What to Do When a Resident Refuses Transfer or Discharge (Skilled Nursing)

A skilled nursing facility may evict a resident only if one of the following criteria are met and documented:

  • Nonpayment of rent;
  • Resident’s health has improved and he/she no longer needs nursing care;
  • Resident’s needs have increased and cannot be met by the facility;
  • Resident is endangering others’ safety;
  • Resident is endangering others’ health; or
  • The facility is going out of business.

Source for Discharge Notes: What to Do When a Resident Refuses Transfer or Discharge by: Andrea R. Sitar,  Attorney at Wroten & Associates.


What to Do When a Resident Refuses Transfer or Discharge (Residential Care)

A residential care facility for the elderly may evict a resident only if one of the following criteria are met and documented:

  • Nonpayment of rate for basic services within ten days of their due date;
  • Failure of the resident to abide by state or local law;
  • Failure of the resident to follow facility policies;
  • Needs of the resident are no longer met; or
  • Facility has changed its purpose.

Source for Discharge Notes: What to Do When a Resident Refuses Transfer or Discharge by: Andrea R. Sitar,  Attorney at Wroten & Associates.


Drive by Shakedowns – Americans with Disabilities Act (ADA)

Limit your exposure to “drive by shakedowns” by addressing common ADA parking lot issues:

  • Determine whether your loading zones/ van access aisles are compliant.
  • Determine whether your parking lot signage is compliant.
  • Determine whether your parking lot contains the required minimum number of accessible parking spaces.
  • Determine whether the routes to and from the parking lost as “accessible”.
  • Determine whether curb ramps or entrance ramps are compliant.

Source for News Notes: Drive by Shakedowns – Americans with Disabilities Act (ADA) by: Stephen R. Hunter, Senior Attorney at Wroten & Associates.


Conquering a Department of Labor Investigation (What Employees Should Know)

What employees should know:

  • Employee interviews are voluntary.
  • Employees should not be intimidated because the investigator’s credentials look like a police badge.
  • Employees are expected to be truthful.
  • Employees should listen carefully to all questions asked.
  • Employees should take a break or end the interview at any time.
  • Employees should feel comfortable asking facility management any questions about the interview process before or after the interview.

Source for Employment Notes: Conquering a Department of Labor Investigation by: Laura K. Sitar, Shareholder at Wroten & Associates.



Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P)

On April 17, 2015 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The proposed rule, which would apply to approximately 3,400 acute care hospitals and approximately 435 LTCHs, would affect discharges occurring on or after October 1, 2015. Entire Proposed Plan and Payment Changes


Government Sues Skilled Nursing Chain HCR Manorcare for Allegedly Providing Medically Unnecessary Therapy

“The government has intervened in three False Claims Act lawsuits and filed a consolidated complaint against HCR ManorCare alleging that ManorCare knowingly and routinely submitted false claims to Medicare and Tricare for rehabilitation therapy services that were not medically reasonable and necessary, the Department of Justice announced today.  ManorCare is one of the nation’s largest healthcare providers, operating approximately 281 skilled nursing facilities (SNFs) in 30 states.” Entire Article


Conquering a Department of Labor Investigation (Be Prepared)

All too often, employers are not prepared and negatively influence the outcome of an investigation by failing to:

  • Immediately respond to a request for an appointment by the DOL or a notice requesting documents be provided.
  • Prepare a game plan ahead of time regarding how to proceed once notice of an investigation has been given.
  • Prepare employees for interviews.
  • Fully understand the laws the DOL is there to enforce.
  • Cooperate with the DOL.
  • Seek assistance or representation, if necessary.

Source for Employment Notes: Conquering a Department of Labor Investigation by: Laura K. Sitar, Shareholder at Wroten & Associates.


Conquering a Department of Labor Investigation (Initial Conference)

The initial conference is part of the investigation and what is said in the conference counts. It is important that whomever is present representing the interests of the employer appears knowledgeable and organized.  Documents generally requested are:

  • Names, addresses and telephone numbers of all business owners and their company officers.
  • Organizational chart.
  • Legal names of company and all other names used.
  • Records showing gross annual dollar volume for past three years.
  • List of all employees with addresses and phone numbers, job titles, hourly rates/ salaries and exempt status.
  • All 1099 forms issued for the past two years.
  • Employers’ federal tax ID number.

Source for Employment Notes: Conquering a Department of Labor Investigation by: Laura K. Sitar, Shareholder at Wroten & Associates.