This year, AMBR for Long-Term Care is partnering with the National Association for Healthcare Revenue Integrity (NAHRI) to offer a track at the Revenue Integrity Symposium dedicated to the unique billing and reimbursement challenges in that setting.
During a Skilled Nursing Facilities (SNF)/Long Term Care Open Door Forum (ODF) held Tuesday, April 23, 2019, Centers for Medicare and Medicaid Services (CMS) officials discussed the Proposed Fiscal Year 2020 Payment and Policy Changes for Medicare Skilled Nursing Facilities (CMS-1718-P) published in the Federal Register on April 25, 2019.
CMS announced several updates to Nursing Home Compare (NHC) that will take place this April, including a removal of the freeze placed on health inspection star ratings instituted in February 2018. The freeze was placed to give all facilities a chance to be surveyed at least once under the new process. Beginning in April, consumers will be able to see the most up-to-date status of a facility’s compliance on NHC.
The Office of Inspector General’s (OIG) studies can serve as a good alert system for long-term care facilities as well as the regulators who monitor them. We’ve compiled a list of relevant reports and recommendations published by the OIG in 2018 to help you prioritize your quality and compliance goals for this year.
Did you know that as a member of the Billers’ Association for Long-Term Care, you get a discount on HCPro boot camps? Our instructors bring best-in-class compliance education to your facility so your entire team can benefit.
A list of facilities with potential staffing issues is being provided to CMS regional offices and state survey agencies to support survey activities for evaluating sufficient staffing, according to a memo released by CMS back in November, 2018. The memo states that “while CMS is encouraged by facilities’ efforts to improve staffing,” payroll based journal (PBJ) data has raised a few concerns, prompting them to inform state survey agencies of facilities with potential staffing issues. These issues include facilities with significantly low nurse staffing levels on weekends and facilities with several days in a quarter without an RN onsite.
By now, most organizations have identified a compliance officer, set up a reporting hotline for staff to report concerns, and done some training with staff on the elements of their facility’s specific compliance and ethics plan to meet the November 28, 2019 implementation deadline.
Providers are encouraged to check the US Department of Health and Human Services, Office of Inspector General’s (OIG) updated List of Excluded Individuals and Entities (LEIE) database file to ensure that excluded individuals are not working in their facility, consequences of which could result in significant fines. The database was updated on December 10, 2018, and does not include individuals and entities that have been reinstated to the federal health care programs.