Healthcare, Senior Living, Economics
In my reading stack this weekend (ok, virtual stack), I came across a number of articles on leadership and management. Some were good, some were not, and lots were focused on “old” issues and problems. One in particular, caught my attention – “Management as We Know it Is Broken: How can Leaders Fix It?” What … Read more
TGIF! I live and have an office in Illinois, though my part of the state differs dramatically from the Illinois most people recognize. I live and work in a small town (Galena) in an area known as the driftless region. The driftless region is “original” terra-firma, where the glaciers did not touch. This area is in the far northwest … Read more
In 2023, regulators re-instituted audits of facilities for inappropriate diagnoses of schizophrenia (justification for anti-psychotic use), plus a five-claim audit of every nursing home. The purpose of the audit was to address a long-standing concern that inappropriate coding was driving higher Medicare reimbursement under PDPM, despite documentation in patient records, not substantiating the level of care … Read more
Happy Hump Day! Yesterday I wrote about the OIG’s (Department of Health and Human Services) report and focus on CMS’ oversight of state survey agencies. The impetus behind this focus no doubt comes from the U.S. Senate Special Committee on Aging’s investigation into nursing home survey activities at the state level. The report is available … Read more
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
The Conference Board, a renowned non-profit research organization, has recently released a comprehensive report that sheds light on the business outlook and concerns of CEOs for the year 2024. This study offers valuable insights into the minds of top executives, highlighting their attention towards the economy and organizational talent. In this post, I’ll delve into … Read more
Happy First Hump Day of 2024! Short weeks aren’t really deserving of a Hump Day, but it is officially a Wednesday that is not a holiday in a workweek (though I’m sure many are still off from the Christmas/New Year’s season). Thus, no matter deserved or not, it is my first Wednesday Feature and therefore, … Read more
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
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
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