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 …

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

Angie Szumlinski Legal

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 …

Study on the Transition from Skilled Nursing Facility to Home Following Heart Failure

Angie Szumlinski Health, News

Discharge to skilled nursing facilities (SNFs) is common in patients with heart failure. SNFs are often used as a transition from hospital to home to regain strength, function, and independence, particularly for medically complex patients. Discharge home from SNF is often the ultimate goal, as the vast majority of these patients were residing at home prior to hospitalization. However, these …

CMS Announces Five Step Plan for Better Nursing Home Quality

Angie Szumlinski Announcements

CMS will undertake a comprehensive review of their regulations, guidelines, internal structure, and processes related to safety and nursing home quality by developing a five-part plan to ensure the care provided in America’s nursing homes is of the highest possible quality. Strengthen Oversite CMS plans to first strengthen oversight. The CMS oversees State Survey Agencies (SSA) which are required to …

New RAI Manual for PDPM Training Released Early

Angie Szumlinski News

This version of the MDS 3.0 RAI Manual incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas. Monday’s posting caught many insiders by surprise, as CMS officials had not been specific about a release date. Based on historical precedent, many were expecting a release late this week, possibly on Friday afternoon, leading …

New Techniques Reduce Healthcare-Associated Infections

Angie Szumlinski Health

The AHRQ’s healthcare-associated infections program funds programs and systems to aid frontline health care staff and prevent HAIs by enhancing and refining patient care methods. AHRQ’s system of grants and contracts focuses on research that improves clinicians’ ability to fight HAIs. This research makes the application of proven care methods safer for all. As a result of this research, AHRQ …

Nursing Facility Faces Wrongful Death Claim Despite Arbitration Agreement

Angie Szumlinski Legal

A young woman signed an arbitration agreement on behalf of her uncle during the admissions process to the nursing facility. However, her uncle still possessed intact mental function and alertness at the time of admission. Though the young woman had been granted both durable power of attorney for finance and healthcare power of attorney on behalf of her uncle, the …

Nonalcoholic Fatty Liver Disease discovered to be new risk factor for heart failure patients

Angie Szumlinski Health, News

A recent study finds that nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for incident heart failure (HF). Before this study, NAFLD was suspected to increase all-cause mortality in patients admitted for acute HF, but was never proven to do so. The study was conducted on 264 patients, of whom all were admitted for acute HF between 2013 …