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.

  • Fiscal Year 2017 HHS OIG Work Plan UPDATED

    By CMS - July 18, 2017
    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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  • Mega-Rule Appendix PP Survey Resources From CMS - Revised (7/17)

    By CMS - July 14, 2017
    CMS has released an Advance Copy of Appendix PP of the State Operations Manual with updated Interpretive Guidance for multiple F-tags, a list of revised F-tags by regulatory grouping, a crosswalk between old and new F-tags, and a survey-and-certification memo explaining upcoming changes, training opportunities, and enforcement issues.
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  • Investigation Still Finds Some Nursing Home Staff Misusing Social Media re: Residents (6/17)

    By ProPublica - June 26, 2017

    Nursing Home Workers Still Posting Nude and Vulgar Photos of Residents on Snapchat

    Federal and state officials have increased their focus on the problem, but ProPublica found 18 incidents in the last year in which employees at nursing homes and assisted living facilities posted unauthorized photos and videos of residents on social media platforms.

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  • Voluntary Terminations and New Certifications: CMS S&C Memo (6/17)

    By CMS - June 26, 2017
    Reasonable Assurance Will Apply to Providers and Suppliers Who Voluntarily Terminate and Seek New Certification If a Termination Action by the State Agency Had Been Initiated
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  • OIG Eye on Oversight: Abuse in Nursing Homes (6/17)

    By OIG - June 26, 2017
    From the OIG: Millions of elderly Americans live in nursing facilities. OIG's oversight and enforcement work has revealed alarming problems. Problems range from overmedicating residents, or patient abuse or neglect. OIG is working to prevent patient harm through identifying program vulnerabilities, investigating wrongdoers, and taking legal action against providers.
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  • MedPAC June 2017 Report to Congress Looks at Postacute Care Payment (6/17)

    By MedPAC - June 19, 2017

    The Medicare Payment Advisory Commission (MedPAC) releases its June 2017 Report to the Congress: Medicare and the Health Care Delivery System. The Commission’s report examines a variety of Medicare payment system issues, including implementing a unified payment system for post-acute care, as well as hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing facilities.

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  • Q&A: Are there courses available to become certified as an "Infection Preventionist"?

    By Amy Stewart, RN, DNS-MT, QCP-MT, RAC-MT - May 16, 2017
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  • PBJ Update: CMS Says Nonsubmission Will Impact Star Ratings (4/17)

    By CMS - April 24, 2017

    Payroll-Based Journal: The Nursing Home Compare website now reflects whether providers have submitted data by the required deadline. Additionally, providers that have not submitted any data for two consecutive deadlines will have their overall and staffing star ratings suppressed.

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  • Measuring Compliance Program Effectiveness: An OIG Resource (3/17)

    By OIG - March 28, 2017
    On January 17, 2017, a group of compliance professionals and staff from the Department of Health and Human Services, Office of Inspector General (OIG) met to discuss ways to measure the effectiveness of compliance programs. The intent of this exercise was to provide a large number of ideas for measuring the various elements of a compliance program. Measuring compliance program effectiveness is recommended by several authorities. This list will provide measurement options to a wide range of organizations with diverse size, operational complexity, industry sectors, resources, and compliance programs.
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  • FY 2017 Special Focus Facility (SFF) Program Update: CMS S&C Memo

    By CMS - March 08, 2017

    • Total SFF slots and candidates for each State: The number of designated slots and candidates for FY 2017 will not change from those effective since May 1, 2014.

    • Initial selection notice: The State Survey Agency (SA) must notify the provider in writing of their SFF selection and conduct a meeting (either onsite or via telephone) with the nursing home’s accountable parties, and the Centers for Medicare & Medicaid Services (CMS) Regional Office (RO), if the RO wants to be included. 

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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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  • 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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  • 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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