Three questions to boost nursing home audit readiness
By
Brian Evans
Sep 20, 2023
Nursing home and long-term care operators have already faced a number of key shifts since the beginning of 2023. Consider a recent example from the Centers for Medicare & Medicaid Services: an update on...
Flurry of Medicare Advantage regulation likely to hit nursing home coffers
By
Kimberly Marselas
Feb 03, 2023
Federal efforts to rein in Medicare Advantage spending and recoup payments awarded for improper diagnoses will likely lead to even more financial pressure on nursing homes that serve plan beneficiaries,...
AHRQ offers new nursing home audit resources aimed at COVID prevention
By
Alicia Lasek
Apr 05, 2021
The Agency for Healthcare Research and Quality has released a comparison tool for differentiating competency checks vs. observational audits, and a step-by-step guide to help establish an effective observational...
Medicare audits ‘ramping up’ with isolation coding in the crosshairs
By
Josh Henreckson
Apr 22, 2024
Auditors are paying special attention to isolation and quarantine coding amid already heightened Medicare nursing home audits that are expected to increase in coming months, experts warn.
Preparing charge nurses for success!
By
Susan LaGrange
Nov 15, 2013
Today more than ever, we hear about the importance of PROACTIVE approaches to prevent as many unfavorable events as possible. One of the key essential proactive approaches that we can implement is to PREPARE...
OIG: Regulators need to sharpen retrieval of Medicare overpayments made to providers
By
McKnight's Staff
May 25, 2012
Medicare recovery audit contractors have not been diligent enough in collecting previously identified overpayments, a government investigation finds.
Claims audit will affect every nursing home starting June 5
By
Kimberly Marselas
May 30, 2023
Every skilled nursing facility in the US will be subject to a five-claim audit starting the week of June 5 as regulators try to better assess and root out improper payments.
‘Audits are back,’ and COVID-19 care is in the hot seat
By
Kimberly Marselas
Apr 21, 2021
Flexibilities granted to providers during the ongoing public health emergency are likely to result in increased medical reviews and automated denials, a therapy billing specialist is warning.
After record penalties, providers can protect themselves from the DOJ with 3 priorities, experts say
By
Joe Bush
Nov 28, 2022
The Department of Justice is on pace to hand out a record $5.6 billion-plus in total fines and penalties under the False Claims Act this year, a clear indicator that the agency has removed the kid gloves...
SNF rehab claims scrutinized more than ever, expert says
Jul 11, 2012
Nursing home administrators who can’t substantiate every minute of rehab therapy delivered in their building leave themselves open to increasingly common audits and surveys, a top MDS 3.0 expert...