http://youtu.be/0My7cUQgW_w What are your rights during a RUG Review? It may be an overstatement to say that you have rights as the deck is so stacked against the provider and in favor of the OIG. But, there are a few things to which you are entitled as part of the process of which you should be aware. First, the OIG is required to give you a letter upon entrance into your facility. This is the signal that the review is beginning. The letter will explain the procedures of the … [Read more...] about YOUR RIGHTS DURING A RUG REVIEW
Three Ways to be Prepared for a RUG Review
Your facility will have a RUG review in the near future. Being prepared for a review can be half the battle. Knowing where all your old documentation is and knowing what, exactly, is in that documentation will make a RUG review much easier on the facility. There are three important steps the facility can take to not only mitigate errors found by reviewers, but create a far less stressful review. Organization of old records is the primary key of your preparation. Make sure a minimum … [Read more...] about Three Ways to be Prepared for a RUG Review
DRILLING DOWN TO ADL MDS ERRORS: THE HOW AND WHY MONEY IS WALKING OUT YOUR DOOR
As discussed last week, ADL's are the major target for HHSC-OIG. ADL's are the source for most errors resulting in RUG write downs. Not only did the facility lose money on incorrectly charted ADL's they will also face large penalties after a RUG review. Charting ADL's For most MDS nurses, ADLS are pieces of paper the CNA's have scribbled some numbers on. Ideally this number reflects both the Plan of Care and what care was really given. Calculating an accurate ADL score for … [Read more...] about DRILLING DOWN TO ADL MDS ERRORS: THE HOW AND WHY MONEY IS WALKING OUT YOUR DOOR
NURSING FACILITY COMPLIANCE PROGRAM: AUDITING OR THE ART OF FINDING OUT IF YOUR POLICIES WORK
The deadline for having your compliance plan in place is rapidly approaching on March 13, 2013. Having a compliance plan in place will be of no real benefit if you are not focusing on effectiveness. As part of the compliance program enforcement under the Affordable Care Act (ACA) starting in March of 2013, the Office of the Inspector General (OIG) and The Center for Medicare Services (CMS) state that a reliable audit and monitoring system are key elements to a effective compliance program. … [Read more...] about NURSING FACILITY COMPLIANCE PROGRAM: AUDITING OR THE ART OF FINDING OUT IF YOUR POLICIES WORK
