A How-To Networking Guide For Niche Industry Professionals Via Forbes

Understanding the needs of your client base and earning their trust is critical, and working in a niche industry can present unique challenges. When done appropriately, networking can play a key role in addressing each of these goals. Read more

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NYS Medicaid bed hold reimbursement changes

There have been changes to Medicaid bed hold reimbursement as part of the new NYS budget approved in April. This clarifies the current situation. http://update.nyshfa.org/en/1611953/1/6226/Alert-2017-18-Budget-has-Changed-the-SNF-Bed-Hold-Rules.htm

Alert: 2017-18 Budget has Changed the SNF Bed-Hold Rules

Carl J. Pucci and Nancy Leveille and Lisa Volk in Clinical & Quality

Effective April 1, 2017, the New York State budget has eliminated the 50% Medicaid payment for bed-hold for residents’ stay in hospitals. Therefore, DOH will no longer reimburse bed-hold days for facilities with a 95% or greater census upon such hospitalization a maximum of 14 days in a calendar year. The DOH will maintain the 2012 enacted bed-hold rate cut necessary to achieve $18M in annual savings (line 14 of the Medicaid rate sheets).  This change does not affect Therapeutic leaves and therefore facilities must continue to follow those rules for implementation. As such, Therapeutic leaves of absence (paid at 95% of Medicaid rate) remain intact, not to exceed 10 days per 12-month period.

With this change, facilities will no longer be required to hold the resident’s specific bed, but must offer the first available, appropriate bed.

With the 14-day paid bed-hold eliminated, skilled nursing facilities must continue to follow both New York State (415.3 resident rights) https://regs.health.ny.gov/content/section-4153-residents-rights and Federal requirements (483.15 (d).  CMS has updated this section based on the new requirements of participation.  https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R168SOMA.pdf  Scroll down to page 63-64 to locate the specific bed-hold information.

NYSHFA recommends that each SNF take the following actions to enact this change to bed-hold:

  1. Update your facility policy for bed-hold specific to NYS code 415.3 and CMS code 483.15(d).
  2. Notify all current residents or their representative of this change in policy due to the 2017/2018 NYS Executive Budget.
  3. Update your notice to new admissions instructing them on the current policy for bed-hold.
  4. Update the facility’s bed-hold letter templates to reflect these changes.
  5. Note that the hospital is still not a discharge location, therefore the SNF is still required to transfer these residents back to the SNF upon discharge from the hospital.
  6. Review the sections of code related to holding the residents’ original bed or offering them the next available bed.
  7. Utilize the NYS regulations 415.3 and CMS 483.15 (e)(1) permitting residents to return to facility codes as your reference for policy and letter changes. This section specifies what the residents and SNF rights are related to when a resident transfers to the hospital and when a resident returns to the facility.

 

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NY Managed Long Term Care Companies (MLTC) Are Killing Elders By Refusing Mandated Services.

NY Managed Long Term Care Companies (MLTC) Are Killing Elders By Refusing Mandated Services. – My Elder Advocate, LLC

The New York Legal Assistance Group has filed a federal class action lawsuit in the Eastern District of New York to challenge threatened and actual reductions in Medicaid-funded home care services. Named Plaintiffs and the class they seek to represent are people with disabling conditions who need home care services to remain safely in their homes and communities.

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Deadly Drugs Misused In U.S. Nursing Facilities

From AARP:

When the family of Bobby Glenn Tweed made the difficult decision to have him admitted to a nursing home in January 2013, little did they realize he would have just months left to live. While diagnosed with dementia, Tweed, 78, was still a vigorous man.

But without his family’s consent, Tweed was given psychotropic drugs that are known to be fatal among older patients with dementia. In 10 months, he was dead. Read more

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Nursing Home Abuse By Guardianship

To Collect Debts, Nursing Homes Are Seizing Control Over Patients

Few people are aware that a nursing home can take such a step. Guardianship cases are difficult to gain access to and poorly tracked by New York State courts; cases are often closed from public view for confidentiality. But the Palermo case is no aberration.

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