ORLANDO, FL — Skilled nursing providers must base their compliance programs on an accurate risk profile in order for them to be effective, according to two experts.
The keys to an effective compliance program required under the Requirements of Participation were emphasized Monday at the American Health Care Association / National Center for Assisted Living 70th Annual Convention and Expo. The third stage of RoP officially kicks in on Nov. 28.
“If you find your own problems and you fix them and address them and pay back money as you need to, it’s a whole lot easier than the government coming in and finding your problems and then you have multiple years of things to pay back as well as penalties,” said Sarah Couture, senior director at Ankura in Chicago. “It’s much better to identify your own problems and have a culture to fix them.”
She was an expert presenter, along with John Dailey, president of Management Advisors, a consulting firm based in Hazard, KY.
They explained that in order to develop a risk profile, providers should assess their risks by identifying external, internal and common risks associated within the long-term care industry. They also said risk assessments should be a collaborative process and involve various members of an organization, such as executives, nurses and billing staff.
“A risk assessment is very, very important and kind of key to the foundation of a compliance plan. But there’s no magic form. There’s no magic assessment,” Dailey said.
They also noted that compliance standards can be achieved by effectively communicating standards and program requirements with all staff members, contractors and volunteers, implementing auditing and monitoring systems to detect violations and concisely enforcing disciplinary actions when violations are reported.
