Posts tagged #healthcare compliance

According to New Study, Preferred SNF Provider Networks Reduce Readmissions

Hospitals using a preferred network were able to reduce their readmission rates from skilled nursing facilities by 6.1 percentage points between 2009 and 2013, the study found. That's compared to a 1.6 percentage point drop in such readmissions to hospitals that did not have a network.

Read more here: 

http://content.healthaffairs.org/content/36/9/1591.abstract

Posted on September 20, 2017 .

Skilled Nursing Operator to pay $170,000 for Falsifying Records

Autumn Health Care of Zanesville and its owner, Steven Hitchens, both pleaded guilty to multiple charges in October following an investigation that revealed that the organization, including Hitchens and a number of facility managers had altered, forged, and, in some cases, destroyed records in order to maintain Medicare and Medicaid funding.

Among the charges against Hitchens and Autumn Health Care are: 

  • providing unnecessary skilled therapy to Medicaid residents and billing Medicare Part B to pay for these unnecessary medical services; 

  • falsely reporting unnecessary medical services in order to receive a higher reimbursement rate from the Ohio Department of Medicaid; 

  • systematically falsifying resident records to defraud the Ohio Department of Health in an effort to make it appear that missed medical treatments were actually provided;

  • destroying a record outlining an incident involving an ill resident who was found in a snow bank after escaping the facility and forging a new record that falsely described the incident in order to avoid a citation from the Ohio Department of Health. 

  • forging a registered nurse's signature on resident assessments that were electronically sent to the Ohio Department of Health to bypass a requirement that a registered nurse certify the accuracy of the assessment.

The organization will be required to repay more than $52,000 to the Ohio Department of Medicaid, and an additional $40,000 in investigative costs to Attorney General Mike DeWine’s Office. Hitchens was ordered to serve three years of community control, 100 hours of community service, and is now under a period of federal exclusion from the Medicare and Medicaid programs as a result of his conviction.

Additionally, several of the organization’s managers and employees were all also sentenced to community controls and are under a period of federal exclusion from the Medicare and Medicaid programs. As a result, to their convictions, the Ohio State Board of Nursing permanently revoked the nursing licenses of all the nurses convicted of felonies.

For more information regarding this case visit: http://www.mcknights.com/news/provider-to-pay-nearly-170000-for-falsifying-destroying-records/article/630792/?DCMP=EMC-MCK_Weekly&spMailingID=16320456&spUserID=MTM0NDIzMDk1MDgwS0&spJobID=940972772&spReportId=OTQwOTcyNzcyS0

Posted on January 19, 2017 .