PDPM and you

PDPM and You!

Angie Szumlinski Compliance

There are many changes coming in the next few weeks and PDPM is one that will likely have the most impact on your operations. The goal of PDPM is to address our residents unique, individual needs (thus Patient Driven) and ultimately improving outcomes. The assessment process will change significantly with the PDPM model and it is critical that your team …

CMS Proposes Removing Requirements for Unnecessary Rules

Angie Szumlinski Announcements, Compliance

The Centers for Medicare & Medicaid Services (CMS) announced  a proposed rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilties: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P). This proposed rule would increase facilities’ ability to devote their resources to improving resident care. The proposed rule would, among other provisions: Reduce  the frequency that LTC facilities are required to …

Is Efficiency a Trade-off For Safety?

Angie Szumlinski Compliance, Health

A randomized clinical trial conducted on a study group of over 3,300 Clinicians, who in total recorded almost 4.5 million order sessions, discovered a causative behavior between the number of patient records open at a time and the number of wrong-patient order errors incurred. Clinicians were placed in one of two groups. The first could only have one record open …

CMS Releases Enforcement of Federal Regulations Related to Antipsychotic Medication Utilization Rates

Angie Szumlinski Compliance, News

As of January 2019, there are 235 late adopter nursing homes that have been cited for noncompliance with federal regulations related to unnecessary medications or psychotropic medications two or more times since January 1, 2016, and who have not shown improvement in their long-stay antipsychotic medication rates. If these facilities are determined not to be in substantial compliance with requirements …

Department of Justice Guidance on Evaluating Corporate Compliance Programs

Angie Szumlinski Compliance, News

The Criminal Division announced today the release of a guidance document for white-collar prosecutors on the evaluation of corporate compliance programs.  The document, entitled “The Evaluation of Corporate Compliance Programs,”updates a prior version issued by the Division’s Fraud Section in February 2017.  It seeks to better harmonize the guidance with other Department guidance and standards while providing additional context to …

CMS Releases Revisions to Appendix Q (Guidance on Immediate Jeopardy)

Angie Szumlinski Compliance

Core Appendix Q and Subparts – Appendix Q to the State Operations Manual (SOM), which provides guidance for identifying immediate jeopardy, has been revised. The revision creates a Core Appendix Q that will be used by surveyors of all provider and supplier types in determining when to cite immediate jeopardy. CMS has drafted subparts to Appendix Q that focus on …

Office of Inspector General – List of Excluded Individuals/Entities: May 2019

Angie Szumlinski Compliance, News

OIG has the authority to exclude individuals and entities from Federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud. Those that are excluded can receive no payment from Federal healthcare programs for any items or services they furnish, order, or prescribe. This includes those that provide health benefits funded directly or …