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Nursing Home Arbitration Agreements: Recent Trends in Citation Risks and Solutions

Hall Render

In 2023, nursing homes have seen increased citations by surveyors for noncompliance tied to their pre-dispute, binding agreements for binding arbitration with their residents. The Arbitration Regulations revised the requirements for arbitration agreements when they are used by nursing homes to resolve disputes with their residents.

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New York Optician Convicted of Medicaid Fraud for Nursing Home Residents

Healthcare Compliance Blog

A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursing home residents, but which were never provided. Additionally, it is necessary that the billing office ensures that no double billing occurs by the nursing home and any consultant.

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Nursing Home Psychologist Convicted of Healthcare Fraud Scheme

Med-Net Compliance

According to court documents and evidence presented at trial, the psychologist caused the submission of fraudulent Medicare claims from July 2016 through June 2019 for psychotherapy services purportedly provided to nursing home residents in Chicago and surrounding areas.

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OIG Audit Finds Certain Nursing Homes May Not Have Complied with Federal Requirements

Med-Net Compliance

The Office of Inspector General (OIG) conducted an audit and found that selected nursing homes may not have complied with federal requirements for infection prevention and control and emergency preparedness. Specifically, 28 of 39 nursing homes they audited had possible deficiencies.

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OIG Finds Certain Nursing Homes May Not Have Complied with Federal Requirements

Med-Net Compliance

They identified that 6,622 nursing homes had been cited for infection prevention and control program deficiencies as of February 26, 2020, and Medicare.gov indicated that 24 nursing homes were part of a nursing home chain. The OIG’s audit found that 23 of the 24 nursing homes had possible deficiencies.

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False Claims Lawsuit Filed Against Alabama Psychiatrist  for Improper Prescribing of Nuedexta to Nursing Home Resident

Healthcare Compliance Blog

The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursing home residents. The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta.

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Nursing Home Update: CMS Updates and Expands Surveyor Guidance for Nursing Homes for Phase 2 and 3 Requirements of Participation – Key Areas and Timeline

Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the quality of care and quality of life for residents. Background. Areas with Significant Updates. Phase 3 Elements.