The New Medicare Patient Driven Payment Model (PDPM): What Does It Mean for Nursing Home Residents?

As an advocate for nursing home residents, Rothkoff Law Group strives to educate our clients, their families and consumers about regulatory changes that may affect the care their loved ones receive.   In October 2019, the Centers for Medicare and Medicaid Services (CMS) implemented a new payment model for skilled nursing facilities (SNFs), the Patient-Driven Payment Model (PDPM).  PDPM is described by CMS as a patient-driven care model  that focuses on the diagnoses and characteristics of the patient rather than the services, including the therapy services, provided to them. The [...]

By |2020-02-07T09:23:01-05:00February 3rd, 2020|Blog, Medicare, Nursing Home|

Important Update to Nursing Home Compare Website

Important Update to Nursing Home Compare Website Will Enable Public to Identify Facilities with a History of Abuse The below is from a Joint alert from the Center for Medicare Advocacy and the Long Term Care Community Coalition. On October 7, 2019, the Centers for Medicare & Medicaid Services (CMS) announced changes to Nursing Home Compare website that make it easier for residents and families to identify facilities with a history of resident abuse, neglect, or exploitation. Starting on October 23rd of this year, consumers will see a new icon [...]

By |2020-02-07T10:23:24-05:00October 14th, 2019|Blog, Nursing Home|

CMS Finalizes Rollback of Pre-Dispute Arbitration Protections in Nursing Home Admission Agreements

In 2016, the Obama Administration promulgated regulations prohibiting pre-dispute arbitration agreements between nursing homes residents (or their representative) and facilities. On July 18, 2019, the Trump Administration published a Final Rule rolling back certain features of the 2016 resident protection. Most notably, the Final Rule removes the requirement prohibiting facilities from entering into pre-dispute arbitration agreements with residents, while maintaining the 2016 ban on requiring residents to agree to arbitration as a condition of admission or as a requirement for continued care. Additionally, the Final Rule includes the following [...]

By |2020-02-07T10:09:16-05:00July 22nd, 2019|Blog, Nursing Home|

How to Choose Rehabilitation Services at Nursing Homes

Your loved one is about to be discharged from the hospital and the hospital social worker advises your loved one is in need of rehabilitation services prior to going home.  The social worker gives you a list of three area rehabilitation centers which have an open bed.  How do you decide which rehabilitation center is best suited for your loved one? A new tool for decision making is Medicare’s Nursing Home Compare website, medicare.gov.  For the first time, the federal government is giving a separate rating to the quality [...]

By |2020-02-07T11:06:43-05:00June 3rd, 2019|Blog, Nursing Home|

Recently Modified Federal Nursing Home Staffing Ratings Result In Revised Ratings for New Jersey & Pennsylvania Nursing Homes

Effective in April 2019, the federal government has revised its ratings system for all nursing homes.  The changes include revisions to the nursing home inspection process, adding new quality measures to its ratings system, and further enhancing details about facilities’ staffing numbers. On the latter, officials say they are dropping the number of days SNFs can go without an RN before they’re bumped down to a one-star rating. The Centers for Medicare & Medicaid Services (CMS) first announced the slew of modifications that it’s making to both Nursing Home [...]

By |2020-02-07T11:37:25-05:00April 29th, 2019|Blog, Nursing Home|

Nursing Home Fails To Address Sexual Activity

Nursing Home in Illinois Failed To Adequately Address Sexual Activity Between Cognitively Impaired Residents – Lessons to be Learned An Illinois nursing home was ordered to pay an $83,800 civil monetary penalty after the Centers for Medicare and Medicaid Services found the facility had failed to adequately address sexual activity between three residents with dementia and/or Alzheimer's which placed the residents in immediate jeopardy. This case addressed a very important issue of balancing the rights of nursing home residents versus protecting residents from harm.  The citation and fine were [...]

By |2020-02-07T11:53:23-05:00December 17th, 2018|Blog, Nursing Home|

Protecting Nursing Homes and Their Residents

The nursing home admission process can be a daunting process for elders and their families. Unfortunately, some nursing homes are compounding the difficult process by referring residents and their families to non-attorney unlicensed Medicaid advisors. Non-lawyer Medicaid advisors can include financial advisors, geriatric care managers, disbarred attorneys, former nursing home employees, and a variety of other untrained and unlicensed individuals. The growing trend in the use of unlicensed, non-lawyer Medicaid advisors raises ethical and legal issues for both the Medicaid advisors and those who refer to such individuals. Should [...]

By |2020-02-07T11:55:18-05:00November 26th, 2018|Blog, Medicaid, Nursing Home|

NJ Ombudsman Publishes Brochure to Protect Against Financial Exploitation of Seniors

The majority of nursing homes in New Jersey provide quality care for their residents and are compliant with applicable federal and state laws as to their billing practices.  However, there are a number of nursing homes statewide which have improperly financially taken advantage of elderly residents.  As a result of the conduct of some nursing homes, the NJ Office of the Long-term Care Ombudsman has published a brochure to educate residents and their families on financial exploitation by nursing homes and their business office representatives.  The brochure contains examples [...]

By |2020-02-21T10:14:09-05:00October 15th, 2018|Blog, Nursing Home|

New Data Indicates Many Nursing Homes Are Perpetually Understaffed

Recent data from a review of nursing home payroll records by Kaiser Health News reveals frequent and significant fluctuations in day-to-day staffing of nursing homes nationwide, with particularly large shortfalls on weekends. On the worst staffed days at an average facility, the new data show, on-duty personnel cared for nearly twice as many residents as they did when the staffing roster was fullest.  The daily payroll records of more than 14,000 nursing homes nationwide were analyzed.  Medicare only recently began gathering and publishing payroll records as required by the Affordable Care [...]

By |2018-07-09T08:15:39-04:00July 9th, 2018|Blog, Nursing Home|

New Data Released to Determine Adequate Nursing Home Staffing Levels

On November 1, 2017, the U.S. Centers for Medicare and Medicaid Services (CMS) released new data on staffing levels in U.S. nursing homes.  Staffing is key to the quality of care and safety provided by a nursing home.  CMS has released, for the first time, information on nursing home staffing that is based on payroll or other auditable data sources.  Up until now, public information on nursing home staffing levels has been based on data that are self-reported by facilities. Also, up until now, there has been no mechanism in place to ensure [...]

By |2017-11-12T09:13:01-05:00November 12th, 2017|Blog, Nursing Home|

CMS Lifts Ban On Nursing Home Arbitration Agreements

Eight months after publishing a final rule on the Revised Requirements of Participation for Nursing Facilities banning pre-dispute arbitration agreements for nursing home residents and family members, CMS is issuing new proposed regulations that rescind resident protections against these arguably unfair provisions. According to CMS, it “now believe[s] that an outright ban on pre-dispute arbitration agreements and the further restrictions on post-dispute arbitration agreements do not strike the best policy balance,” and also that “a ban on pre-dispute arbitration agreements would likely impose unnecessary or excessive costs on providers.”  In the [...]

By |2017-06-11T08:18:15-04:00June 11th, 2017|Blog, Nursing Home|

National Nurses Day – Gratitude

  I come from a family of nurses. My mom, mother-in-law, brother-in-law, and all of my aunts and cousins, and extended family are nurses. Growing up in a family of nurses, here is what I’ve learned about them: 1. Nurses have an unbelievable work ethic. One eight-hour shift is never enough. They are always readily available, when the hospital or nursing home calls them in need of extra help, even after they’ve worked a 12-hour shift. 2. Nurses are advocates for their patients. Nurses will fight for their patients, [...]

By |2017-05-16T12:32:13-04:00May 12th, 2017|Blog, Nursing Home|

Nursing Home Compare Website – A Consumer Tool That Can Use Improvement

The Federal Nursing Home Compare website is an important tool that families use when choosing a nursing home.  Unfortunately, the information contained on the website can, in some cases, be misleading and confusing to the average consumer.  Nursing homes over the years have used the website as a marketing tool if they are rated as a "five-star" facility pursuant to the website ratings.  I know of one nursing home in the Philadelphia area that recently reduced staff due to an outside consultant advising the nursing home that they can [...]

By |2016-12-18T15:34:44-05:00December 18th, 2016|Blog, Nursing Home|

Lawsuit Filed Challenging CMS Nursing Home Arbitration Regulation

We are updating you on CMS' revised regulations banning binding arbitration in nursing home admission agreements. The American Health Care Association last onday filed a lawsuit challenging part of a Centers for Medicare and Medicaid Services (CMS) regulation that would ban nursing homes from entering into arbitration agreements. The organization, along with four long-term care providers, filed the lawsuit against Health and Human Services Secretary Sylvia Burwell and Acting Administrator of the Centers for Medicare and Medicaid Services Andy Slavitt.  The plaintiffs say the regulation, which CMS finalized last month, goes [...]

By |2016-10-30T19:14:22-04:00October 30th, 2016|Blog, Nursing Home|

Oversight of PA Nursing Homes Comes Under Scrutiny By State Audit

According to a recent PA audit, the Pennsylvania Health Department does too little to ensure that Pennsylvania's  700 nursing homes are meeting minimum staffing standards in caring for vulnerable residents. The report by Auditor General Eugene DePasquale also said the state is overdue for legislative review of whether staffing requirements and maximum fines against nursing homes should be raised, considering they have been unchanged in the 21st century.  You can read more about the PA nursing home staffing audit at the below link. Nursing Home Staffing Enforcement Audit

By |2016-07-31T08:48:02-04:00July 31st, 2016|Blog, Nursing Home|
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