Nurses who don't pay taxes or student loans could trigger penalties for SNFs, expert says

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Nurses who don't pay taxes or student loans could trigger penalties for SNFs, expert says
Nurses who don't pay taxes or student loans could trigger penalties for SNFs, expert says

Registered nurses who default on a student loan or fail to pay taxes could put a skilled nursing facility in the crosshairs of federal fraud investigators, a compliance expert told an audience Sunday at the American College of Health Care Administrators annual meeting in Las Vegas.

In some states, such as Missouri, nurses who do not pay state taxes have their licenses pulled and are essentially not allowed to practice, said healthcare consultant and strategist Kendall Brune, Ph.D., MBA, LHNA, FACHCA, a principal with compliance software company Global Compliance Tracker. If these nurses continue to come to the nursing home and treat Medicare residents, the resulting claims could be considered fraudulent. Brune made his remarks in an educational session on possible actions from the Health and Human Services Office of the Inspector General.

Failure to pay student loans also could lead to this scenario, triggering fines for the SNF, Brune noted.

Administrators in the audience questioned how they are supposed to know this information, to which Brune said that workforce education is essential.

Although facilities can check whether there are any outstanding issues with nurses' state licenses, only the RN would receive a notice when his or her license is in jeopardy, Brune said. Because they fear for their jobs or are embarrassed, nurses understandably might not want to bring this to the attention of the SNF. Therefore, they need to be educated about why it is important that they do so, and the facility needs to respond appropriately, Brune emphasized.

Providing one example scenario, he said a facility may want to work out a payment strategy for a nurse to pay a $1,600 state tax bill rather than expose the facility to OIG fines. “You've got to take care of your staff,” he said.

The Office of the Inspector General was much discussed on the first day of ACHCA's annual convocation and expo, due in large part to the agency's recent report on adverse events in skilled nursing facilities. In a session on risk mitigation, a prominent healthcare technology company CEO sharply criticized that report.

The OIG extrapolated the number of adverse events from a tiny sample that would not meet standard academic thresholds for statistical significance, said John Sheridan, MHSA, co-owner/founder and CEO of eHealth Data Solutions. The finding that about one in five nursing home residents experiences an adverse event each year “is a fiction,” he said.

Still, surveyors are poised to use the types of harm identified in the OIG report to tag facilities for deficiencies, Sheridan said. He advised administrators to utilize the report as a framework for implementing preventive measures. For instance, because food aspiration was flagged in the report, it would be wise to create restorative dining programs, he said.

Keynote speaker Harry Paul — co-author of the book "FISH! A Proven Way to Boost Morale and Improve Results" — compared workplaces that produce average results with those that produce excellent results.The ACHCA meeting is scheduled to conclude Wednesday.

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