HHS Office of Civil Rights: Nondiscrimination in Health Programs and Activities Final Rule

AGENCY: Office for Civil Rights, Office of the Secretary, Department of Health and Human Services; Centers for Medicare & Medicaid Services, Department of Health and Human Services. ACTION: Final rule and interpretation. SUMMARY: The Department of Health and Human Services (HHS or the Department) is issuing this final rule regarding …

Process Surveillance Plus QAPI Equals Better Infection Prevention Training

Nursing homes are required to establish a surveillance system (i.e., “the routine, ongoing, and systematic collection, analysis, interpretation, and dissemination of surveillance data”) as part of their infection prevention and control program (IPCP) under F-tag 880 (Infection Prevention and Control) in Appendix PP of the State Operations Manual. This surveillance …

Expedited Determination Notices: Keys to Avoiding Financial Liability, Survey Issues

The expedited determination beneficiary notification process covers a lot of ground in skilled nursing facilities (SNFs), affecting residents in the fee-for-service (FFS) Medicare Part A program and Medicare Advantage plans, as well as residents who receive Part B rehabilitation therapies under consolidated billing, says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, …

Schizophrenia Audit Takeaways for NACs and the IDT

In the Jan. 18, 2023, Quality, Safety, and Oversight (QSO) memo QSO-23-05-NH, the Centers for Medicare & Medicaid Services (CMS) announced plans to conduct offsite audits to assess whether nursing homes appropriately assess, document, and code diagnoses captured in MDS item I6000 (Schizophrenia (e.g., Schizoaffective and Schizophreniform Disorders)) that are …

OIG General Compliance Program Guidance (GCPG) Updated

The GCPG is a reference guide for the health care compliance community and other health care stakeholders.  The GCPG provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other items useful for understanding health care compliance. The GCPG is voluntary guidance that discusses general compliance risks and compliance programs.  The GCPG …

What the DNS Needs to Know About Drug Regimen Review

Over the past few years, the Centers for Medicare & Medicaid Services (CMS) has placed increasing emphasis on drug regimen review (DRR) aka medication regimen review (MRR). Since 2018, skilled nursing facilities have captured one type of DRR/MRR in item N2001 (Drug Regimen Review) on PPS 5-Day MDS assessments for …

Tips for a Comprehensive Post-Admission Medical Record Review

Admissions are vital to a facility. They may occur daily, or even multiple times a day, and should be a part of routine operations. However, the admission process can be cumbersome, and it is easy for staff to miss things, especially if the facility receives multiple admissions in a shift. …

Medical Record Audit: New Admission/Readmission

The admission process can be lengthy, and staff can miss important details. Use the Medical Record Audit: New Admission/Readmission checklist to ensure the facility has obtained critical information from newly admitted and readmitted residents and appropriately documented it in the medical record. This AAPACN resource is copyright protected. AAPACN individual …

CMS QSO Memo: Civil Money Penalty Reinvestment Program Revisions

Memo # QSO-23-23-NHs Posting Date 2023-09-25 Fiscal Year 2023 Title Memorandum Summary CMS is committed to reinvesting civil money penalty (CMP) funds for projects to support the quality of care and life for nursing home residents in a consistent and equitable manner. Therefore, we are revising the structure of the …