Breaking Compliance News Blog

Compliance Boosts Census

Posted by Margaret Scavotto, JD, CHC on 1/20/15 7:00 AM

Compliance is mandatory. Ultimately, many long term care operators see compliance as a lot of work—and perhaps a burden. While all of these things are true, compliance also keeps health care providers out of hot water and away from the headlines. Did you know that your compliance program is a tremendous asset that boosts your bottom line?

The benefits of your compliance efforts go far beyond adhering to the government mandate. One of the benefits of investing in compliance is that your census may see a boost!

Compliance improves quality.

Quality Assurance & Performance Improvement (QAPI) plans are an essential component of each and every effective compliance program.  An effectively monitored quality assurance program should advance your quality of care by addressing issues immediately, before they become widespread. By actively managing your quality indicators with a data-driven, team approach, your SNF can improve the processes that translate into better quality, better care, and satisfied residents. Providing quality care is, after all, the reason we are in this business. And it comes with a perk: quality care is the best PR you can find. Invest in your QAPI effort, and see the favorable online reviews and word of mouth campaigns grow. This will increase your census.

Compliance reduces readmissions.

By using their compliance programs to reduce hospital readmissions, SNFs can increase admissions from hospitals—and boost census. The Affordable Care Act’s Hospital Readmissions Reduction Program reduces hospital inpatient prospective payments based on a hospital’s percent of preventable Medicare readmissions. The government instituted this program because it believes a high readmission rate indicates poor pre- or post-discharge care. In response, hospitals are increasing their efforts to reduce readmission rates to the extent possible.

As a result, hospitals’ readmission problem has become SNFs’ problem, too. Hospital discharge planners are more likely to direct patients to nursing homes with lower readmission rates. By actively monitoring, managing and ultimately reducing readmissions with their QA programs, nursing homes can increase admissions from hospitals and boost census.

Learn about the other ways that compliance can boost your bottom line by downloading MPA's free whitepaper: Compliance Saves Money.

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Topics: Quality Assurance, Affordable Care Act

OIG: “It doesn’t matter” that ACA compliance regulations aren’t here.

Posted by Margaret Scavotto, JD, CHC on 7/2/14 4:20 PM

CMS recently hosted a Medicare Learning Network Webinar series called “How Effective Is Your Compliance Program”? The speakers included individuals from CMS, a provider, and the Office of Inspector General (OIG). CMS provided this webinar because the Affordable Care Act made compliance mandatory for all nursing facilities, and all Medicare and Medicaid providers. The Affordable Care Act also requires CMS to issue regulations that explain what these programs should look like—however the regulations are nowhere in sight, leaving many providers puzzled as to what to do next.

CMS stated at the beginning of the webinar that they don’t know when CMS will issue the regulations implementing the Affordable Care Act’s compliance mandate. MPA asked if the government could at least say whether these programs will be a condition of participation, or a condition of enrollment. Dr. Julie Taitsman, Chief Medical Officer for the OIG, responded that “It doesn’t matter.”  

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Topics: Compliance Basics, Penalties and Enforcement, Affordable Care Act

March 23 Came and Went: Now What?

Posted by Margaret Scavotto, JD, CHC on 6/28/13 11:51 AM

As all in the long term care industry are very aware, the Affordable Care Act mandates compliance programs in all nursing homes by March 23, 2013 -- a date that is now behind us.

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Topics: Penalties and Enforcement, Affordable Care Act

Supreme Court gives green light to mandatory compliance programs

Posted by Margaret Scavotto, JD, CHC on 7/13/12 4:13 PM

On June 28, 2012, the United States Supreme Court upheld the majority of the Patient Protection and Affordable Care Act. This means that the Act's requirement that all nursing homes have effective compliance programs by March 23, 2013 is here to stay--and quickly approaching.
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Topics: Compliance Basics, Affordable Care Act

Compliance: Why you should care, now

Posted by Margaret Scavotto, JD, CHC on 2/10/12 3:56 PM


Currently, SNFs are not required to have compliance programs. That's about to change. On March 23, 2013, the Patient Protection and Affordable Care Act (also known as the health reform law) takes the government's compliance recommendation and makes it mandatory. SNFs without compliance programs will soon be unable to participate in Medicare and Medicaid.
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Topics: Compliance Basics, Penalties and Enforcement, Affordable Care Act

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