Author archive: ltcdefense

Recent Findings by Office of Inspector General Regarding Reporting of Potential Abuse and Neglect at Skilled Nursing Facilities

The Office of Inspector General (OIG) recently released the findings of an audit performed to determine the prevalence of incidents of potential abuse or neglect of Medicare beneficiaries residing in skilled nursing facilities (SNFs). Specifically, OIG looked at beneficiaries who resided in a SNF during 2016 and who also had a hospital ER Medicare claim…

Recent Amendments to the Illinois Nursing Home Care Act

The Illinois Nursing Home Care Act was recently amended by the Illinois General Assembly (IGA) after the passage of what both nursing home and patient advocates consider a mutually agreeable bill. One area the law is designed to address is the conflict between appropriate levels of direct nursing care and the well-known shortages in this…

Big Changes to Illinois Involuntary Discharges

Changes are coming to Illinois Involuntary Transfer or Discharge procedures as a result of a recent Appellate Court ruling in Lakewood v. IDPH, et al. Lakewood raised three questions: 1) whether the law requires IDPH to hold the hearing within 10 days of a request, 2) whether the law requires IDPH to render a decision…

Proposed Legislation Regarding Long-Term Care Facilities in Missouri – March 2018

Pilot Program To Transfer Facility Inspections From The Department Of Health And Senior Services to Local Health Departments (HB – 1555) Missouri Representative James Neeley is sponsoring a bill that would create a pilot program to transfer the authority to inspect nursing homes from the Department of Health and Senior Services to local health departments….

Significant Changes Ahead for Missouri Litigators – Part III

The Missouri Supreme Court approved two completely new jury instructions for civil cases that require the immediate attention of Missouri civil litigators, becoming effecting July 1, 2017. Rules E1.00 and E1.01 allow the Court to read an Early Case Summary to the jury before the beginning of voir dire. The instruction is not mandatory, but…

Significant Changes Ahead for Missouri Litigators – Part II

In addition to the proposed changes to the collateral source rule discussed in last week’s article, the Missouri Legislature is also working toward significant changes to the standard for the admission of expert witness testimony. Currently, pursuant to RSMo § 490.065, witnesses can be qualified as experts and permitted to offer opinions if they possess…

Significant Changes Ahead for Missouri Litigators – Part I

Recent actions by both the Missouri Senate and Missouri House of Representatives regarding the admissibility of evidence in civil actions would substantially change the litigation of medical negligence cases. In this article I discuss the proposed changes to RSMo § 490.715 related to the admissibility of evidence of the cost of medical care; commonly referred…

CMS Changes Position to Support Arbitration Agreements in Long Term Care Settings

The Centers for Medicare and Medicaid Services (CMS) advised in June that it was going to back off its prior position on prohibiting nursing homes from including arbitration provisions in admission contracts. CMS has reversed its prior position and is currently drafting a new rule, which would allow pre-occurrence arbitration agreements to stand. The Fair…

Delays in Illinois Medicaid Approval Under Fire

As every long-term care facility doing business in Illinois can attest, Medicaid eligibility determinations and benefit awards have been slow, with HFS often falling months, if not years, behind. A group of SNFs and their residents are trying to change that. Several healthcare providers and their patients have filed suit against Felicia Norwood in her…

CMS: Change in Direction on Arbitration Ban

On September 28, 2016, CMS created the “Arbitration Rule”, banning arbitration agreements in nursing home admission agreements. By creating this Rule, CMS took the position that, due to the inequality of bargaining power between potential nursing home residents and long term care facilities, those facilities could no longer require, or even offer, binding arbitration as…

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