Three questions to boost nursing home audit readiness
Sep 20, 2023
Nursing home and long-term care operators have already faced a number of key shifts since the beginning of 2023. Consider a recent example from the Centers for Medicare & Medicaid Services: an update on...
Claims audit will affect every nursing home starting June 5
May 30, 2023
Every skilled nursing facility in the US will be subject to a five-claim audit starting the week of June 5 as regulators try to better assess and root out improper payments.
Flurry of Medicare Advantage regulation likely to hit nursing home coffers
Feb 03, 2023
Federal efforts to rein in Medicare Advantage spending and recoup payments awarded for improper diagnoses will likely lead to even more financial pressure on nursing homes that serve plan beneficiaries,...
CMS to begin audits for schizophrenia coding, says citations will affect quality ratings
Jan 19, 2023
The agency will start auditing nursing homes this month to determine whether residents’ schizophrenia diagnoses are accurate and appropriately coded. A pattern of inaccurate coding may result in a quality...
Stricter audits may be on the horizon from the OIG
Jan 11, 2023
Long-term care facilities and providers should brace themselves for what may be an uptick in enforcement activity from Medicaid Fraud Control Units (MFCUs) in the coming year. In 2023, the U.S. Department...
After record penalties, providers can protect themselves from the DOJ with 3 priorities, experts say
Nov 28, 2022
The Department of Justice is on pace to hand out a record $5.6 billion-plus in total fines and penalties under the False Claims Act this year, a clear indicator that the agency has removed the kid gloves...
Providers warned: Ongoing relief fund audits may bring unprecedented info demands
Nov 21, 2022
Provider Relief Fund audits have started in earnest, with the threat of federal investigators demanding more and different data than most skilled nursing providers have ever been asked to account for.
Honey is sweeter
Jacqueline Vance, RNC, CDONA/LTC
May 24, 2022
We all have heard the expression about getting more flies with honey than vinegar. Personally, I have absolutely zero desire to attract these annoying insects anywhere near me; bleh! But I get it. I...
Clinical briefs for Thursday, March 24
Mar 24, 2022
OIG adds audits of nursing home staff vaccination status to its schedule … Repeat COVID-19 hospitalization unlikely with vaccination or prior infection, Mayo Clinic finds … Fauci does not expect to...
Clinical briefs for Monday, Oct. 4
Oct 04, 2021
Patients on chemotherapy likely not fully protected by COVID vaccine … Unauthorized nursing home COVID tests lead to audit demands … ‘Game-changing’ wellness model takes person-centric approach...