Patient Driven Payment Model

Angie Szumlinski Compliance

In July 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. You can go to the site that includes a variety of educational and training resources …

Poorly Performing Nursing Home Face Limited Fines

Angie Szumlinski Compliance, News

A study by the Center for Medicare Advocacy finds that facilities that are identified as among the most poorly performing facilities in the country provide extremely poor care and may fail to have sufficient numbers of RNs, but they face limited, if any, fines.  Going forward, nursing facilities are likely to have even lower fines. http://www.medicareadvocacy.org/special-focus-facilities-poor-care-for-residents-limited-enforcement-consequences-for-facilities/

Policy Memorandum for the Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems Available for Download

Angie Szumlinski Compliance, Health

According to the Centers for Medicare & Medicaid Services (CMS), the bacterium Legionella can cause a serious type of pneumonia called LD in persons at risk. Those at risk include persons who are at least 50 years old, smokers, or those with underlying medical conditions such as chronic lung disease or immunosuppression. Outbreaks have been linked to poorly maintained water systems …

Corporate Compliance Update

Andrea DeLand Compliance, News

Focus on Exploitation Our policy defines “exploitation” as taking advantage of a resident for personal gain through the use of manipulation, intimidation, threats or coercion. (See Administrative SOP, “Abuse and Neglect Prohibition Policy”). There has been a tremendous focus on this issue by both the survey and criminal authorities. It is important for all staff to be able to define …