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Nursinghomes should serve as sanctuaries of care, compassion, and safety for the elderly and vulnerable. Alarmingly, approximately 1 in 6 individuals aged 60 or older have experienced some form of abuse in community settings, including nursinghomes, according to the World Health Organization (WHO).
Unfortunately, despite regulations and oversight, nursinghome neglect remains a critical issue, often leading to devastating consequences such as malnutrition, infections, emotional distress, and even premature mortality. As trusted professionals, healthcare providers are on the front lines of protecting these residents from harm.
One place where aging adults are likely to experience elder abuse occurs in long-term care (LTC) environments; this has been described as a “public health concern” in relation to the nursinghome setting. In 2020, 15,000 complaints of abuse and neglect in nursinghomes were reported to states’ ombudsmen across the U.S.,
Its compliance program guidance (CPG) has improved the efficiency and effectiveness of Medicare and many other federal programs. Last November, the OIG published industry-specific compliance guidance for 2024 for several healthcare subsectors, including nursinghomes and facilities.
My commitment to this work has led me to build innovative programs both in the community and in skilled nursing facilities, designed to provide more and better-focused care to our frail elderly. According to Bureau of Labor Statistics data 1 , the number of workers employed at nursing care facilities nationwide has declined by 15%—from 1.59
Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursinghome members of the health care compliance community. Medical Directors in NursingHomes 42 CFR 483.70(g) See 42 C.F.R.
The Office of Inspector General (OIG) released an updated Nursing Facility Industry Compliance Program Guidance (ICPG) in November 2024 to assist nursing facilities in navigating the complex regulatory landscape and mitigating compliance risks.
In 2023, nursinghomes 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 nursinghomes to resolve disputes with their residents.
Depression and psychiatric conditions are relatively common in the elderly and nursinghome residents. However, compliance professionals need to be aware of proper medical necessity, coding, and documentation when it comes to providing psychotherapy services for nursinghome residents.
Compliance professionals in the nursinghome sector are well aware of the many ways government agencies survey, audit, and enforce regulatory compliance. Nursinghomes have seen significant enforcement over the last few years, and the U.S.
Health and Human Services Office of Inspector General (OIG) recently signaled an even stronger focus on nursinghomes. The OIG plans to more closely scrutinize nursinghomecompliance in their work plans, audits, and oversight.
The Justice Department has filed a complaint under the False Claims Act against an Ohio nursinghome operator and three affiliated nursinghomes for providing grossly substandard skilled nursing services between 2016 and 2018. The nursinghomes are in Ohio, Pennsylvania, and Iowa.
The HHS Office for Civil Rights announced on Tuesday that during the coronavirus pandemic it will use discretion when enforcing HIPAA-compliance for telehealth communications tools. WHY IT MATTERS. and Google G Suite Hangouts Meet. THE LARGER TREND. ON THE RECORD.
A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursinghome residents, but which were never provided. Additionally, it is necessary that the billing office ensures that no double billing occurs by the nursinghome and any consultant.
The following Abuse, Neglect, and Exploitation in NursingHomes Training educates healthcare personnel (HCP) on how to properly recognize and prevent elderly abuse from occurring in nursinghomes. This training aims to foster a safer environment for nursinghome residents. AMA PRA Category 1 Credits.
A "BedSense" App provides insights into the needs of memory care and nursinghome residents. A mobile application that manages team skills and ensures compliance standards. A virtual training platform that connects long-term care homes and hospitals with background-checked nurses and support workers.
On June 30, 2023, the New York State Department of Health (DOH) issued a notice to nursinghome operators and administrators announcing that it will begin conducting assessments on July 10, 2023 of nursinghomes’ compliance with the State’s minimum staffing requirements.
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 nursinghome residents in Chicago and surrounding areas.
" The company says the HIPAA-compliant system can help patients avoid the skyrocketing costs of assisted living and in-home care and help address caregiver shortages, and claims the virtual caregiver offers better oversight and care coordination. Deliver dosing compliance verification to caregivers and providers. ON THE RECORD.
A large long-term care facility located in Vermont violated federal law by allowing black nurses and nurse assistants to be subjected to ongoing and egregious racial harassment, the US Equal Employment Opportunity Commission (EEOC) charged in a lawsuit. Update as needed. Stress the importance of nonretaliation.
On November 3, 2022, the OIG released the results of a recent inspection of a nursinghome by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections).
By mastering these skills, providers reduce infection risks, protect residents, and ensure compliance with regulatory standards. American Medical Compliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians. AMA PRA Category 1 Credits.
A Pennsylvania nursinghome will pay $819,640 to settle claims that it provided medically unnecessary rehabilitation therapy to residents to maximize revenue, and without prioritizing clinical needs. The post Pennsylvania NursingHome to Pay More than $819,000 to Resolve False Claims Act Liability appeared first on Med-Net.
The healthcare sector has been a prime target for cyberattacks and data breaches over the last several years, which makes compliance with the Health Insurance Accountability and Portability Act (HIPAA) all the more important. Worse still, these breaches result in non-compliance with the guidelines established by HIPAA. Let’s find out.
The Minnesota Department of Health (MDH) assumed control of a nursinghome in Pine Island due to concerns that a growing list of unpaid bills threatened critical services for residents. The post MN Department of Health Takes Control of NursingHome to Ensure Residents’ Safety appeared first on Med-Net.
They identified that 6,622 nursinghomes had been cited for infection prevention and control program deficiencies as of February 26, 2020, and Medicare.gov indicated that 24 nursinghomes were part of a nursinghome chain. The OIG’s audit found that 23 of the 24 nursinghomes had possible deficiencies.
An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 Discussion Points: Review your policies and procedures for operating an effective compliance and ethics program to ensure that identifying and reporting of false claims is included. The post NursingHome Provider to Pay over $5.5M
Complaints of resident abuse in a Michigan nursinghome led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursinghome while her license was suspended, which is a felony.
A fire at a Washington nursinghome displaced seventy-seven residents and drew a coordinated response from local firefighters. The post Washington State NursingHome Fire Displaces 77 Residents appeared first on Med-Net. Crews responded to the blaze at about 5:30 p.m.
A nursinghome health system has agreed to pay the United States $1.75 A nursinghome health system has agreed to pay the United States $1.75 The company is a not-for-profit corporation located in Florida that oversees healthcare facilities on its campus, including a nursinghome and an assisted living facility.
The Centers for Medicare & Medicaid Services launched its enhanced NursingHome Five-Star Quality Rating System which integrates data nursinghomes report on their weekend staffing rates for nurses and information on annual turnover among nurses and administrators. Ratings are updated quarterly.
An Oklahoma nurse aide pleaded guilty to abusing a nursinghome resident and was placed on a deferred sentence probation for three years under the supervision of the Oklahoma Department of Corrections. The post Former Oklahoma NursingHome Employee Pleads Guilty to Abuse appeared first on Med-Net.
In a March 11, 2022, release by the Northern District of Georgia’s Office of the Department of Justice, it was reported that an investigation determined a Georgia nursinghome knowingly submitted claims for unreasonable, unnecessary, and unskilled services for Medicare patients. Attorney Kurt R. To avoid a “reverse false claim” (i.e.,
A Maine nursinghome with a history of federal fines was listed as a special focus facility (SFF) after two residents wandered off in separate incidents last year. They were one mile from the nursinghome, so police took her to the facility. In the second case, the resident was hit and killed by a motor vehicle.
A certified nurse’s aide (CNA) who was working in an Oklahoma nursinghome has pled guilty to stealing money from a resident. Our office will not tolerate the financial exploitation of our beloved nursinghome residents, no matter how large or small the amount.”.
On January 7, 2022, the Centers for Medicare & Medicaid Services (CMS) published a memorandum stating that nursinghome staff turnover and weekend staffing will be posted on the Medicare.gov Care Compare public website. The QSO memorandum can be accessed at: QSO-22-08-NH (cms.gov).
After a three-and-a-half-day trial, a jury returned a verdict for the US Equal Employment Opportunity Commission (EEOC) on behalf of a former employee of a Tennessee nursinghome who had been fired after requesting intermittent leave to address her anxiety. The former employee suffered from anxiety throughout her adult life.
An Illinois nursinghome was fined $25,000 after the Illinois Department of Public Health determined it failed to implement progressive interventions to prevent falls. The post Illinois NursingHome Fined $25,000 over Resident’s Fall appeared first on Med-Net.
Selection Approach In establishing the SFP, CMS examined the Special Focus Facility Program for nursinghomes and its methodology for facility selection. Selected hospices either successfully complete the SFP program or are terminated from the Medicare program.
A jury found a North Dakota certified nursing aide (CNA) guilty of Aggravated Assault causing permanent impairment and Reckless Endangerment. The evidence at the trial showed that the CNA performed an improper, one-person lift of a nursinghome resident which resulted in severe and painful injuries to the resident.
The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursinghome residents. In return, the psychiatrist prescribed Nuedexta to nursinghome residents who did not have pseudobulbar affect.
Charges were filed against two nursinghome employees who were caught on camera beating and dragging an 87-year-old resident, according to officials with the Texas City Police Department. Texas City police said they had received a complaint about an elderly male being assaulted by two caregivers at an area nursinghome.
The Iowa Department of Inspections and Appeals (DIA) reported that an Iowa nursinghome would be fined $20,000 after a resident was inappropriately discharged and left outside for 11 hours overnight. The post NursingHome Fined after Resident Left Outside 11 Hours Overnight appeared first on Med-Net.
The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursinghome residents’ rights to vote. On September 26, 2024, CMS issued a QSO Memo , “Compliance with Residents’ Rights requirement related to NursingHome Residents’ Right to Vote.” 42 CFR §483.10(b)(1)
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