programmatic (rule) updates from CMS. This is normal and it occurs at about the … Read more

Skilled Nursing Operator Takes Legal Action Against Staffing Platform for Alleged Overbilling

A little over a week ago, an SNF operator dropped a lawsuit in U.S. District Court in the District of Utah against a staffing platform that works somewhat, like a staffing agency. The platform Nursa acts as a software clearinghouse connecting nursing staff (RNs. LPNs, CNAs, etc.) to facilities with open shifts – “Nursa exists … Read more