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Is there any new guidance or regulation of which we should be particularly aware

In April 2008, the Office of the Inspector General (OIG) published its Draft OIG Supplemental Compliance Program Guidance for Nursing Facilities. When the final supplement is published, it looks like the OIG is joining others in looking at more areas of compliance in nursing homes.

The guidance will supplement the original OIG guidance that was published in 2000. According to the draft guidance, the new supplement will address areas of concern that have been seen over the last few years. 

These areas include Quality of Care, Incorporating Sufficient Staffing, Comprehensive Resident Care Plans, Appropriate Use of Psychotropic Drugs, Medication Management, and Resident Safety. 

The other major area of focus is submission of accurate claims, which incorporates proper reporting of resident case mix, therapy services (including medical necessity), screening for excluded individuals and entities and restorative/personal care services.

The federal anti-kickback statute will be readdressed and further guidance is included on self-reporting.  It is important that you read this document carefully. It appears to reflect many of the changes we have seen in the last few years in regulatory guidance and really focuses on the plan of care “driving” patient care.

You can find this draft guidance here.