In nursing home settings, ensuring medically necessary visits by physicians or Qualified Healthcare Professionals (QHPs) is critical for providing high-quality care and maintaining compliance with Medicare guidelines. This whitepaper outlines the definition of medical necessity, Medicare’s guidance on billing and documentation, and key considerations for determining the necessity of patient visits. Definition of Medical Necessity Medicare defines medical necessity as: “Services or items reasonable and necessary for the diagnosis or treatment of illness or injury
June 25, 2025
Empowered Leadership, Meaningful Impact: Insights from the 2025 LeadingAge PA Annual Conference
LW Consulting, Inc. (LWCI) had the pleasure of attending the 2025 LeadingAge PA Annual Conference & Expo. This year’s theme was IMPACT – the impact that we have on our peers and the future of aging services. The conference kicked off with an incredible keynote by Ryan Leak on his book “Leveling Up: 7 Questions for Next-Level Leadership.” He discussed identifying personal success and the questions that you need to ask yourself to “level up.”
June 19, 2025
Update on the Hertel & Brown Case: Guilty Pleas, Trial Outcomes, and What Therapy Clinics Need to Learn
Significant developments have occurred since the March 2025 blog on “The Hertel & Brown Case: Harsh Reminders for Therapy Clinics.” The federal case against Hertel & Brown Physical and Aquatic Therapy has reached a turning point. With guilty pleas from the owners and sentencing dates approaching, this case is no longer just about uncovering fraud; it is about what the fallout means for outpatient therapy clinics across the country. Key Developments Guilty Pleas from Leadership
