Corporate Compliance

Is your facility doing everything that it can to be compliant? With all of the updates in one place below, you can stay up to date on OIG guidance and the requirements of the Affordable Care Act standards. Also, learn about the most effective prevention tactics to protect your facility from non-compliance so that you can focus on what’s most important - caring for your residents.

  • March 15 SNF VBP: Understanding Your Facility’s Confidential Feedback Report Call - Register Now

    By CMS - February 24, 2017
    During this call, CMS experts present on the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program, including confidential quarterly feedback reports and implementation guidance. Gain an understanding of the significance of readmissions and how SNF risk-standardized readmission rates are computed. Learn how to navigate through the Quality Improvement and Evaluation System (QIES) and the Certification and Survey Provider Enhanced Reporting (CASPER) application systems to report SNF quality performance. A question and answer session follows the presentation.
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  • 2014 SNF Utilization and Payment Public Use File (SNF PUF) Released by CMS (1/17)

    By CMS - January 19, 2017

    CMS has posted the second annual release of the Skilled Nursing Facility Public Use File (Skilled Nursing Facility PUF) with data for 2014. The Skilled Nursing Facility PUF presents summarized information on services provided to Medicare beneficiaries by skilled nursing facilities. It contains information on utilization, payment (Medicare payment and Medicare standardized payment), submitted charges, and beneficiary demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Resource Utilization Group (RUG), and state of service. 

     

    The new 2014 PUF has information for 15,026 skilled nursing facilities, almost 2.5 million stays, and over $27 billion in Medicare payments for 2014. New in the 2014 data is the demographic and chronic condition information. CMS protects beneficiaries’ personal information in all public data releases.

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  • Fiscal Year 2017 HHS OIG Work Plan

    By CMS - November 10, 2016
    The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan for fiscal year (FY) 2017 summarizes new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond. Work planning is an ongoing and evolving process, and the Work Plan is updated throughout the year.
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  • Emergency Preparedness Rule FAQs and Other Resources (11/16)

    By CMS - November 02, 2016
    The Centers for Medicare & Medicaid Services (CMS) Survey and Certification Group is providing general information regarding the implementation plans for the new Emergency Preparedness Rule. The information addresses the implementation date for providers and suppliers, the development of Interpretive Guidelines (IGs), surveyor training and resources available to assist in the implementation of this regulation.
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  • CMS Phase 1 Mega-Rule Online Surveyor Training Available to Providers Nov. 18, 2016 - July 2017

    By CMS - October 28, 2016

    The Centers for Medicare & Medicaid Services (CMS) is developing an online training that will include information about Phase 1 of new Nursing Home Regulations, and will be available to all parties starting November 18, 2016.

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  • Quality Improvement Organization (QIO) Manual Changes (10/16)

    By CMS - October 24, 2016

    These updates appear to be associated with new regulations published in the Nov. 15, 2012, Federal Register as part of a final rule on the 2013 outpatient hospital PPS. (See Section XVIII, Revisions to the Quality Improvement Organization Regulations, on pages 68508 – 68526 of the final rule.)

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  • Get Ready for the CMS Final Mega-Rule: Compliance and Ethics “Top Ten” for SNF Providers

    By Janine Savage, RN, RAC-CT, CHC - August 10, 2016

    This October, the Centers for Medicare & Medicaid Services (CMS) fiscal year 2017 payment and policy changes for skilled nursing facilities take effect—with PPS payment rate updates, changes to the SNF Quality Reporting Program, and the SNF Value-Based Purchasing Program. Right on the heels of that, we expect CMS to issue the long-awaited Final “Mega-Rule.” This additional new rule will revise requirements for long-term care facilities’ participation in the Medicare and Medicaid programs and will be the first comprehensive change to the Conditions of Participation since 1991. When the Proposed Rule was issued on July 13, 2015, it was evident that the Department of Health and Human Services intended to align priorities for all healthcare providers, as it included major revisions in the areas of quality, person-centered care, facility assessment, competency-based approaches, and modernization of standards—as well as robust requirements for compliance and ethics.

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  • Q&A: How many days should you document post fall?

    By Amy Stewart RAC-CT, RN, DNS-CT, RAC-MT - June 15, 2016
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  • PEPPER Report Q4FY15 Changes: Recorded Webinar (5/16)

    By PEPPER Team - May 31, 2016

    An update on what is new/changed in the Q4FY15 PEPPER for Skilled Nursing Facilities (SNFs).

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  • Q&A: What are the rules governing telephone orders when physicians are in the facility?

    By Linda Winston RN, MSN, BS, DNS-CT, RAC-CT - May 18, 2016
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  • OSHA Final Rule on Workplace Injury Reporting Effective Aug. 10, 2016

    By OSHA - May 12, 2016
     The U.S. Department of Labor’s Occupational Safety and Health Administration today issued a final rule to modernize injury data collection to better inform workers, employers, the public and OSHA about workplace hazards. With this new rule, OSHA is applying the insights of behavioral economics to improve workplace safety and prevent injuries and illnesses. 
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  • PEPPER Reports: Q4FY15 Release Available to Assess Your Medicare Part A Compliance (4/16)

    By PEPPER Team/TMF Health Quality Institute - April 12, 2016
    The Q4FY15 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2015 is now available for download through the PEPPER Resources Portal. Your Chief Executive Officer, President, Administrator or Compliance Officer can obtain your SNF's PEPPER.
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  • Suite of Products & Resources for Compliance Officers Educational Tool — Revised (1/16)

    By CMS - January 28, 2016

    Corporate compliance resources

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  • Medicare Parts C and D: Compliance and Fraud Online Training Courses (1/16)

    By MLN Networks / CMS - January 25, 2016
    The FREE (1) Medicare Parts C and D General Compliance Training and (2) Combating Medicare Parts C and D Fraud, Waste and Abuse training courses provide separate content for compliance and FWA, and provide web-based versions that are printable and PDF versions that are downloadable. The training content is generic since various entities (e.g., health plans, labs, hospitals, providers, etc.) complete the training.
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  • Part B (Outpatient) Therapy: OIG Provider Audit Offers Lessons

    By OIG - November 12, 2015

    This audit by the Office of Inspector General of the U.S. Department of Health and Human Services found that 43 out of 100 claims in a random sample of one provider's bills did not comply with Medicare requirements for Part B therapy services. Learn where the provider fell short.

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