Posts tagged #compliance

Compliagent's COO, Paige Pennington, Addresses New Regulatory Developments in LTC Discharge and Transfer Requirements at the National ACO, Bundled Payment & Readmission Summit  

On October 26, 2017, Compliagent's COO, Paige Pennington, delivered a talk regarding new regulatory developments in LTC discharge and transfer requirements at the National ACO, Bundled Payment & Readmission Summit (Part of the 2017 NRPC C-Suite Invitational Series) at the California Endowment Conference Center in Los Angeles, California.  

Call or email us for more information about how these changes may impact your facility -- 310-996-8950;

Posted on November 2, 2017 .

The Office of Inspector General Focuses on Nursing Home Abuse

The Office of Inspector General (OIG) released a special “Eye on Oversight” webinar series, which features top areas of interest for the OIG. Recently, the series presented by Regional Inspector General, General Brian Whitley, focused on nursing home abuse. The OIG reported that in 2016, there were more than 1,000 open nursing home abuse cases and that 85% of nursing homes reported at least one instance of abuse or neglect in 2016 alone. The OIG utilizes various tools to combat abuse and neglect in nursing homes including:

1.       Conducting Investigations;

2.       Exclusions;

3.       Corporate Integrity Agreements; and

4.       Recommendations to the Centers for Medicare and Medicaid Services (CMS) regarding nursing home abuse and neglect.

In past years, the OIG has made recommendations to CMS regarding the reduction of antipsychotics, which have been implemented through various education, guidance, and regulation revisions. The OIG reports a 30% reduction in abuse and neglect related to antipsychotics due to the recommendations made by the OIG.

Throughout the OIG's recent audits and reports including information gathered through partnerships with state Medicaid enforcement partners, the OIG found three common factors that contributed to the incidences of abuse in nursing homes:

1.       Lack of staffing including adequate and trained staff as well as sufficient supplies;

2.       Over medication of residents leading to negative quality of care outcomes including falls; and

3.       Individual bad actors, such as nursing assistants, who had previous criminal histories.

The OIG maintains that focusing on these areas may help nursing homes reduce deficiencies related to nursing home abuse and neglect. The Regional Inspector General also stated that the OIG will continue its efforts to root out fraud, hold wrongdoers accountable, and recommend solutions to better protect nursing home residents.


Posted on August 2, 2017 .

New California Bill Introduced Regarding Residents Affected by Skilled Nursing Facility Closures

On February 2, 2017, California Assemblymember Jim Wood (D-Healdsburg), introduced AB 275 that would provide certain protections to residents of skilled nursing facilities (SNFs) when those facilities have a change in license status or operation, such as closure.  

Among other changes, AB 275 requires facilities to provide 90 days’ notice to residents and, if resident’s concerns cannot be appropriately addressed, the California Department of Public Health (CDPH) can extend this period for another 90 days. The bill requires a resident assessment by both a physician and mental health professional and gives CDPH the authority to require a resident transfer plan to assure that residents’ needs have been considered. Last, whenever two or more SNFs propose to close on the same date, the SNFs will be required to prepare a comprehensive community impact report. 

Read the text of the bill here:

Posted on February 9, 2017 .

LA Business Journal: Social Media a Bitter Pill for Some Docs

Compliagent CEO Nick Merkin was recently featured in an article by Marni Usheroff at the Los Angeles Business Journal on social media for physicians. To read the original source article, please visit Los Angeles Business Journal.

PRIME Act: Are Healthcare Providers Ready for an Increase in Costs and Compliance Burdens?

In late March 2015, a group of US Senators, having received motivation from the US House of Representatives, restored the introduction of the PRIME Act, which looks to amend the Social Security Act and harden securities against Medicare and Medi-Cal fraud and abuse and raise fraud detection measures across the board and could prove to be a double-edged sword for the healthcare industry.