Medicare Compliance & Reimbursement

What you need to fine tune -- before the OIG does it for you.

Nursing homes may have federal staffing laws down pat, but how clear are they on state requirements? And are the direct care hours posted on Nursing Home Compare the same ones auditors will find?
 
As its staffing requirement crusade continues on, the HHS Office of Inspector General drops more valuable hints on what's tripping up many long-term care facilities -- and what SNFs may need to double check before it's too late.

An audit of one facility, titled "Review of Nursing Facility Staffing Requirements at Woodland Center for Nursing" (A-03-03-00217), found that even though federal staffing rules were up to snuff, 13 of the 75 direct care employees reviewed did not comply with state background check requirements. Another hiccup: Woodland's staffing levels fell below state required levels for 17 percent of the workdays.

The OIG also has its eye on the numbers SNFs are handing over to state surveyors, particularly with the advent of the Center for Medicare & Medicaid Services' Nursing Home Compare Web site. In another report, titled, "Effect of Staffing on Quality of Care at Nursing Facilities - Mountain View Community Living Center" (A-04-04-04000), Mountain View had no wrinkles in its compliance with federal and state staffing regulations, but auditors did note that direct care hours per resident per day were not flush with hours of care reported in Nursing Home Compare.

Mountain View has since agreed to put controls in place to independently confirm the direct care hours provided to survey agencies.

To see the reports, go to: http://oig.hhs.gov/oas/oas/cms.html.