Case Studies


staff

SURVEY DEFICIENCY CORRECTION

A skilled nursing facility requested an audit related to the correction of survey deficiencies. The audit was designed to assist the facility in identifying trends in deficiencies issued as a result of both standard and complaint surveys over the past three years. 

“Compliagent’s team was extremely effective and efficient in their audit, identifying areas of improvement and recommended corrective actions in order to meet best practices and ensure compliance. The audit was thorough, comprehensive, and professionally conducted. And the knowledge we gained from the audit will help us greatly in the years to come.”

                                                                        Read the full case study here > 


DRUG DIVERSION GUIDANCE

A skilled nursing facility was first made aware of the possible diversion of narcotics when they were advised by their pharmacy that refills were being ordered too soon and too frequently. In order to ensure that the investigation and corrective actions were in compliance with all state and federal regulations, as well as best practices, our client then contacted us seeking guidance and instruction for the investigation of possible drug diversion.

“Compliagent’s team was very impressive in their immediate response and continued involvement. Right from the start, we felt confident in Compliagent's guidance and looked forward to seeing the investigation through with their support. We could not have been more pleased with their service.”  

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Triple Check

TRIPLE CHECK OBSERVATIONS - BILLING AUDITS

A long term care (LTC) operator had outsourced rehabilitation services for three LTC facilities to a therapy company that later was investigated by the Office of Inspector General (OIG) and Department of Justice (DOJ) for overutilization of therapy services and overpayment of Medicare funds.  While the outsourced provider’s therapists provided the services to residents, the LTC facilities were still responsible for billing and oversight of care.  As a result, the OIG found the LTC facilities also at fault for the overutilization and overpayment.  After settling with the OIG, the LTC operator called Compliagent to determine how the overutilization and its subsequent overbilling happened, and ways to mitigate the risk of recurrence. 

“Compliagent’s team was easy to work with and went above and beyond our expectations in scheduling and response time.  They were very knowledgeable, bringing valuable insight in assisting our organization with improving compliance knowledge and identifying areas of opportunity.”  

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EMPLOYEE TRAINING - CUSTOMER SERVICE AND RESIDENT DIGNITY

Employee training is an essential component of our turnkey compliance services. Compliagent recently designed and implemented an interactive training program for an operator of multiple skilled nursing facilities, specifically addressing customer service and the risks of resident rights deficiencies.  

“Compliagent’s interactive training program was very well-received by all levels of staff.  Having our nurses share stories about the pitfalls of resident dignity negligence and customer service delivery made everyone sit up and listen.”

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HIPAA - BUSINESS ASSOCIATE RISKS

A healthcare insurance brokerage firm knew it needed to comply with the Health Insurance Portability and Accountability Act (HIPAA) as a business associate, but did not know how to proceed, so it contacted Compliagent for guidance. Pursuant to HIPAA, business associates are entities that perform functions or activities that involve the use or disclosure Protected Healthcare Information (PHI). 

“Compliagent took the burden of worry away by quickly implementing the tools we need to be HIPAA compliant. As we hire new employees, we make sure their onboarding includes HIPAA training from Compliagent.”

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MDS ASSESSMENT & TRAINING

A skilled nursing facility (SNF) had hired a new Minimum Data Set (MDS) Coordinator.  To ensure her success, the SNF’s administrator called Compliagent to provide comprehensive MDS training in the following areas:  determining residents’ functional capabilities; formulating and implementing care plans in conformance with federal and state regulations and documentation guidelines; and, completing MDS assessments pursuant to Medicare reporting guidelines and ethical business practices.

“I was very impressed with Compliagent’s MDS trainer’s expertise and teaching ability. Her trainee seems confident in her duties as she continues to learn through experience.”

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M&A DUE DILIGENCE - HOSPITAL ACQUISITION

A private capital firm considering the acquisition of a community hospital wanted to validate the purchase price, effectively measure the target’s post-acquisition compliance and regulatory risk, and determine any future costs required to remedy deficient areas in the hospital’s compliance infrastructure.

“We appreciate Compliagent’s guidance in the highly-specialized area of healthcare compliance, which helped us close the transaction.”

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