Long-Term Care

For long-term care (“LTC”) facilities in California, a recent bill known as “AB 641” is about to make the calculus of appealing citations more complicated.

The federal government continues its war against hospice providers.  In its 2012 work plan, the OIG announced that it will determine whether Medicaid payments for hospice services complied with Federal reimbursement requirements.  In fiscal year 2010, Medicaid payments for hospice services totaled more than $816 million.

OIG's 2012 Work Plan targets hospice marketing practices and financial relationships with nursing facilities.

Hospitalizations of residents of skilled nursing facilities are expensive, potentially dangerous, disruptive to ongoing care, and often times preventable.  The Center for Medicare and Medicaid Services (CMS) estimates that nearly 40 percent (40%) of all hospitalizations involving nursing home residents are preventable.  The collective cost to CMS of these hospitalizations is estimated to be $2.6 billion annually.

Many commentators have observed that the Health Care Reform bill enacted March 23, 2010, known as the Patient Protection and Affordable Care Act (“PPACA”) represents the most significant legal change to the American health care system since the adoption of the Medicare Program itself in 1965. To assist our skilled nursing facility clients in preparing to meet the new requirements of law, Fenton Nelson has broken down PPACA’s requirements that are directly relevant to skilled nursing facilities (“SNF’s”).