Florida Governor warns that SNFs and ALFs have “no excuse” if caught unprepared for Hurricane Michael

Last year, Hurricane Irma knocked out power to a nursing home in Hollywood, Florida. Without a functioning generator, 14 residents died. According to CBS News, Gov. Rick Scott is warning facilities to prepare in order to avoid a similar tragedy:
“If you’re responsible for a patient, you’re responsible for the patient. Take care of them,” Scott said. “That means you need to make sure that you have back up generation power or you shouldn’t be taking …

SNFs: Are you billing Occurrence Code 22 correctly?

By The Bottom Line.
In an MLN Matters article issued on October 5, 2018, CMS described systems changes they made to ensure SNFs and swing beds bill Occurrence Code 22 correctly. It also ensures the same benefit period logic used for SNF claims is used for swing bed claims. As a result of these changes, MACs will return to provider an inpatient SNF claim (TOB 21X or swing bed claim with TOB 18X) when all of …

Hospice owner found guilty for fraud of $12m

A former Mississippi hospice owner Charline Brandon has pleaded guilty to making fraudulent hospice claims.
Brandon acknowledged submitting nearly $12 million in fraudulent claims to Medicare and nearly $3 million to Medicaid while she was running Haven Hospice, North Haven Hospice, Lion Hospice and North Lion Hospice. A 2017 indictment alleged she was engaged in fraud for nearly a decade. She faces up to 10 years in prison and $250k in fines.
Mississippi has been targeted by …

NY DOL’s order on ‘13-hour standard’ for live-in caregivers ruled invalid

By Home Health Line
A recent New York Supreme Court ruling has further muddied the waters around the practice of paying live-in caregivers in the state for 13 hours a day.
On Sept. 26, the court ruled invalid a New York Department of Labor (DOL) emergency order that was designed to clarify the DOL’s stance on previous DOL guidance. The emergency regulation noted the DOL wage order already in existence shouldn’t be interpreted as requiring home care …