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 …

OIG Releases Study on the Assessment of State Background Checks for LTC Providers

Angie Szumlinski Announcements, Compliance

The National Background Check Program (Program) provides grants to States to develop systems to conduct background checks of State and Federal criminal history records for prospective long-term-care employees. Congress mandates that the Office of Inspector General evaluate various aspects of Program implementation. This report provides an assessment of States that concluded Program participation prior to 2017, and it also provides …

CMS Changes to Nursing Home Compare and Five-Star Ratings Explained

Angie Szumlinski Compliance, News

A recent blog post from bakerdonelson.com provides a brief overview of the 2019 changes to Nursing Home Compare and the Five-Star Quality Rating System. Following is a summary of that blog. To read the entire blog, please click HERE. Health Inspection Domain: The methodology for the health inspection rating returned to what it was prior to February 2018. Specifically, results …