CMS Presses States on Medicaid Nursing Home Spending

Medicaid nursing home spending - Excelas Medical Legal Solutions
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CMS

States’ Medicaid nursing home spending should help drive better health outcomes among nursing home residents

Medicaid nursing home spending should use already available tools to improve staff pay, training, and retention efforts, suggested the agency’s Centers for Medicaid and CHIP Services said states. The bulletin, while encouraging state governments to do more to fund nursing homes and hold them accountable for quality care, does not impart any new requirements on states or providers.

The bulletin came on the same day that CMS posted a blog outlining more information about its nursing home minimum staffing study. Many providers have said they will need better state support to meet any additional staffing requirements imposed at a federal level.

SENIOR LIVING TRENDS

6 trends will drive future of senior living

Six social, technologic and economic trends will drive the future of senior living, and providers will need to respond to them soon, according to industry thought leader Robert Kramer.

He noted six realities:

  1. The pandemic altered the way senior living works and ushered in the third generation of senior living.
  2. The endemic staffing crisis will continue; providers will need to determine how to recruit and retain the best workers.
  3. New customers want their lifespans to match their healthspan or wellspans. “We need an engagement view of aging and retirement shaped by growth and opportunity, not by deficits and decline,” Kramer wrote.
  4. The industry must reframe the focus on health and healthcare; no more sick care.
  5. Operators must harness data and analytics to transform the industry. In the future, Kramer said, market data will be coupled with personalized health, genomic, social determinants of health, lifestyle and psychographic data, and it will be aggregated by local market.
  6. There will be a shift from fragmented, single-point healthcare solutions and technology applications to integrated, longitudinal solutions that can apply to general settings, diseases and payers.

When that quality is called into question, facilities must be able to demonstrate the type and level of care that was provided through documentation in the resident’s medical records, as well as through policies, procedures, and other business records.  Excelas has the tools and the expertise to assist long-term care facilities in conducting audits, assessing documentation quality and completeness, integrating facility policies and procedures with individual resident medical records, reviewing staffing records, and preparing comprehensive analyses for facility administrators, risk managers, insurers, and counsel. Learn more >>

CMS

Pressure injury study hits at ‘misleading’ self-reported nursing home data

Nursing home operators have underreported the number of pressure injuries in Medicare residents by as much as 40%, said University of Chicago researchers, who have joined a push for less provider-reported data.

Such underreporting makes the data unreliable, particularly for consumers using it to judge a facility’s quality, the authors of a new study asserted. They encouraged federal regulators to toughen the metrics they use to monitor and rate long-term care providers.

“This research is really important in showing that nursing homes often underreport important health changes among their residents,”  Harvard Medical School health policy expert David Graboswki, PhD.

KNOWLEDGE-BUILDING

2022 DRI Senior Living and Long-Term Care Litigation Seminar
September 7–9, 2022 | Nashville, Tennessee

Excelas, LLC is proud to sponsor the 2022 DRI Senior Living and Long-Term Care Litigation Seminar. We’d love to meet you there to learn, grow, and work together.

The annual seminar includes two days of learning and networking for healthcare providers, defense attorneys, in-house counsel, claims specialists, insurance brokers and other professionals involved in the defense of senior housing providers across the country.

Relevant topics to be discussed:

  • Emerging issues, challenges, and trends facing our industry, including COVID-19 litigation and class action and ADA claims
  • Practical tips, suggestions, and defense strategies on how senior living communities can address the staffing crisis and anticipated new CMS guidance
  • The nuts and bolts of defending 30(b)(6) depositions
  • The latest legal and technical arguments for responding to requests for audit trail information
  • COVID-19 outcomes and prevention for the long-term care population from the perspective of an infectious disease specialist
METRICS

Through July 31, 2022, Excelas, LLC has delivered customized solutions to our healthcare clients:

13,724   Records/Cases Reviewed
17,695,414   Pages reviewed
373  Nationwide Clients & Firms Supported

Team Metrics
4.71%   Average Voluntary Turnover 2012 – 2020
26%      Advanced Degrees
48%      Certifications

JUST UPDATED

Excelas’ PREP Act Updates list summaries of relevant articles and selected court decisions, as well as additional recent court decisions, with hyperlinks for reference. The attached update is the most recent, including listings through June 2022.

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