Documentation and CERT Program

Angie Szumlinski Compliance

CMS has a video on the Importance of Proper Documentation for providers. The video is intended to help providers and physicians understand the need and importance of medical record documentation to support the services billed. Learn about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s …

Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities

Angie Szumlinski Compliance

Nursing home surveys are conducted in accordance with survey protocols and Federal requirements to determine whether a citation of non-compliance is appropriate. Consolidated Medicare and Medicaid requirements for participation (requirements) for Long Term Care (LTC) facilities (42 CFR part 483, subpart B) were first published in the Federal Register on February 2, 1989 (54 FR 5316). The requirements for participation …

Provider Relief Fund General and Targeted Distribution

Angie Szumlinski Compliance

The Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136), the Paycheck Protection Program (PPP) and Health Care Enhancement Act (P.L. 116-139), and the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act (P.L. 116-123) appropriated funds to reimburse eligible health care providers for healthcare-related expenses or lost revenues attributable to coronavirus. These funds were or will be distributed by …

Advance Care Planning Coverage

Angie Szumlinski Compliance, Training

In 2016 Medicare launched a much-anticipated advance care planning (ACP) benefit that pays physicians to counsel patients about living wills, advance directives, and end-of-life care options. During the ACP process clinicians can help patients determine the type of care they would want in a medical crisis or at the end of life and reassure them that their preferences will be …

Surveys Yikes

Angie Szumlinski Compliance

In case you haven’t heard, regulatory surveys are back with a vengeance! Federal data indicates that the number of surveys conducted nationwide has risen 132% since 2020, leaving some wondering how fairly standards are being applied when COVID-19 is already forcing facilities to deal with staffing shortages, aging infrastructure, profit loss and increased scrutiny over everything from infection protocols to …

Long-Term Care Regulatory Provider Letter – Texas Health and Human Services

Angie Szumlinski Announcements, Compliance

The Texas Health and Human Services Commission issued a Long-Term Care Regulatory Provider Letter detailing “a new expanded emergency rule” as part of the continued reopening of the State of Texas. The new guidance contains the following updates: More flexibility in visitation rules Guidance on COVID-19 vaccination status for visitors Requirements for essential caregivers visiting the facility Requirements for end-of-life …

OIG Exclusion List

Angie Szumlinski Compliance, Featured

In the year of the pandemic, many of us struggled with staffing and continue to be challenged, however, it is important that we not skip important steps in the hiring process such as checking the OIG exclusion list. The Office of the Inspector General (OIG) has the authority to exclude individuals and entities from Federally funded health care programs for …

Just Wash Your Hands!

Angie Szumlinski Compliance, Studies

In a recent study published in JAMA Network, hand hygiene compliance remains low, averaging 50% across hospitals nationwide. Some institutions have implemented automated monitoring versus direct observation which tends to capture few events and may lead to inaccurate measurements. The University of Chicago Medical Center (UCMC) implemented an automated hand hygiene monitoring system in 2015. An infrared sensor anonymously records …

Remote Works

Angie Szumlinski Compliance, Health

In a study conducted in New York skilled nursing facilities over a two-week period, a three-component Infection Prevention and Control (IPC) assessment was performed virtually. The key components of the assessment were: Screening tool Telephone Infection Prevention and Control checklist COVID-19 video Infection Prevention and Control assessment (COVIDeo) Of the 92 SNFs competing the IPC screening tool and checklist, 52/92 …

Access to Ombudsman – Revised QSO-20-28-NH

Angie Szumlinski Compliance, Featured

CMS updated the original QSO-20-28-NH from April 24, 2020 on July 09, 2020 and again on March 10, 2021. A summary of the updates are below: CMS is committed to taking critical steps to ensure America’s nursing homes are prepared to respond to the threat of the COVID-19. Nursing Home Compare website and Nursing Home Five Star Quality Rating System: …