Home Health & Hospice Week

Medical reviewers may start taking a harder look at ENT claims for nursing home patients, thanks to a new HHS Office of Inspector General report on the topic.

Twenty-one percent of the enteral nutrition therapy (ENT) claims from 2006 that the OIG reviewed didn't pass muster. About 75 percent of the unacceptable claims for non-Part A nursing home patients were inadequately documented. The remaining claims were "inappropriate," the OIG says in the report.

Hot spot: "Claims for pumps and pump supply kits represented 70 percent of the inadequately documented sampled services," the OIG report says.

One widespread problem the OIG saw was lack of documentation for more expensive pumps that delivered ENT at slower than gravity rate. The record should document a medical condition, such as diabetes, risk of aspiration, or a fluctuating glucose level, which makes the more expensive pump necessary, the watchdog agency says. The report is online at www.oig.hhs.gov/oei/reports/oei-06-07-00090.pdf.