Jeannine LeCompte, Compliance Research Specialist
The third element of the Office of the Inspector General’s (OIG) seven elements of a compliance program includes a stipulation that all vendors serving a Medicare- and Medicaid-using Skilled Nursing Facility (SNF) are compliant with all rules and regulations. Ensuring this compliance is the legal duty of the SNF, and any failures in this duty can have serious consequences for the facility.
The first step in ensuring vendor compliance is to check the vendor’s status against the OIG’s list of debarred contractors, which can be done online at the System for Award Management’s (SAM) website, https://www.sam.gov/. A vendor is placed on the debarred contractor list for any offense involving fraud or other behavior likely to result in the misuse or misallocation of Medicare or Medicaid funds.
The SAM list continually updates its active exclusions, so a single check is not regarded as compliance. SNFs must have a process in place to regularly check their vendors against the SAM list. In addition, SNFs must also check the vendor owner names against the OIG’s employee exclusion list at https://exclusions.oig.hhs.gov, as vendor companies owned by excluded individuals are also noncompliant.
SNF records should show that the vendors have been checked for compliance with all rules relating to the Code of Conduct, Conflict of Interest regulations, the Anti-Kickback Statute, and the Deficit Reduction Act in states where this is required. Vendor details and attestations in this regard must be kept current and on file, ready for inspection by the OIG. In addition, all business associate agreements must be current, signed, and on file.
SNFs should also have an established process in place to ensure that all vendor and other third-party agreements are managed consistently with the terms of the agreement between the parties. This process must contain a document review and interviews to ensure there is communication between the developers of the agreements and facility level personnel who manage the day-to-day interactions with the vendor.
SNFs should also have a policy on how often screenings are required to be done by a vendor, and a stipulation requiring third parties to produce proof that they are checking their own employees for compliance.
Finally, SNFs must ensure that they have auditable evidence in their files to show that all contractors are being screened pursuant to contractual requirements. This includes “downstream” (or second or third level contractors) who may be supplying the main vendor. Checking vendor compliance can be an onerous task, but failure to do so can have serious legal consequences.
