Staffing Mandate Relief – A Much-Needed Win
Positive responses continue to make headlines following the Monday, April 7th ruling made by Judge Kacsmaryk from the US District Court of North Texas in favor of the American Health Care Association (AHCA), LeadingAge, and several nursing homes’ fight against CMS’s staffing mandate, throwing out the RN minimum hours per resident day requirements. “The Court has confirmed that CMS does not […]
New Surveyor Guidelines on MDS Coding Errors
On March 10, 2025, CMS and the Department of HHS released a revision to the LTC Surveyor Guidance (originally released on January 16, 2025) that will go into effect on April 28, 2025. This revision includes an update on the Accuracy of MDS Assessments (F641), which has been expanded to incorporate the former Coordination/Certification of Assessment (F642), now […]
A View from Washington – Telehealth Extension and More
The following is a summary of key topics discussed at ADVION’s 2025 Legislative & Regulatory Conference held last week in Washington, DC. At the center of every conversation was an appreciation for the extension of Telehealth. While the government’s Continuing Resolution (CR) included a few healthcare policies, the Telehealth extension was especially significant to the […]
New Hospital Observation vs. In-Patient Stay Appeal Process and Updates
The Center for Medicare Advocacy (CMA) filed a lawsuit in November of 2011 regarding the length of patient hospital stays being classified or reclassified as “observation” versus “inpatient” days—resulting in the loss of a qualifying Part A stay in an SNF. In the ruling on October 15, 2025, the results of that lawsuit became final. […]
Telehealth Extension through March 31, 2025
As of December 21st, the President signed into law the bill which extended the government funding deadline to March 14th, 2025. Notably for SNFs, this bill extends the current Telehealth provisions through March 31, 2025.
Updates to CMS Beneficiary Notice Requirements Effective 1/1/25
On November 18, 2024, the Office of Management and Budget (OMB) renewed beneficiary notice requirements and released updated CMS beneficiary notification forms, including the Notice of Medicare Non-Coverage (NOMNC) and the Detailed Explanation of Non-Coverage (DENC). These forms will be required with Medicare Fee-for-Service (FFS) and Medicare Advantage beneficiaries effective January 1, 2025. Notice of Medicare Non-Coverage […]
Call for Advocacy; CMS 2025 Physician Fee Schedule and Final Rule: Plus QRM’s Updated 2025 Rate Calculator
CMS’ Final Rule has several key items impacting SNF rehab beginning January 1, 2025 (CMS’ Final Rule Fact Sheet). Priority items needing an immediate advocacy push include Telehealth and Provider Relief surrounding the Part B Fee Schedule. Note: Click here to access the updated QRM/Data IQ PDPM Rate Calculator with a tab including the Part B Fee Schedule […]
CMS’ October Care Compare Reveals DC Improvement Score
October’s Care Compare refresh features updated data, including SNF Quality Reporting (QRP) information. Updates in this refresh include: Expected DC Functional Improvement Score Defined: This measure reports the percentage of residents who are at or above their expected ability at discharge from the SNF for specific self-care and mobility activities. Sample from Care Compare:
CMS Revalidation Deadline Extension for Skilled Nursing Facilities
We are committed to keeping you updated on critical regulatory changes. Following our 10/21/24 blog post, “Avoid Disruption in Billing – CMS Mandatory Off-Cycle SNF Provider Revalidation,” CMS has released additional guidelines impacting Skilled Nursing Facility (SNF) providers. We’ve added these updates to our blog and will continue to share more details as they become […]
Avoid Disruption in Billing – CMS Mandatory Off-Cycle SNF Provider Revalidation
We’re here to ensure you have the most up-to-date information on critical regulatory changes! Since our last blog, “Avoid Disruption in Billing – CMS Mandatory Off-Cycle SNF Provider Revalidation,” new developments have been announced. To keep everything in one place, we’ve added these important updates to the blog and will continue to provide more details […]