---
title: "Perspectives"
description: "Articles, case studies, and whitepapers on regulatory change, litigation trends, and documentation practice from the team that reads the medical records."
url: "https://excelas1.com/blog"
updated: "2026-02-10"
type: "index"
---

# Writing on medical-legal practice

Regulatory change, litigation trends and documentation practice, from the team that reads the records.

## Categories

- [Blog](https://excelas1.com/blog/categories/blog.md)
- [Case Study](https://excelas1.com/blog/categories/case-study.md)
- [Company News](https://excelas1.com/blog/categories/company-news.md)
- [Whitepaper](https://excelas1.com/blog/categories/whitepaper.md)

## All posts (164)

- [Navigating Wound Infection Claims in Long-Term Care](https://excelas1.com/blog/navigating-wound-infection-claims-in-long-term-care.md) (2026-02-10): Approach of medical causation and litigation strategies for allegations of negligence and improper treatment of pressure injuries in LTC
- [Focus on Mobility in Senior Living](https://excelas1.com/blog/focus-on-mobility-in-senior-living.md) (2026-01-08): Senior living communities are turning to technology to focus on the mobility of their residents—while also reducing risks related to falls.
- [Human Oversight in the Age of AI](https://excelas1.com/blog/human-oversight-in-the-age-of-ai.md) (2025-12-23): As the growth of AI use continues, the synergy between AI and human experts is essential to ensuring quality outcomes, especially in high-stakes environments like healthcare and law.
- [Recent Verdicts and Litigation Trends and the Impact on Senior Living](https://excelas1.com/blog/recent-verdicts-and-litigation-trends-and-the-impact-on-senior-living.md) (2025-12-02): The latest insights on recent verdicts, decisions, and evolving plaintiff arguments in staffing cases in long-term care facilities.
- [Preparation is Key to Defending Managerial Employees in Long-Term Care Litigation](https://excelas1.com/blog/preparation-is-key-to-defending-managerial-ltc-employees.md) (2025-11-19): In LTC litigation, plaintiffs often targets managerial staff. Thorough deposition preparation for key employee and front staff is critical.
- [Senior Living Litigation: The Impact of Agency and Ancillary Staff](https://excelas1.com/blog/senior-living-litigation-the-impact-of-agency-and-ancillary-staff.md) (2025-10-30): best practices to help long-term care providers navigate the complex legal environment of minimum staffing standards.
- [Strengthening Legal Defense Through Documentation: Distinguishing Assisted Living from Skilled Nursing](https://excelas1.com/blog/distinguishing-al-from-snfs.md) (2025-10-16): The distinctions between assisted living facilities and skilled nursing facilities shape the delivery of care, the regulatory frameworks, the legal exposures involved, and challenges & strategies for defending cases.
- [How AI Is Reshaping Litigation: Insights from DRI’s Senior Living Seminar](https://excelas1.com/blog/how-ai-is-reshaping-litigation-insights-from-dris-senior-living-seminar.md) (2025-09-30): Artificial intelligence is rapidly transforming daily life, with its impact on medicine and law proving especially consequential.
- [Alternative Models in Senior Living](https://excelas1.com/blog/alternative-models-in-senior-living.md) (2025-08-06): The aging population is driving up the senior housing market, with an emphasis on service quality, causing facilities to modify existing buildings.
- [Technology Expectations of Seniors](https://excelas1.com/blog/technology-expectations-of-seniors.md) (2025-07-24): Technological expectations of residents and their families within long-term care facilities are rising causing more facilities to invest in digital technology to support overall healthcare.
- [Record Retrieval Challenges – Electronic Medical Records](https://excelas1.com/blog/record-retrieval-challenges-electronic-medical-records.md) (2025-06-25): Attorneys face significant challenges in retrieving and interpreting electronic medical records (EMRs) due to their complexity, variability across systems, legal and privacy regulations, and the need for collaboration with multiple departments to ensure accurate, complete, and legally admissible documentation in litigation.
- [A Look Forward – Excelas’ Twentieth Anniversary and Beyond](https://excelas1.com/blog/a-look-forward-excelas-twentieth-anniversary-and-beyond.md) (2025-06-11): 20 years of business has given the opportunity to reflect on where the company has been, the exciting projects completed, the innovative processes and products developed, and the outstanding individuals who have been part of this journey.
- [Data and Continuity of Care](https://excelas1.com/blog/data-and-continuity-of-care.md) (2025-03-27): Technology and regulatory changes can help LTC facilities with structured data sharing, allowing for better patient outcomes.
- [Interdisciplinary Approach to Dementia Care](https://excelas1.com/blog/interdisciplinary-approach-to-dementia-care.md) (2025-02-25): LTC residents should be assessed by an interdisciplinary team, starting with a neurology consult followed by psychiatric/psychological care.
- [Skin Wound Documentation: Implications in Care, Claims and Compliance](https://excelas1.com/blog/skin-wound-documentation-implications.md) (2025-01-08): Accurate documentation of wound care is essential for defending claims and litigations, as they are a significant percentage of LTC claims.
- [Early, Focused Reviews to Combat “Profits over People” Claims](https://excelas1.com/blog/early-focused-reviews-to-combat-profits-over-people-claims.md) (2024-11-15): The plaintiffs’ bar has redirected its efforts from the allegations relating to a breach of the standard of care to claims of fraud and conspiracy in the name of corporate profits.
- [Malnutrition Diagnosis and Documentation](https://excelas1.com/blog/malnutrition-diagnosis-and-documentation.md) (2024-10-17): Comprehensive medical record documentation is critical in demonstrating quality care and defending against allegations of malnutrition.
- [Excelas, LLC’s President Moderated “The Bloody Truth about Brain Bleeds & Blood Thinners,” a Panel Discussion at DRI’s Senior Living and Long-Term Care Litigation Seminar – September 2024](https://excelas1.com/blog/2024-dri-panel-discussion-brain-bleeds-and-blood-thinners.md) (2024-09-19): Insights on the inherent risks associated with falls with brain injury while on blood thinners in long-term care settings.
- [How Early Adoption of Remote Work Allowed for Success: Excelas Celebrates its 19th Anniversary](https://excelas1.com/blog/early-adoption-of-remote-work.md) (2024-08-14): Early adoption of remote work has played a big part in Excelas’ success and the happiness of the staff.
- [Vision, Challenges, and Lessons Learned: Excelas Celebrates its 19th Anniversary](https://excelas1.com/blog/vision-challenges-and-lessons-learned-with-excelas.md) (2024-05-15): Jean Bourgeois, founder of Excelas, reflects on her journey building a successful business on the 19th anniversary.
- [Perspectives From Capitol Hill: Mark Parkinson on the Long-Term Care Landscape](https://excelas1.com/blog/the-long-term-care-landscape-capitol-hill.md) (2024-04-25): A look at top regulatory developments affecting providers, implications of the staffing mandate, and trends shaping the healthcare industry.
- [Technology Trends 2024](https://excelas1.com/blog/technology-trends-2024.md) (2024-03-27): Higher expectations of residents and families, increasing documentation requirements due to MDS changes, looming minimum staffing requirements, and tightening reimbursement are all incentives to optimize technology use in long-term care. The category of technology solutions designed to meet the needs of seniors has recently been termed AgeTech. AARP has established the […]
- [Enterprise Risk Management Essential in Long-Term Care Organizations](https://excelas1.com/blog/risk-management-essential-in-ltcs.md) (2024-02-21): Best practices for a successful Enterprise Risk Management program in long-term care organizations and how Excelas, LLC can help.
- [CMS Changes to the Minimum Data Set October 2023 Implementation Challenges](https://excelas1.com/blog/cms-changes-to-the-minimum-data-set-2023.md) (2024-01-29): CMS issued changes to the MDS underscores the need for providers to be proactive in training, documentation, and coding practices.
- [The Medical Record is the Medical Record… Supporting Defense Strategies](https://excelas1.com/blog/supporting-defense-strategies.md) (2023-12-12): Excelas is widely respected for its expertise in managing and evaluating medical records related to long-term care litigation. Our clients value the ability to incorporate our chronologies and analyses into their overall case assessment and defense strategy. It may not be as widely known, however, that Excelas’ expertise extends to other types of cases, product [...]
- [Artificial Intelligence in Healthcare – Regulations, Standards, and Legal Issues](https://excelas1.com/blog/ai-in-healthcare.md) (2023-12-02): The use of artificial intelligence is exploding. Concurrently, the healthcare sector, particularly long-term care, is facing ongoing workforce challenges. Artificial intelligence (AI) tools can potentially alleviate some tasks to allow medical staff to focus on direct patient care as well as augment clinical decision-making. Opportunities with, and concerns around, the use of AI are at [...]
- [Strategic Senior Living Documentation](https://excelas1.com/blog/strategic-senior-living-documentation.md) (2023-11-21): Senior living providers, their insurers, and counsel who represent them understand that quality medical record documentation is critical in deterring survey citations, combatting predatory plaintiffs’ lawyers, and most importantly improving healthcare outcomes for residents. High quality medical record documentation also allows providers to contain the cost of claims and litigation through early dispute resolution. The [...]
- [Regulatory Issues in Assisted Living](https://excelas1.com/blog/regulatory-issues-in-assisted-living.md) (2023-11-15): There are over 30,000 assisted living communities in the United States which provide residents with assistance in activities of daily living, housekeeping, meals, medication management, and wellness programs. Some also provide Alzheimer’s/dementia care. While assisted living facilities do not provide 24-hour skilled nursing services, they do typically coordinate with other care providers, which requires integration [...]
- [Anchoring Damages through Early Case Evaluation](https://excelas1.com/blog/anchoring-damages-through-early-case-evaluation.md) (2023-11-01): Early case evaluation can help defense counsel combat large aberration and nuclear verdicts by anchoring the damages.
- [False Claims Act and Documentation Practices](https://excelas1.com/blog/false-claims-act-and-documentation-practices.md) (2023-10-10): False Claim Act allegations in long-term care stem from poor documentation or medical record keeping as defense relies on complete records.
- [Responding to the Silver Tsunami](https://excelas1.com/blog/responding-to-the-silver-tsunami.md) (2023-10-02): An increase in the older population has led long-term care leaders to develop mitigation strategies to address staffing concerns.
- [CMS Increases Focus on Hospice Care: As Always, Documentation is Key](https://excelas1.com/blog/cms-increases-focus-on-hospice-and-documentation.md) (2023-09-20): Hospice care and billing have become a focus for lawmakers and CMS calling for an increase in documentation to support admission
- [2023 DRI Senior Living and Long-Term Care Litigation Seminar](https://excelas1.com/blog/2023-dri-senior-living-and-long-term-care-litigation-seminar.md) (2023-08-30): Recap of the experts at the 2023 DRI Senior Living and Long-Term Care Litigation Seminar speaking on key topics impacting the industry.
- [Enterprise Risk Management in Long-Term Care](https://excelas1.com/blog/enterprise-risk-management-in-long-term-care.md) (2023-08-24): Enterprise Risk Management strategy programs are important for long-term care providers to adopt to provide safe and high-quality care.
- [Evolving Technology in Long-Term Care Integration of Data](https://excelas1.com/blog/evolving-technology-in-long-term-care-integration-of-data.md) (2023-08-16): As technology in healthcare is evolving with telehealth, remote patient monitoring, and AI, there is an increased need for comprehensive EMR.
- [Assisted Living Accreditation and Guidelines](https://excelas1.com/blog/assisted-living-accreditation-and-guidelines.md) (2023-08-02): Excelas’ experience in internal audit and record review can assist ALFs in preparing for accreditation/certification and defending allegations
- [Trends in Insurance Claims: Medical Record Management and Early Case Resolution](https://excelas1.com/blog/trends-in-insurance-claims-medical-record-management-and-early-case-resolution.md) (2023-07-12): Early case valuation and medical record management can help providers, counsel, and insurers save time and money with insurance claims.
- [Why Excelas? The Value Proposition](https://excelas1.com/blog/why-excelas-the-value-proposition.md) (2023-06-13): The benefits and value of working with Excelas as told by former client and now Excelas President, Beth Wilson.
- [As COVID Cases Go to Trial…](https://excelas1.com/blog/as-covid-cases-go-to-trial.md) (2023-05-31): COVID cases are going to trial and Excelas’ Comprehensive Integrated Timeline Tool (CITT) can assist in defending COVID related cases.
- [The Importance of Documentation in Pressure Injuries](https://excelas1.com/blog/the-importance-of-documentation-in-pressure-injuries.md) (2023-05-18): Medical record documentation of each aspect of the wound assessment and staging is important for wound management and the defense of claims.
- [Medical Record and Document Management](https://excelas1.com/blog/medical-record-and-document-management.md) (2023-05-03): Excelas attended a webinar by the Adelman Law Firm on the importance of policies and procedures, compliance and training, and complaint response in record retention and release practices as part of a comprehensive risk management program
- [The End of the Public Health Emergency Implications for Long-Term Care](https://excelas1.com/blog/the-end-of-the-public-health-emergency-implications-for-long-term-care.md) (2023-04-27): The status of CMS’s healthcare delivery waivers and flexibilities once the Public Health Emergency May 11, 2023.
- [Shock Verdicts: Defense Strategies to Combat Excessive Verdicts and Settlements](https://excelas1.com/blog/shock-verdicts-defense-strategies-to-combat-excessive-verdicts-and-settlements.md) (2023-03-27): Shock Verdicts, are becoming more common during verdicts and settlements. Excelas can assist defense in combating these unprecedented amounts
- [Remote Patient Monitoring: Uses and Challenges](https://excelas1.com/blog/remote-patient-monitoring-uses-and-challenges.md) (2023-03-09): Telehealth and remote patient monitoring continues to expand but RPM technology is quickly evolving which brings challenges with the successes
- [Best Practices in Nursing Documentation](https://excelas1.com/blog/best-practices-in-nursing-documentation.md) (2023-02-23): Nursing documentation facilitates continuity of care between providers and supports clinical decision making. Medical record documentation impacts many aspects of healthcare, including, but not limited to, quality of care, patient outcomes, reimbursement, accreditation, and legal actions. The Ohio Health Care Association recently provided a seminar on Nursing Documentation to Support Services and Care Delivery to [...]
- [Trends for 2023 – Health Information Management Industry](https://excelas1.com/blog/trends-for-2023-health-information-management-industry.md) (2023-02-01): The American Health Information Management Association presented a webinar titled “The State of the HI Industry: 2023 Key Trends.” Industry experts including Dr. Liz Kwo of Everly Health, Dr. David Marc of the College of St. Scholastica, and policy expert Dr. Chantal Worzala examined current issues facing health information managers. The panel discussed three key [...]
- [Communication between LTC Providers and Emergency Departments Avoiding Unnecessary ER Transfers](https://excelas1.com/blog/avoiding-unnecessary-er-transfers-from-ltc-facilities.md) (2023-01-20): Although the Centers for Medicare & Medicaid Services (CMS) has determined the use of Skilled Nursing Facility readmission data for Value Based Purchasing will be suppressed in FY 2023 due to the continuing effects of COVID-19 on the data, acute care facilities face payment reduction based on unplanned hospital readmissions under the Hospital Readmissions Reduction [...]
- [Healthcare Provider Perspectives on Telehealth](https://excelas1.com/blog/healthcare-provider-perspectives-on-telehealth.md) (2022-12-16): The American Health Information Management Association (AHIMA) recently reviewed the “nuances of health information and telehealth” in ambulatory care from the perspective of nurses, physicians, and overall management of health information. The pandemic vaulted the use of telehealth; however, the rapid increase in utilization brought with it challenges in implementation, acceptance, privacy, and security. Nursing [...]
- [Class Action Litigation Trends in Long-Term Care](https://excelas1.com/blog/class-action-litigation-trends-in-long-term-care.md) (2022-12-05): An update to class action litigation trends in Long-Term Care and recommendations for risk mitigation strategies.
- [COVID-19 Trends and Practice Strategies](https://excelas1.com/blog/covid-19-trends-and-practice-strategies.md) (2022-11-22): An update to the COVID litigation trends and practice strategies with the recommendation cases should be litigated and tried to verdict
- [Industry Experts: Long-Term Care Issues Post-COVID](https://excelas1.com/blog/industry-experts-long-term-care-issues-post-covid.md) (2022-11-10): In the DRI Long-Term Care and Senior Living session titled “Post-COVID Headwinds: An Overview of Senior Living and Long-Term Care Challenges,” industry experts reviewed the impact of the White House Nursing Home Initiative, trends in insurance claims and litigation, and CMS initiatives. The following summarizes the insightful overview provided by Tara Clayton of Marsh, Christopher [...]
- [Defending Staffing Allegations in Long-Term Care](https://excelas1.com/blog/defending-staffing-allegations-in-long-term-care.md) (2022-10-26): providers must aggressively defend understaffing cases in long-term care, as staffing data does not elucidate the full story of care provided
- [Regulatory Updates: Long-Term Care Staffing](https://excelas1.com/blog/regulatory-updates-long-term-care-staffing.md) (2022-10-13): The latest information on CMS’s staffing mandate for long-term care facilities: F725 Sufficient Nursing Staffing.
- [An Infectious Disease Specialist Discusses COVID-19 Transmission](https://excelas1.com/blog/infectious-disease-specialist-discusses-covid-transmission.md) (2022-09-28): Transmission risks and infection prevention recommendations for COVID-19 in Long-Term Care Facilities as presented at the DRI conference 2022.
- [2022 DRI Senior Living and Long-Term Care Litigation Seminar](https://excelas1.com/blog/dri-senior-living-and-ltc-litigation-seminar-2022.md) (2022-08-24): Excelas is attending the 2022 DRI Senior Living and Long-Term Care Litigation Seminar in Nashville in September.
- [Nursing Home Ownership and Quality of Care](https://excelas1.com/blog/nursing-home-ownership-and-quality-of-care.md) (2022-08-11): The Fact Sheet issued in February by the White House addressed improving safety and quality of care in nursing homes. The statement cited studies that nursing homes owned by private equity firms tended to have “significantly worse outcomes for residents,” which is disputed by the nursing home industry. Regardless of ownership structure, long-term care facilities are facing significant staffing and economic pressures. Whether public or private, for-profit or not-for-profit, providing high quality care to residents is the primary focus in this time of unprecedented challenges.
- [Staffing Crisis in Long-Term Care](https://excelas1.com/blog/staffing-crisis-in-long-term-care.md) (2022-08-02): Across the country, nursing homes are limiting admissions due to staffing shortages. Hospitals and families are being impacted as seniors face restricted access to appropriate care. Long-term care leaders are asking lawmakers for resources to help expand staffing options; however, looming federal mandates on staffing minimums are predicted to make the situation worse.
- [PREP Act in Long-Term Care Settings Update](https://excelas1.com/blog/prep-act-in-long-term-care-settings-update-july-2022.md) (2022-07-19): Due to state statute of limitations, many firms are rushing to file claims related to incidents from the early days of the pandemic. As of June 2022, the Hunton Andrews Kurth COVID-19 Complaint Tracker reports 541 suits have been filed against healthcare providers, with wrongful death cases accounting for over 66% of those cases. Defense attorneys have argued that COVID-related cases fall under the PREP Act and should be heard in federal court. To date, judges in U.S. District and in Court of Appeals have consistently remanded cases to state courts.
- [Growth through the development of the Comprehensive Integrated Timeline Tool (CITT)](https://excelas1.com/blog/growth-through-the-development-of-citt.md) (2022-07-05): In 2020, Excelas began collecting and creating timelines of the government COVID-19 guidelines in a database of over 10,000 relevant documents
- [Resident Monitoring and Fall Prevention Technology and Privacy](https://excelas1.com/blog/fall-prevention-technology-and-privacy.md) (2022-06-22): According to CNA Aging Services 2022 Claim Report data, resident falls account for over 40% of closed claims across aging services settings, with an average paid indemnity of over $226,000.
- [The Advantages of Accreditation: Demonstrating Quality of Care in the Face of Rising Lawsuits](https://excelas1.com/blog/demonstrating-quality-of-care-in-ltc-facilities.md) (2022-06-08): Demonstrating quality of care is more crucial then ever as wrongful death suits are being brought against long-term care providers.
- [Defending Allegations of Malnutrition and Dehydration Documentation in Long-Term Care](https://excelas1.com/blog/defending-allegations-of-malnutrition-and-dehydration.md) (2022-05-26): Appropriate documentation can help defend against the rising number of allegations of malnutrition and dehydration in long term care settings
- [Dementia Care During the Pandemic and Beyond](https://excelas1.com/blog/dementia-care-during-the-pandemic-and-beyond.md) (2022-05-05): An increase in dementia cases, high cost of patient care, and ongoing staffing issues presents many challenges in long-term care settings.
- [Telehealth Update – March 2022 Legislation, Remote Patient Monitoring Usage & Privacy](https://excelas1.com/blog/covid-waivers-update-on-the-usage-of-telehealth-in-medicine.md) (2022-04-07): Congress continues to consider making COVID-era telehealth waivers permanent. As a component of the Consolidated Appropriations Act, 2022, which was signed into law on March 15, several telehealth waivers were extended for Medicare beneficiaries beyond the end of the public health emergency.
- [Arbitration Agreements in Long-Term Care March 2022](https://excelas1.com/blog/arbitration-agreements-in-long-term-care-march-2022.md) (2022-03-31): As reported by McKnights Senior Living in February, recent court cases have been decided based on who signs an arbitration agreement. CMS ruled in 2019 that residents are not required to sign binding arbitration agreements as a condition of admission or to receive care, and this regulation was upheld in October 2021 by the 8th U.S. Circuit Court of Appeals. Nursing homes are permitted to use these agreements if they are explained to, and acknowledged by the resident or family member that the contents are understood.
- [Webinar Summary: Risk Management in Long-Term Care](https://excelas1.com/blog/webinar-summary-risk-management-in-long-term-care.md) (2022-03-25): Risk management and medical record documentation is essential in managing surveys, claims, and litigation against long-term care facilities.
- [Industry Perspective and the Comprehensive Integrated Timeline](https://excelas1.com/blog/maintaining-comprehensive-covid-19-documentation-and-the-comprehensive-integrated-timeline.md) (2022-02-25): Excelas is maintaining a library of COVID-19 documentation and guidance to help in the defense of COVID claims.
- [Leveraging Best Practices in Long-Term Care Litigation: Medical Record Analysis Services](https://excelas1.com/blog/best-practices-in-long-term-care-litigation-medical-record-analysis-services.md) (2022-02-16): Efficient management of medical information must be emphasized to contain costs because of the backlog of long-term care claims & litigation.
- [Technology for Health Management in LTC Settings](https://excelas1.com/blog/technology-in-long-term-care-settings.md) (2022-01-20): Use of technology during COVID-19 has increased communication in LTCs, but can create potential privacy, security, and documentation issues.
- [The COVID Challenge: Part Three](https://excelas1.com/blog/the-covid-challenge-part-three.md) (2021-12-14): Excelas’ COVID-19 Comprehensive Integrated Timeline Tool can be used to assist in the preparation for and defense of COVID-19 claims.
- [The COVID Challenge: Part Two](https://excelas1.com/blog/the-covid-challenge-part-two-covid-19-guidance.md) (2021-12-07): Collecting, storing, and organizing COVID-19 guidance will be crucial to protect a facility’s patients, residents, staff, and business. Excelas can help make the process more efficient.
- [The COVID Landscape: Part One](https://excelas1.com/blog/covid-19-data-in-nursing-homes.md) (2021-11-18): The latest data on resident and staff vaccination rates, vaccine mandates, and staffing shortages in nursing homes during the pandemic.
- [Telehealth/Telemedicine Regulations Update: Through the COVID-19 Public Health Emergency and Beyond](https://excelas1.com/blog/telehealth-regulations-update-through-covid-19-phe.md) (2021-11-12): Regulatory changes have expanded the use of telehealth, but federal and state action must be taken to continue its use after the pandemic.
- [The Third Circuit Court of Appeals Affirmed the District Court’s Remand to State Court](https://excelas1.com/blog/covid-19-cases-remanded-to-state-court.md) (2021-10-21): The latest on COVID-19 cases in the court room where thee Third Circuit Court of Appeals affirmed the District Court’s remand to state court.
- [What to Know About COVID-19 Wounds: Essential Medical Record Documentation](https://excelas1.com/blog/wound-documentation-during-covid-19-phe.md) (2021-10-18): DRI Senior Living and Long Term Care Litigation Seminar in Las Vegas’s discussion on “COVID Wounds: Clinical Insights” differentiated wounds caused by pressure with those due to skin failure related to critical illness, including COVID-19.
- [Early Case Valuation from a Medical Standpoint: What Counsel Needs to Know](https://excelas1.com/blog/importance-of-early-case-valuation.md) (2021-10-05): Excelas, LLC can assist Defense Counsel with early case valuation to allow Counsel to focus on the legal issues and reduce overall litigation costs.
- [The PREP Act and State Laws: COVID-19 in Long-Term Care Settings Update](https://excelas1.com/blog/prep-act-and-state-laws-in-ltc-settings.md) (2021-08-26): Update to the PREP Act and state immunity laws for healthcare workers in skill nursing as it pertains to the public health emergency.
- [Trends in LTC: Vaccine Mandates](https://excelas1.com/blog/covid-19-vaccine-mandate-in-ltc-facilities.md) (2021-08-19): An increase in COVID-19 cases due to the Delta variant have led many to consider mandating the vaccine for Long-Term Care workers.
- [Forget Zoom…the Return to In-person Education and Networking](https://excelas1.com/blog/return-of-in-person-networking.md) (2021-08-10): Excelas Employee Terri Lightner attended the DRI Medical Liability and Health Care Law conference in Las Vegas focused on cutting-edge medical defense issues.
- [The PREP Act and State Laws: COVID-19 in Long-Term Care Settings](https://excelas1.com/blog/prep-act-in-ltc-settings.md) (2021-07-08): As of June 2021, the Hunton Andrews Kurth COVID-19 Complaint Tracker reported that 255 wrongful death suits have been filed against healthcare providers, with LTC providers accounting for at least 20% of those cases. California, Florida, Texas, New Mexico and Kansas account for over half of these claims. Many states have implemented immunity provisions for healthcare facilities, including senior living, as a result of the pandemic. In addition, the Public Readiness and Emergency Preparedness Act (PREP Act) provides some immunity to facilities on the federal level. However, the PREP Act and state immunity provision have not preempted state tort claims in all cases to date.
- [Telehealth Access After the Public Health Emergency](https://excelas1.com/blog/telehealth-after-the-phe.md) (2021-07-08): While HHS has renewed the Public Health Emergency (PHE) through July 19 and is expected to remain in effect through the end of the year, many states are allowing their public health emergency orders to expire. The expiration of these PHE orders will impact the use of telehealth in all settings, including long-term care.
- [Managing Expectations: End-of-Life Care](https://excelas1.com/blog/end-of-life-care-expectations.md) (2021-06-21): Our staff had the opportunity to attend a discussion on Setting Realistic Expectations for Collaborative End-of-Life Care Planning in Senior Living Communities presented by the Adelman Law Firm. Rebecca Adelman and her team have developed “Expectations Management” programs that have been implemented in senior living communities throughout the country. These programs have been central to mitigating risk, improving quality of care, quality end-of-life care and enhancing staff satisfaction, while reducing turnout. This case study relates to a professional negligence claim arising at an Assisted Living Facility (ALF).
- [A Corporate COVID-19 Timeline – An Employer’s Defense Against Claims](https://excelas1.com/blog/corporate-covid19-timeline.md) (2021-05-18): While employers did their best to act quickly and execute on the recommended health and safety protocols for COVID-19, we may now be witnessing a new wave of issues – lawsuits filed by employees who do not feel their employers “did enough” to keep them safe. Excelas, LLC can help you defend COVID-related claims and/or litigation by preparing and displaying your company response to this global pandemic.
- [The Impact of the COVID-19 Pandemic on Telemedicine in Long Term Care](https://excelas1.com/blog/telemedicine-covid19-impact.md) (2021-04-27): A report by FAIR Health found private payer telehealth claims increased 3,000% in 2020. Is this level of telehealth use here to stay and if so, what is the impact on the long-term care setting?
- [The Rationale for a Medical Literature Chronology Database](https://excelas1.com/blog/the-rationale-for-a-medical-literature-chronology-database.md) (2021-03-12): Risk managers, industry experts, and long-term care leaders have been discussing the importance of the following in defending COVID-19 claims and litigation cases: • Federal Guidance • State Guidance • Local Guidance • Company Response to the Guidance • Facility Response to the Guidance Excelas, LLC has been instrumental in developing a way to memorialize all this information in an easy to use, cloud-based system. Will this be all we reference? We believe there is an additional layer to the already voluminous amount of information individuals and providers were being forced to evaluate on a daily basis – the medical treatment expectations, and how they were changing throughout 2020. Through our software, all information can be merged into an individual patient or resident’s medical chronology to exhibit a comprehensive, sequential record of all relevant standards and expectations at a specific point in time. Sharon Ezzone, MBA, Excelas, LLC., Vice President, Operations
- [ACI hosts 2nd National Forum on COVID-19 Liability for Long-Term Care & Senior Care Providers](https://excelas1.com/blog/aci-long-term-care-covid19-forum-highlights.md) (2021-02-25): This February, our Founder and President, Jean Bourgeois, attended the ACI’s 2nd National Forum on COVID-19 for Long-Term Care and Senior Care Providers. With outstanding and diverse panels, this one day event covered the many challenging issues relating to best practices for COVID claims and litigation defense, federal and state immunity protections, the threat of class actions, and current challenges in the long-term care insurance industry.
- [COVID-19 demands collaboration and new directions](https://excelas1.com/blog/collaboration-during-covid19-demands-new-directions.md) (2020-11-05): The conversations and collaboration among friends and colleagues locally, nationally, and here within Excelas have been the foundation I needed to take action, optimistically look toward, and plan for the future.
- [COVID-19 Record Review](https://excelas1.com/blog/covid-19-record-review.md) (2020-04-21): Healthcare has been threatened as a result of COVID-19 and your facility may have been impacted by high rates of COVID-19 among your residents and/or staff.
- [Are National Standards on The Horizon for the Senior Living Industry?](https://excelas1.com/blog/national-standards-senior-living.md) (2020-02-07): The senior living industry group Argentum has been approved to be the accredited developer of national standards by the American National Standards Institute (ANSI).
- [Disproving Understaffing in Fall Claims](https://excelas1.com/blog/disproving-understaffing-in-fall-claims.md) (2020-01-30): If allegations of negligence arise, the Staffing Scorecard shows whether or not there were fluctuations or inconsistencies in staffing levels during a certain period of time.
- [Using PBJ Data to Defend Against Negligence Claims](https://excelas1.com/blog/payrollbasedjournaling.md) (2020-01-22): Anyone who regularly follows the news has undoubtedly heard about the workforce shortage in America and how it’s affecting different industries.
- [Assisted Living Challenges Lead to Rise in Litigation](https://excelas1.com/blog/assisted-living-challenges-lead-to-rise-in-litigation.md) (2020-01-03): The increase of assisted living claim payouts, lack of a consistent regulatory structure, and predominance of the for-profit business model attracts plaintiff counsel to bring creative actions against assisted living facilities.
- [Best reads of the week, 12-20](https://excelas1.com/blog/best-reads-of-the-week-12-20.md) (2019-12-20): Topics: nutrition, Amazon’s transcription service, healthy traveling, employee cyber security risks
- [Telemedicine: Considerations for Documentation and Medical Records](https://excelas1.com/blog/telemedicine-considerations-for-documentation-and-medical-records.md) (2019-12-16): The rapidly growing telemedicine industry is on track to transform the way healthcare is delivered. With new technologies generating large amounts of patient data across multiple platforms, there is a direct impact to health information management and documentation. What is Telemedicine? Telemedicine, or telehealth, is a means to connect patients to health care services and [...]
- [Best reads of the week, 12-13](https://excelas1.com/blog/best-reads-of-the-week-12-13.md) (2019-12-13): Topics: Future health innovations, physician privilege disclosures, Amazon insurance risks, loneliness
- [Best reads of the week, 12-6](https://excelas1.com/blog/best-reads-of-the-week-12-6.md) (2019-12-06): Topics: Telehealth, ergonomics and opioid-related deaths, living-donor transplant campaign, illegal nursing home evictions
- [A Note of Gratitude: Scalerator](https://excelas1.com/blog/a-note-of-gratitude-scalerator.md) (2019-11-27): With Thanksgiving a day away, we wanted to reflect on an experience we had this year for which we are very grateful.
- [Best reads of the week, 11-22](https://excelas1.com/blog/best-reads-of-the-week-11-22.md) (2019-11-22): Topics: 401(k) limit increase, $3 million HIPAA settlement, Ohio pharmacy closures, issues facing nursing
- [Best reads of the week, 11-15](https://excelas1.com/blog/best-reads-of-the-week-11-15.md) (2019-11-15): Topics: PDPM & therapy reimbursement, Google & Ascension partnership, Amazon Care
- [Best reads of the week, 11-8](https://excelas1.com/blog/best-reads-of-the-week-11-8.md) (2019-11-08): Topics: Seasonal affective disorder, 4-day work week experiment, insurance risk landscape, and courtroom confirmation bias.
- [Best reads of the week, 11-1](https://excelas1.com/blog/best-reads-of-the-week-11-1.md) (2019-11-01): Topics: Arbitration agreements, PDPM and SNF consolidation, flu season, and the effect of politics on our health.
- [2019 DRI Seminar Reflection](https://excelas1.com/blog/2019-dri-seminar-reflection.md) (2019-10-31): Excelas was fortunate to attend and sponsor the DRI Nursing Home/ALF Litigation Seminar in Chicago this September.
- [Best reads of the week, 10-26](https://excelas1.com/blog/best-reads-of-the-week-10-26.md) (2019-10-26): Topics: Fall prevention and mobility, opioid settlement, hospice in senior living, and dementia risk.
- [Best reads of the week, 10-18](https://excelas1.com/blog/best-reads-of-the-week-10-18.md) (2019-10-18): Topics: ACA lawsuit, AI innovation, accessibility, and alleviating financial stress.
- [Best reads of the week, 10-11](https://excelas1.com/blog/best-links-of-the-week-10-11.md) (2019-10-11): Topics: abuse icon on nursing home compare, cost of healthcare waste, Best Buy entering home health market, opioid news.
- [Best reads of the week, 9-27](https://excelas1.com/blog/best-links-of-the-week-9-27.md) (2019-09-27): Topics: nurse burnout, daily pay, flu season, and opioid fraud in Texas.
- [Why Defense Attorneys Should Care About Duplicate Medical Records](https://excelas1.com/blog/why-defense-attorneys-should-care-about-duplicate-medical-records.md) (2019-09-16): Duplicate records pose issues for defense attorneys because they use medical records to evaluate the validity of a claim or allegation, determine case value, and form a defense strategy.
- [Best reads of the week, 9/13](https://excelas1.com/blog/best-links-of-the-week-9-13.md) (2019-09-13): Topics: PDPM, the economy, tattoo DNRs, and EHR-related claims.
- [Best reads of the week, 9/6](https://excelas1.com/blog/best-links-of-the-week-9-6.md) (2019-09-06): Topics: Hurricane evacuation, tech and privacy, and positive psychology.
- [Best reads of the week, 8/26](https://excelas1.com/blog/best-links-of-the-week-8-26.md) (2019-08-30): Topics: Opioid litigation, duplicate medical records, and hospital marketing
- [Payroll Data Shows Reality of SNF Staffing Problem](https://excelas1.com/blog/payroll-data-shows-reality-of-snf-staffing-problem.md) (2019-08-20): Facilities can better prepare to defend themselves by understanding and using their publicly documented payroll-based journal data
- [CMS Ruling: LTC Patients Not Required to Sign Binding Arbitration Agreements to Receive Care](https://excelas1.com/blog/cms-ruling-long-term-care-arbitration.md) (2019-07-18): CMS announces final rule on binding arbitration agreements in long-term care.
- [Patient Driven Payment Model (PDPM) will require SNFs to focus on documentation practices](https://excelas1.com/blog/pdpm-requires-snfs-to-focus-on-documentation.md) (2019-07-01): Providers should expect increased scrutiny of nursing records under PDPM as SNFs will be required to capture information they haven’t had to in the past.
- [Determination of the Robinson v. Bates Number](https://excelas1.com/blog/determination-of-the-robinson-v-bates-number.md) (2019-05-30): The Robinson number can be used as one basis for negotiations early in the evaluation process. A comprehensive review of all related medical bills, including but not limited to outpatient, inpatient, rehabilitation and physician bills, along with the amount paid by insurers and out of pocket by the plaintiff, is necessary.
- [Litigation Review: Roundup](https://excelas1.com/blog/litigation-review-roundup.md) (2019-05-14): As of April 2019, over 11,200 people have sued in U.S. state and federal courts alleging Roundup has caused cancer.
- [The Challenges and Opportunities of Payroll-Based Staffing Data for Your Facility](https://excelas1.com/blog/challenges-opportunities-payroll-based-staffing-data.md) (2019-05-03): Skilled nursing facilities (SNFs) around the country are feeling the effects of the recent changes to Nursing Home Compare rating methodology by the Center for Medicare and Medicaid Services (CMS).
- [Crittenden Insurance Conference: Mega Verdicts on the Rise](https://excelas1.com/blog/mega-verdicts-on-the-rise.md) (2019-04-29): Reasons for this mega verdict trend are speculative, but here are two factors believed to be at play.
- [Understanding the Systemic Effects of Opioids can Help Mitigate Litigation Risk](https://excelas1.com/blog/understanding-the-systemic-effects-of-opioids-can-help-mitigate-litigation-risk.md) (2019-04-22): As the opioid crisis continues, we are likely to see more lawsuits initiated by patients who develop debilitating addictions to pain pills.
- [Arbitration Agreements in Long-term Care](https://excelas1.com/blog/arbitration-agreements-in-long-term-care.md) (2019-04-05): Arbitration agreements in long-term care have been the subject of recent industry news.
- [A Look at Long-term Care Litigation and Liability Risks](https://excelas1.com/blog/a-look-at-long-term-care-litigation-and-liability-risks.md) (2019-03-20): To evaluate liability risk, aging services providers need to be aware of the current legal landscape in long-term care, what it is expected to look like in the future, and where they should focus their efforts within their own organization to reduce risk exposure.
- [Current Opioid Litigation and the Role of Medical Record Reviews](https://excelas1.com/blog/opioid-litigation-medical-record-reviews.md) (2019-02-27): According to the Centers for Disease Control (CDC), from 1999 to 2017, approximately 218,000 people died in the US from overdoses related to prescription opioids.
- [Cloning in EHR can lead to fraud, patient harm](https://excelas1.com/blog/cloning-in-ehr-can-lead-to-fraud-patient-harm.md) (2018-03-28): Documentation integrity is critical for avoiding fraudulent billing, HIPAA violations, claim denials, audits and compliance violations, and threats to patient care.
- [Is Your Facility Too Lenient on Physician Certifications?](https://excelas1.com/blog/is-your-facility-too-lenient-on-physician-certifications.md) (2018-01-26): Problems with documentation in skilled nursing facilities (SNF) often lead to claim denials that can negatively impact cash flow and make these facilities susceptible to audits. According to findings in the 2017 Comprehensive Error Rate Testing report, one of the most common errors in medical reviews is missing or insufficient physician certification and/or recertification statements.
- [CMS Extends Moratorium on Phase 2 Enforcement Penalties](https://excelas1.com/blog/cms-extends-moratorium-on-phase-2-enforcement-penalties.md) (2018-01-26): In November, the Centers for Medicare and Medicaid Services (CMS) announced it would give SNFs more time to adjust to some of the regulatory changes in LTC requirements before being penalized. Previously, the agency said it would restrict enforcement for one year, but due to readiness concerns from long-term care providers, they have extended their moratorium on penalties to 18 months.
- [10 Nutritional Considerations for Long-Term Care Residents](https://excelas1.com/blog/10-nutritional-considerations-for-long-term-care-residents.md) (2017-09-02): Nutrition is major focus at many nursing facilities because it is often linked to medical conditions. Malnutrition and dehydration, in particular, are recurring issues at nursing facilities, especially because they can lead to falls, the development of pressure injuries and/or cognitive impairment.
- [7 Ways to Adjust Nursing Home Patient Care Plans After a Fall](https://excelas1.com/blog/7-ways-to-adjust-nursing-home-patient-care-plans-after-a-fall.md) (2017-08-02): Falls are an enormous issue in long-term care facilities, and are often at the heart of lawsuits against care providers. The medical record is a crucial tool for the defense as it pieces together a timeline of what happened before, during and after a fall. It is imperative to document all of the steps the provider took to demonstrate its awareness of the resident’s fall risk, attempts to prevent them from falling, and response when a fall does happen.
- [11 Risk Factors for Infections Among the Elderly](https://excelas1.com/blog/11-risk-factors-for-infections-among-the-elderly-excelas-legal-medical-solutions.md) (2017-08-02): Infections in long-term care (LTC) facilities are associated with higher rates of morbidity, mortality, rehospitalization, extended hospital stays, and substantial expense. Urinary tract infections (UTIs) are among the most common infections seen in LTC facilities. For these reasons, many medical malpractice lawsuits involve patients who were treated for an infection of some kind.
- [5 Interventions to Prevent Falls in Nursing Facilities](https://excelas1.com/blog/5-interventions-to-prevent-falls-in-nursing-facilities.md) (2017-07-25): Falls are an enormous issue in long-term care facilities, and are often at the heart of lawsuits against care providers. The medical record is crucial to the defense when piecing together a timeline of what happened—including all the steps the care team took to demonstrate awareness of the patient’s fall risk and attempts to prevent the patient or resident from falling.
- [3 Ways to Improve Your Billing Process and Avoid Recovery Audits](https://excelas1.com/blog/3-ways-to-improve-your-billing-process-and-avoid-recovery-audits.md) (2017-07-07): Recovery auditors typically look for discrepancies in the nursing facility’s reimbursement requests. And while recovery audit decisions are generally appealable, it’s better to avoid an audit than to appeal one. Fortunately, there are a few proactive steps to take prior to finalizing billing that may help avoid audits—or allow a facility to successfully weather closer scrutiny.
- [The Five-Step Process for Assessing Quality of Care](https://excelas1.com/blog/the-five-step-process-for-assessing-quality-of-care.md) (2017-06-08): There are many aspects to building a strong defense, but one crucial factor is using the medical record to paint a picture of the quality of care that was provided. In many cases, the medical record contains much of the information the defense needs. The trick is knowing how to navigate the complexities of the medical record.
- [Three Steps to Building a Successful Wrongful Death Defense](https://excelas1.com/blog/three-steps-to-building-a-successful-wrongful-death-defense.md) (2017-05-17): Defending against a wrongful death claim can prove challenging. Often, the “blame” is directed at the last place the deceased received care, although myriad factors may have contributed to the cause of death. To be successful, the plaintiff must first prove that an event or injury occurred as a result of negligence. Then it must be proven that the event or injury proximately caused or contributed to cause of death. Even with a death certificate, the cause of death can remain uncertain, so an accurate and detailed medical record review is vital. Here are a few recommendations to consider…
- [Legal Implications Of Changes To Pressure Ulcer Terminology](https://excelas1.com/blog/legal-implications-of-changes-to-pressure-ulcer-terminology.md) (2016-11-29): Recent—and controversial—changes to pressure ulcer (now pressure injury) terminology and staging are accompanied by potentially significant legal implications for the healthcare field.
- [Are You Using The Correct Terminology For Pressure Injuries?](https://excelas1.com/blog/are-you-using-the-correct-terminology-for-pressure-injuries.md) (2016-11-22): The National Pressure Ulcer Advisory Panel (NPUAP), a not-for-profit organization of pressure injury experts, recently made changes to the terminology and staging system used for the identification and assessment of pressure ulcers.
- [EMR: Details To Watch For When Extracting Records](https://excelas1.com/blog/emr-details-to-watch-for-when-extracting-records.md) (2016-10-11): Excelas has retrieved more than 600,000 pages of medical records from a variety of EMR systems and for a variety of projects and has observed some common trouble areas. Be aware of these six top issues when pulling electronic records.
- [Reptile Strategy in Healthcare Litigation: Opening Statements](https://excelas1.com/blog/reptile-strategy-in-healthcare-litigation-opening-statements.md) (2016-09-30): Reptile Theory is ubiquitous, and it’s here to stay. With many plaintiffs’ attorneys now employing this theory in their trial strategy, defense attorneys must face the challenge of effectively defending against it.
- [Hospital Finds Peace of Mind with Excelas’ Coding Verification Audits](https://excelas1.com/blog/hospital-finds-peace-of-mind-with-excelas-coding-verification-audits.md) (2016-09-16): Performing proactive internal audits of processes and procedures is an excellent way to ensure compliance with corporate or regulatory standards. But sometimes, it’s not until an external audit returns unexpected results that an inward examination begins.
- [Reptile Theory in Healthcare Litigation: Deposition and Witness Testimony](https://excelas1.com/blog/reptile-theory-in-healthcare-litigation-deposition-and-witness-testimony.md) (2016-08-25): The Reptile Theory is arguably the most game-changing trend in litigation in recent history. The goal of the theory, which was created by Don Keenan, Esq. and jury consultant Dr. David Ball as a counter to tort reform, is to achieve plaintiff verdicts and high damages even in jurisdictions where damage caps exist.
- [Reptile Defense Tactics: Priming In Voir Dire](https://excelas1.com/blog/reptile-defense-tactics-priming-in-voir-dire.md) (2016-08-25): With more than $6 billion (and counting) in verdicts and settlements since 2009, the Reptile Theory has been a slam dunk for the plaintiff bar. The defense bar has devised a three-part strategy for battling the theory, starting with witness testimony and deposition, as proposed by jury expert Bill Kanasky. The next opportunity to fight the Reptile: Priming potential jurors in voir dire.
- [Preparing for Government Audits: Hospice Services](https://excelas1.com/blog/preparing-for-government-audits-hospice-services.md) (2016-07-05): In the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) maintains a consistent vigilance over providers and their utilization, billing, and claims practices to ensure that the services they pay for are appropriate and in compliance. This vigilance extends to providers within the entire long-term and post-acute care continuum—including hospice services.
- [Preparing for Government Audits: Therapies](https://excelas1.com/blog/preparing-for-government-audits-therapies.md) (2014-08-05): There is little argument that the Centers for Medicare & Medicaid Services (CMS) are justified in seeking to ensure that the long-term and post-acute care services they pay for are appropriate and meet federal standards. And from a purely budgetary standpoint, it makes perfect sense to put checks and balances in place to make sure the dollars are spent where they should be.
- [A Business Associate’s Compliancy Journey: Business Associate Agreements](https://excelas1.com/blog/a-business-associates-compliancy-journey-business-associate-agreements.md) (2014-07-29): Small businesses commonly face challenges in HIPAA compliance that larger companies do not face. One such challenge may be creating and executing Business Associate Agreements with subcontractors such as document management companies, couriers, and technology providers.
- [Reptile Theory in Healthcare Litigation: Introduction](https://excelas1.com/blog/reptile-theory-in-healthcare-litigation-introduction.md) (2014-07-29): The Reptile Theory is arguably the most game-changing trend in litigation in recent history. Originally developed by Don Keenan, Esq. and jury consultant Dr. David Ball, the trial method was created in response to tort reform. The strategy was designed specifically to achieve plaintiff verdicts and high damages, even in jurisdictions where damage caps exist. It has been so successful for the plaintiff bar in personal injury and medical malpractice cases that it has now made its way into other areas of law, including product liability and transportation. Because of the theory’s prevalence in medical malpractice, it’s important for healthcare providers to be aware of how the strategy typically unfolds during litigation.
- [How to Evaluate the Use of General Inpatient Care](https://excelas1.com/blog/how-to-evaluate-the-use-of-general-inpatient-care.md) (2014-07-29): General inpatient care (GIP) is the second most expensive level of hospice care. GIP, which provides 24/7 nursing care, is intended for short-term use to manage pain and symptoms when palliation cannot be achieved in other settings.
- [All Ulcers Are Not The Same: Diabetic Ulcers](https://excelas1.com/blog/all-ulcers-are-not-the-same-diabetic-ulcers.md) (2014-07-18): [vc_row][vc_column][vc_empty_space height=”16px”][/vc_column][/vc_row][vc_row][vc_column width=”1/3″ el_class=”vc_col-sm-push-8″][vc_single_image image=”299″ img_size=”full” style=”vc_box_border”][/vc_column][vc_column width=”2/3″ el_class=”vc_col-sm-pull-4″][vc_column_text]Skin ulcerations. They can be painful for patients and terrifying for families. They bring to mind the image of bed sores, possibly caused by neglect and abuse. But, anyone who has a loved one in a healthcare facility should understand that not all ulcers are the same—and, […]
- [A Business Associate’s Compliancy Journey: Electronic Transfer Of PHI](https://excelas1.com/blog/a-business-associates-compliancy-journey-electronic-transfer-of-phi.md) (2014-06-30): For small companies whose primary function includes receiving, reviewing, and analyzing information contained in medical records, dealing in the transfer of protected (or personal) health information (PHI) will be a daily occurrence. These types of companies constantly deal with medical records, and protecting PHI that is electronically transferred is of primary importance. This can naturally lead to a major focus on becoming fully HIPAA compliant.
- [All Ulcers Are Not The Same: Venous Stasis Ulcers](https://excelas1.com/blog/all-ulcers-are-not-the-same-venous-stasis-ulcers.md) (2014-06-10): There are a variety of skin ulcers. Most people are somewhat familiar with decubitus ulcers, more commonly known as pressure sores (and also sometimes called bedsores). Kennedy Terminal Ulcers (KTUs), another type of pressure sore, occur at the end of life. There are several other types of ulcers that are non-pressure-related, including venous stasis ulcers, arterial ulcers, and neurotrophic (diabetic) ulcers. In this post will cover venous stasis ulcers.
- [Nursing Home Eviction And The Defensible Medical Record](https://excelas1.com/blog/nursing-home-eviction-and-the-defensible-medical-record.md) (2014-05-24): A recent Associated Press (AP) article discusses the growing issue of complaints regarding involuntary discharges and evictions from nursing homes and other long-term care facilities. According to the article, complaints about evictions have increased 57% since 2000, and were the most frequently reported grievance received by the Long-Term Care Ombudsman Program in 2014, with 11,331 [...]
- [A Business Associate’s Compliancy Journey: Remote Workforce](https://excelas1.com/blog/a-business-associates-compliancy-journey-remote-workforce.md) (2014-05-15): Small businesses may struggle to achieve and maintain HIPAA compliance, especially when there are added challenges such as employees who work remotely—whether full-time or on occasion—and need to access protected or personal health information (PHI) on a daily basis. Ensuring corporate office compliance is often an easier task than ensuring compliance for remote workspaces, but the HIPAA requirements stay the same no matter the location.
- [Facts About Pressure Ulcers (Bedsores)](https://excelas1.com/blog/facts-about-pressure-ulcers-bedsores.md) (2014-04-23): A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence. Areas most at risk include the sacrum (tailbone), ischium (the lower, back side of the hip bones), hips, heels, and elbows. Pressure ulcers are caused by prolonged pressure on the prominence, or pressure in combination with shear, such as a dragging or brushing motion.
- [Dementia And Falls Among The Elderly](https://excelas1.com/blog/dementia-and-falls-among-the-elderly.md) (2014-04-02): Falls are, unfortunately, common among the elderly—regardless of whether they’re at home or in a healthcare facility. Many healthcare providers are faced with litigation related to elderly patients falling and injuring themselves, but familiarity with why falls happen can help providers prevent them from occurring, or document what contributed to the event.
- [The Role Of Aging In Malnutrition Of The Elderly](https://excelas1.com/blog/the-role-of-aging-in-malnutrition-of-the-elderly.md) (2014-03-10): Much of the litigation involving the elderly in nursing homes includes allegations of malnutrition. But malnutrition is not necessarily a sign of negligence. Instead, aging—and its many side effects—is a major contributor to the problem.
- [All Ulcers Are Not the Same: Arterial Ulcers](https://excelas1.com/blog/all-ulcers-are-not-the-same-arterial-ulcers.md) (2014-02-03): Unlike pressure ulcers, arterial ulcers are due to poor blood circulation, which can occur acutely (such as with trauma or thrombosis) or chronically (such as with atherosclerotic disease).
- [Aging and the Long-term Effects of Alcohol](https://excelas1.com/blog/aging-and-the-long-term-effects-of-alcohol.md) (2014-01-16): For many people, coming home at the end of the day and having a couple drinks to unwind and relax is a common occurrence. It’s a seemingly benign behavior that’s more harmful than what most people expect—mainly because of its negative impact on health later in life.
- [The Basics of Preventing Infection in Long Term Care Facilities](https://excelas1.com/blog/the-basics-of-preventing-infection-in-long-term-care-facilities.md) (2013-08-22): Infections pose a significant threat to the frail elderly in long-term care settings, often resulting in life-altering complications, including death. Infection control measures must be consistently practiced by caregivers in long term care settings.
- [Are Kennedy Terminal Ulcers Gaining Recognition Among Federal Regulators?](https://excelas1.com/blog/are-kennedy-terminal-ulcers-gaining-recognition-among-federal-regulators.md) (2013-08-07): Long-term care (LTC) providers have, for years, asserted that not all skin alterations are an indication of poor-quality care. The Kennedy Terminal Ulcer (KTU) was originally noted more than a century ago, and was formally studied for the first time in the 1980s. But it has taken until now for federal regulators to give any credence to the phenomenon—and specifically, to consider excluding this particular type of ulcer from among the list of quality indicators.
- [What Is A Kennedy Terminal Ulcer?](https://excelas1.com/blog/what-is-a-kennedy-terminal-ulcer.md) (2013-08-01): Sometimes, when a person approaches the end of life, multi-organ failure begins to occur. And sometimes, such organ failure includes the largest organ of the human body—the skin. This can result in patients developing a Kennedy Terminal Ulcer (KTU). Similar in some ways to other pressure ulcers, KTUs are also distinctly different in important ways.
- [Reinvesting Your Resources in Patient Care](https://excelas1.com/blog/reinvesting-your-resources-in-patient-care.md) (2013-06-06): The Alliance for Quality Nursing Home Care recently released a report that shared some sobering statistics about the financial health of the country’s skilled nursing facilities. While a majority of the factors contributing to this challenge are beyond the control of the SNFs, the good news is that there are some things you can control that can make a significant and positive impact on your organization.
- [The List of Monitored Atypical Antipsychotic Drugs Just Got Longer](https://excelas1.com/blog/the-list-of-monitored-atypical-antipsychotic-drugs-just-got-longer.md) (2013-05-31): The use of atypical antipsychotics in elderly nursing home residents with dementia continues to be a hot topic for CMS. Newly updated guidelines offer more guidance and criteria for when the drugs can appropriately be prescribed
- [RAC Audits: The Calm Before the Storm](https://excelas1.com/blog/rac-audits-the-calm-before-the-storm.md) (2013-05-23): The Center for Medicare and Medicaid Services (CMS) recently announced that healthcare providers would begin to see a decline in the number of additional documentation requests (ADRs) they receive, beginning in June 2013. There is one implication and one opportunity to be found in this announcement.
- [Preparing for Government Audits: Atypical Antipsychotics](https://excelas1.com/blog/preparing-for-government-audits-atypical-antipsychotics.md) (2013-05-17): Most people would agree that the Centers for Medicare & Medicaid Services (CMS) are justified in seeking to ensure that the long-term an acute care services they pay for are appropriate and meet federal standards. After all, ours is a rapidly aging population that is increasingly reliant on the Medicare/Medicaid system. From a purely budgetary standpoint, it makes perfect sense to put checks and balances in place to make sure the dollars are spent where they should be.
- [Medical Legal Analysts: The Credentials and Qualifications That Matter Most](https://excelas1.com/blog/medical-legal-analysts-the-credentials-and-qualifications-that-matter-most.md) (2013-04-18): Medical Legal Analysts. Legal Nurse Reviewers. Medical Analysts. Although the titles may vary, it’s the skills that matter. There’s a lot of discussion in the industry about what courses to take, what certifications to obtain, and how best to get a foot in the door doing medical analysis for the legal industry. Companies that recruit [...]
- [Securing a Nursing Home’s Reputation in the Face of Lawsuit Onslaught](https://excelas1.com/blog/securing-a-nursing-homes-reputation-in-the-face-of-lawsuit-onslaught.md) (2013-04-11): Just like thousands of skilled nursing providers in the United States, a nursing home in the Midwest had worked hard every day to provide dignified care that serves the needs and enhances the quality of life of its residents.
- [How to Successfully Defend Against Multiple, Changing Allegations](https://excelas1.com/blog/how-to-successfully-defend-against-multiple-changing-allegations.md) (2013-04-11): A busy law firm in Florida spent months prepping a case for trial. The allegations that their client, a nursing home, faced were clear. A defense was prepared and documentation was gathered to support their position. But, like so many things in life, their best-laid plans went awry—a few times.
- [Who’s Who In Your Medical Records?](https://excelas1.com/blog/whos-who-in-your-medical-records.md) (2013-04-11): A crucial step in any medical review process or analysis of medical records is the Wrong-Patient Check—a confirmation during project initiation that ensures each piece of the record being reviewed belongs to the patient in question.

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