A researcher from the University of Texas found a pattern of poor health outcomes in skilled nursing facilities that fraudulently overbilled Medicare. The paper, “Overbilling and Killing? An Examination of the Skilled Nursing Industry,” revealed how patients at fraudulent Skilled Nursing Facilities suffered worse health outcomes because those facilities sought to increase revenue rather than
On December 12, 2022, the US Government Accountability Office issued a report that recommended that the Center for Medicare and Medicaid Services (CMS) expand all hospice abuse and neglect report requirements. These requirements will be reflected more in nursing homes and hospital reports. All hospice care providers will report all instances of suspected abuse and
This past spring, CMS proposed removing some conditions from the Patient-Driven Payment Model’s Non-Therapy Ancillary category. McKnight’s reported that nursing homes receive an NTA add-on for those with patients coded for a specific diagnosis. Patients who are at risk for both Malnutrition and are at risk get one point toward increased pay of the PDPM.
McKnight’s had an article on spending in nursing homes. Nursing home care and home health care were two of the fastest-growing fields of healthcare spending in 2023 according to Altarum’s monthly Health Sector Economic Indicators brief. Data shows that overall national health spending increased by 6.2% for the entire year, gross domestic product increased by
McKnights reported the US Department of Health and Human Services Office of Inspector General has been investigating Supportive Care Holdings LLC and its CEO, Joseph Newmark, for alleged billing misconduct between 2019 and 2023. This company offered mental telehealth services to skilled nursing facility residents. Telehealth services have recently become very popular for seniors and
The Times Union reported another fraud case. Contained in that lawsuit are multiple allegations that owner/operator Rozenberg and Hagler submitted misleading or false information to Department of Health regulators related to funding and ownership structures for some of their nursing homes. They ignored and violated laws meant to protect nursing home residents and they pocketed
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