Med-Net Concepts Letter (November Edition)

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Med-Net
November 21, 2019
Med-Net Concepts Letters

cms, compliance and ethics program, Concepts Letter, QAPI, risk management

CMS Releases Revisions to Special Focus Facility Program

On October 21, 2022, the Centers for Medicare & Medicaid

CMS Issues Revised COVID-19 Nursing Home Visitation Guidance

On September 23, 2022, the Centers for Medicare & Medicaid

CMS Issues Guidance on Interim Final Rule Regarding LTC Facility COVID Testing Requirements

On September 23, 2022, the Centers for Medicare & Medicaid

CMS Enhances Nursing Home Rating System with Staffing and Turnover Data

The Centers for Medicare & Medicaid Services launched its enhanced

Several COVID-19 Emergency Declaration Blanket Waivers Expiring

On April 7, 2022, the Centers for Medicare & Medicaid

Nursing Home Weekend Staffing Levels and Staff Turnover to Be Posted for Public on CMS Website

On January 7, 2022, the Centers for Medicare & Medicaid

CMS Issues Guidance on Interim Final Rule Regarding Healthcare Staff Vaccinations

On December 28, 2021, the Centers for Medicare & Medicaid

CMS Announces New Visitation Guidance for Nursing Homes

On November 12, 2021, the Centers for Medicare & Medicaid

CMS Announces Changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes

On November 12, 2021, the Centers for Medicare & Medicaid

CMS Releases Assessment Reference Guides for Accurate Coding

Quick Assessment Reference Pocket Guides were released on November 10,

Med-Net Academy Healthcare Compliance Training

CMS Updates Web-based Training on the Assessment and Coding of Section GG

Recently, the Centers for Medicare and Medicaid Services (CMS) released

Annual Compliance and Ethics Program Assessment Checklist: Monitoring and Reporting

Jeannine LeCompte, Publishing and Research Coordinator The annual assessment of the

Annual Compliance and Ethics Program Assessment Checklist: Education and Training

Jeannine LeCompte, Publishing and Research Coordinator An annual assessment of the

Annual Compliance and Ethics Program Assessment Checklist: Screening Procedures and Discipline for Noncompliance

Jeannine LeCompte, Publishing and Research Coordinator All long-term care facilities using

Annual Compliance and Ethics Program Assessment Checklist: Standards, Policies, and Procedures

Jeannine LeCompte, Publishing and Research Coordinator All long-term care facilities using

Managing Risks in Handling Protected Health Information

Jeannine LeCompte, Publishing and Research Coordinator All healthcare providers are legally

Compliance Program Core Components: Identification and Response to Compliance Risks

Jeannine LeCompte, Publishing and Research Coordinator The final component of a

Compliance Program Core Components: Disciplinary Standards

Jeannine LeCompte, Publishing and Research Coordinator A Medicare- and Medicaid-approved long-term

CMS Releases New Training Video to Promote Accurate Coding for Height, Weight, and Nutritional Approaches for SNF Providers

On August 10, 2021, the Centers for Medicare & Medicaid

Compliance Program Core Components: Effective Training and Communication

Jeannine LeCompte, Publishing and Research Coordinator A Medicare- and Medicaid-approved long-term

Compliance Program Core Components: Written Policies and Oversight

Jeannine LeCompte, Publishing and Research Coordinator A Medicare- and Medicaid-approved long-term

Compliance with Financial Business Practices: Financial Cost Reporting

Jeannine LeCompte, Publishing and Research Coordinator Skilled Nursing Facilities (SNFs) are

Ensuring Compliance with Financial Business Practices: Billing Routines

Jeannine LeCompte, Publishing and Research Coordinator Skilled Nursing Facilities (SNFs) are

Ensuring Compliance with Financial Business Practices: Billing Issues

Jeannine LeCompte, Publishing and Research Coordinator Skilled nursing facilities (SNFs) are

Demonstrating Compliance in Employee Licensing

Jeannine LeCompte, Publishing and Research Coordinator According to the Centers for

Update to 2021 Annual Update of HCPCS Codes for Skilled Nursing Facility Consolidated Billing Enforcement Released

The Centers for Medicare & Medicaid Services (CMS) recently released

GAO Study Finds that Most Nursing Homes had Multiple Outbreaks and Weeks of Sustained Transmission of COVID-19 from May 2020 through January 2021

The U.S. Government Accountability Office (GAO) analysis of the data

An OIG Study Finds that CMS Could Improve the Data it uses to Monitor Antipsychotic Drugs in Nursing Homes

The Office of Inspector General (OIG) conducted a follow-up study

CMS Publishes New Interim Final Rule for COVID-19 Vaccine Immunization Requirements for Residents and Staff

On May 11, 2021, the Centers for Medicare & Medicaid

CMS Releases New Training for Cognitive and Mood Assessment for SNF Providers

The Centers for Medicare & Medicaid Services (CMS) released a

QAPI and Compliance and Ethics Programs: Do They Overlap?

Jeannine LeCompte, Publishing and Research Coordinator Although Quality Assurance Performance Improvement

Compliance and Ethics Program Requirements

Jeannine LeCompte, Publishing and Research Coordinator A Compliance and Ethics program

CMS Announces the Ending of Several Temporary Emergency Blanket Waivers

In March 2020, the Centers for Medicare & Medicaid Services

QAPI Program Requirements

Jeannine LeCompte, Publishing and Research Coordinator A Quality Assurance and Performance

Med-Net News & Views (February 2021 Edition)

CMS Releases New Training Video to Promote Accurate Coding for Resident Mood Interview

On April 2, 2021, the Centers for Medicare & Medicaid

QAPI vs Compliance and Ethics: What’s the Difference?

Jeannine LeCompte, Publishing and Research Coordinator All long-term care facilities (LTCs)

GAO Recommendations for Pandemic Have Not Been Fully Implemented by CMS

The CARES Act includes a provision for the U.S. Government

CMS Updates Guidance on Visitation in Nursing Homes

On March 10, 2021, the Centers for Medicare & Medicaid

CMS Releases a COVID-19 Resource Page

On February 8, 2021, the Centers for Medicare & Medicaid

Med-Net News & Views (January 2021 Edition)

Med-Net News & Views (December 2020 Edition)

Med-Net Concepts Letter (October 2020 Edition)

CMS Releases Two New Training Courses

The Centers for Medicare & Medicaid Services (CMS) released two

OIG Provide Recommendations to CMS After Review of Focused Infection Control and Complaint Surveys

The Office of Inspector General (OIG) is recommending to the

CMS Recommends Nursing Home Residents Do Not Leave Facilities During the Holiday Season

The Centers for Medicare & Medicaid Services (CMS) is recommending

CMS Releases COVID-19 Vaccine Reimbursement Toolkit

The initial supply of COVID-19 vaccines will be federally purchased,

Nursing Homes Urged to Follow Established COVID-19 Guidelines this Holiday Season

The Centers for Medicare & Medicaid Services (CMS) is imploring

Med-Net News & Views (November 2020 Edition)

Company Contracts and Ethics: Professional Service Providers

Jeannine LeCompte, Publishing and Research Specialist Just as is the case

Company Contracts and Ethics: Vendors

Jeannine LeCompte, Publishing and Research Coordinator Medicare- and Medicaid-approved long-term care

Company Contracts and Ethics: An Introduction

Jeannine LeCompte, Publishing and Research Coordinator All Medicare- and Medicaid-approved long-term

Med-Net Concepts Letter (September 2020 Edition)

Maintaining Financial Integrity through Cost Reporting

Jeannine LeCompte, Publishing and Research Coordinator Another component of the financial

CMS Acts to Ensure Reliability of COVID-19 Testing

A recent record check by the Centers for Medicare &

Med-Net News & Views (July 2020 Edition)

Med-Net News & Views (June 2020 Edition)

Adhering to the Law: Implementing a Compliance Program

Jeannine LeCompte, Publishing and Research Coordinator Medicare- and Medicaid-approved Skilled Nursing

Enforcing a Structured Compliance Program Administration

Jeannine LeCompte, Compliance Research Specialist Once a skilled nursing facility has

The Appointment of a Compliance Committee

Jeannine LeCompte, Compliance Research Specialist The appointment of a compliance committee

Family of 86-Year-Old Resident Alleges Facility Failed to Inform Them of Resident’s COVID-19 Status

The family of an 86-year-old resident in an Alabama nursing

The Purpose of a Compliance and Ethics Program

Jeannine LeCompte, Compliance Research Specialist The Office of the Inspector General

Investigations Which Adhere to Compliance and Ethics Programs

Investigations into allegations of fraud, waste, and abuse at Medicaid

Med-Net Concepts Letter (June 2020 Edition)

Med-Net Concepts Letter (May 2020 Edition)

Nursing Homes with Infection Control Violations Face Increase in Penalties

The Centers for Medicare & Medicaid Services (CMS) and Centers

Employee Verification: Part of the Mandated Compliance and Ethics Requirement

Jeannine LeCompte, Compliance Research Specialist Employee verification in the long-term care

Most NYC Nursing Homes Hit Hard by COVID-19 Found by DOH Totally Compliant with CMS Infection Control Guidelines

The New York State Department of Health (DOH) recently reported

Med-Net News & Views (May 2020 Edition)

Med-Net News & Views (April 2020 Edition)

New Hampshire Nursing Home’s Pen Pal Program Bridges Isolation Gap for Residents

The mandated social isolation to control and prevent the spread

New Independent Commission to Assess Nursing Homes’ Response to COVID-19 Pandemic

New Independent Commission to Assess Nursing Homes’ Response to COVID-19

CMS/CDC Guidance on Staff and Resident Care during COVID-19 Crisis

CMS/CDC Guidance on Staff and Resident Care during COVID-19 Crisis Jeannine

Med-Net News & Views (March 2020 Edition)

Latest COVID-19 Long-Term Care Facility Guidance from CMS

Latest COVID-19 Long-Term Care Facility Guidance from CMS Jeannine LeCompte, Compliance

New Targeted Facility Inspection Plan for Healthcare Facilities Announced by CMS

New Targeted Facility Inspection Plan for Healthcare Facilities Announced by

Iowa Nursing Home Placed on CMS Special Focus Facilities List

Iowa Nursing Home Placed on CMS Special Focus Facilities List An

Med-Net News & Views (January 2020 Edition)

Med-Net Concepts Letter (February 2020 Edition)

Med-Net Concepts Letter (January 2020 Edition)

CMS Checklist Review of Care and Services for Dementia Patients Part II

CMS Checklist Review of Care and Services for Dementia Patients

CMS Checklist Review of Care and Services for Dementia Patients Part I

CMS Checklist Review of Care and Services for Dementia Patients

Meeting CMS Requirements for Dementia Care, Part II

Meeting CMS Requirements for Dementia Care, Part II Jeannine LeCompte, Compliance

Meeting CMS Requirements for Dementia Care, Part I

Meeting CMS Requirements for Dementia Care, Part I Jeannine LeCompte, Compliance

Med-Net News & Views (November Edition)

Identifying Residents with Trauma-Related Issues

Identifying Residents with Trauma-Related Issues Jeannine LeCompte, Compliance Research Specialist With the

Understanding Trauma-Informed Care

Understanding Trauma-Informed Care Jeannine LeCompte, Compliance Research Specialist November 28, 2019 will

Med-Net News & Views (October Edition)

Med-Net News & Views (September Edition)

Med-Net Concepts Letter (September Edition)

Safety Issues Alleged to Have Contributed to Patient’s Suicide in Florida VA Hospital

Safety Issues Alleged to Have Contributed to Patient’s Suicide in

Med-Net Concepts Letter (August Edition)

Federal Nursing Home Inspection Reports Indicate Increasing Number of Abuse-Related Citations Nationwide

Federal Nursing Home Inspection Reports Indicate Increasing Number of Abuse-Related Citations Nationwide A recent

Med-Net News & Views (July Edition)

QAPI Phase III: The PIP Cycle, Analysis, and Implementation

QAPI Phase III: The PIP Cycle, Analysis, and Implementation Jeannine LeCompte,

QAPI Phase III: The Identification of Indicators and Their Measurement

QAPI Phase III: The Identification of Indicators and Their Measurement Jeannine

QAPI Phase III: Data Collection and Monitoring

QAPI Phase III: Data Collection and Monitoring Jeannine LeCompte, Compliance Research

QAPI Phase III Deadline Approaches: Are You Ready?

QAPI Phase III Deadline Approaches: Are You Ready? Jeannine LeCompte, Compliance

Med-Net News & Views (June Edition)

Med-Net Concepts Letter (June Edition)

Failure by Montana Hospital to Follow Patient’s “Do Not Resuscitate or Intubate” Order Results in Jury Award of Over $400K

Failure by Montana Hospital to Follow Patient’s “Do Not Resuscitate or

Unsafe Discharge – QAPI Case Study #354

Unsafe Discharge - QAPI Case Study #354 A resident who was admitted to

Med-Net Concepts Letter (May Edition)

Med-Net Concepts Letter (April Edition)

Med-Net Concepts Letter (March Edition)

Highest National Percentage of Falls in Wisconsin Nursing Homes and Assisted Living Centers Reported

Highest National Percentage of Falls in Wisconsin Nursing Homes and

Rise in Number of Georgia Legionnaires’ Disease Cases Since 2008 Has Experts Baffled

Rise in Number of Georgia Legionnaires’ Disease Cases Since 2008 Has

Med-Net Concepts Letter (February Edition)

Avoiding and Disclosing Possible Conflicts of Interest

Avoiding and Disclosing Possible Conflicts of Interest Jeannine LeCompte; Compliance Research Specialist A

Federal Audit Sample Results Indicate CMS Paid Skilled Nursing Facilities $84 Million for Ineligible Post-hospital Extended Care Services

Federal Audit Sample Results Indicate CMS Paid Skilled Nursing Facilities

Training Staff about Situations Which Can Create Possible Conflicts of Interest

Training Staff about Situations Which Can Create Possible Conflicts of Interest Jeannine

Drawing up a Code of Conduct to Avoid Conflicts of Interest

Drawing up a Code of Conduct to Avoid Conflicts of

Montana Nurse Sentenced for Taking Fentanyl for Personal Use

Montana Nurse Sentenced for Taking Fentanyl for Personal Use QAPI

Two Residents and One Officer Injured in Baltimore Nursing Home Fire

Two Residents and One Officer Injured in Baltimore Nursing Home Fire Risk

Women Stole Personal Items from Multiple Nursing Homes in Two States

Women Stole Personal Items from Multiple Nursing Homes in Two

Med-Net Concepts Letter (January Edition)

Woman Died After Fall From Wheelchair Lift, Illinois Nursing Home Blamed

QAPI Perspective Policy/Procedure: Policies and procedures need to be up-to-date and meet

Woman Charged with Stealing Drugs from Assisted Living Residents in Minnesota

Diversion of Medication Remains a Concern in Most Nursing Homes. Nursing

Centers for Medicare & Medicaid Services Revised Requirements for Long-Term Care Facilities

Centers for Medicare & Medicaid Services Revised Requirements for Long-Term

Nursing Home Visitor Sexually Assaulted Resident

QAPI Perspective Skilled nursing facilities are entrusted with maintaining resident

New CMS Emergency Preparedness Rule

New CMS Emergency Preparedness Rule September 2016 The Centers for Medicare and

OIG 2016 Mid-Year Work Plan

OIG 2016 Mid-Year Work Plan June 2016 In its 2016 mid year

As Out-of-Town Investors Buy WNY Nursing Homes, Residents Pay the Price

QAPI / Risk Management Perspective Policy/Procedure: Policies and procedures need to

‘Psychopathic’ Hospital Patient Held Broken CD to Female Nurse’s Throat in Hostage Attempt

QAPI Perspective Policy/Procedure: Policies and procedures need to be up-to-date and

Louisiana Nursing Home Employee Accused of Scratching Resident to ‘Show Her How it Feels’

QAPI Perspective Policy/Procedure: Policies and procedures need to be up-to-date and

New Jersey Woman Admits Healthcare Fraud Conspiracy Targeting State Health Benefits Programs

QAPI Perspective Policy/Procedure: Policies and procedures need to be up-to-date and

Federal Appeals Board Upholds CMS Imposed Civil Money Penalty of $162,000 Assessed Against Kentucky Health and Rehabilitation Center

Does a facility’s failure to immediately begin correcting deficiencies after

The CMS Medication Regimen Review: An Introduction

The CMS Medication Regimen Review: An Introduction Jeannine LeCompte, Compliance Research

Med-Net Concepts Letter (October Edition)

Med-Net Concepts Letter (August Edition)

Med-Net Concepts Letter (July Edition)

Does the “Compliance and Ethics” Process Intersect with QAPI at Any Stage?

Does the “Compliance and Ethics” Process Intersect with QAPI at

Compliance and Ethics Program Details

Compliance and Ethics Program Details Jeannine LeCompte, Compliance Research Specialist The CMS

QAPI vs “Compliance and Ethics” Requirements

QAPI vs “Compliance and Ethics” Requirements Jeannine LeCompte, Compliance Research Specialist Understanding

Med-Net News & Views (September Edition)

QAPI vs “Compliance and Ethics”—What’s the Difference?

QAPI vs “Compliance and Ethics”—What’s the Difference? Louise Lindsey, Editor On November

Fifteen California Nursing Homes Sued for Knowingly Understaffing to Increase Profits

Compliance Perspective - Understaffing: The Compliance Officer will review the facility’s

Staffing Concerns Cause Nearly 1,400 Nursing Homes to Get Lower Medicare Ratings

Compliance Perspective - Medicare Ratings: The Compliance Officer should review the

Employees Forced to Resign After Denial of Reasonable Accommodation Basis for EEOC Lawsuit

Compliance Perspective - EEOC Lawsuit: The Compliance Officer should review with

Family Members of Patient Sued by Hospital Over Facebook Post and Picketing

Compliance Perspective: The Compliance Officer should review with the QAPI Nurse

Nursing Home Resident Tested Positive for Legionnaires’ disease

Compliance Perspective: The CMS has issued a clarification on Facility Requirements

14 Arizona Assisted-Living Centers Found Discriminating Against Prospective Deaf Residents

Healthcare Compliance Perspective: The Compliance Officer will review the policies and

Nurse Staffing Agency and Nurse Aide Sued in Death of 101-Year-Old Nursing Home Resident

Healthcare Compliance Perspective - Death of a Resident: The Compliance Officer

Religious Discrimination Alleged in Civil Complaint against Health and Rehabilitation Center in Virginia

A former employee (plaintiff) has filed a civil complaint against

Increase in Respiratory Illnesses in Illinois Nursing Home Being Investigated

Healthcare Compliance Perspective - Respiratory Illnesses: The Compliance Officer should review

Medicaid Provider Agrees to Lifetime Exclusion from Medicaid

Healthcare Compliance Perspective - Lifetime Exclusion from Medicaid: The Compliance Officer

Religious Discrimination Alleged in Civil Complaint against Health and Rehabilitation Center in Virginia

Religious Discrimination Alleged in Civil Complaint against Health and Rehabilitation

Employee Checks in a SNF Environment—Employer Obligations

Employee Checks in a SNF Environment—Employer Obligations The extensive penalties imposed

Woman Sues Houston Area Nursing Home for Wrongful Termination

Healthcare Compliance Perspective - Wrongful Termination: The Compliance Officer will review

Home Healthcare Provider Agrees to $3 Million False Claims Settlement

Healthcare Compliance Perspective - False Claims Settlement: The Compliance Officer will

July Heatwave Forces New Jersey Nursing Home Evacuation When Air Conditioning System Fails

Healthcare Compliance Perspective - Nursing Home Evacuation: The Compliance Officer will

Resident of Skilled Nursing Home Injured in Smoking-Related Accident

Healthcare Compliance Perspective - Resident Injured: The Compliance Officer should review

SNF and Employee Checks—Mandatory and Permissive Exclusions

SNF and Employee Checks—Mandatory and Permissive Exclusions The Office of the

20 months After Family Files Complaint Unlicensed Nurse Finally Faces Charge

Healthcare Compliance Perspective - Nurse Faces Charge: The Compliance Officer should

Kentucky Skilled Nursing Facility, Corporate Management and Owner Agree to Pay $540,000 to Resolve False Claims Allegations

Healthcare Compliance Perspective - False Claims Allegations: The Compliance Officer should

Former Business Manager Arrested and Charged with Embezzling $227,000 from Healthcare Agency

Healthcare Compliance Perspective - Embezzling: The Compliance Officer should review business

Kentucky Man Jailed for Allegedly Stealing from Nursing Home Residents While “Squatting” in an Unoccupied Room

Healthcare Compliance Perspective - Squatting: The Compliance Officer should evaluate the

Med-Net News & Views (June Edition)

Staffing Agency Settles EEOC Sex Harassment and Retaliation Suit for $30,000

Healthcare Compliance Perspective - Retaliation Suit: The Compliance Officer will confer

Wound Services Provider to Pay Almost $400,000 for False Claims Act Allegations

Healthcare Compliance Perspective - False Claims: The Compliance Officer should verify

Bed Rails: Avoiding Noncompliance Penalties

Given that bed rails fall under the category of restraints,

Nearly $50,000 in Overstated Medicaid Claims by Nursing Home Revealed by Tennessee State Auditors

Healthcare Compliance Perspective - Medicaid Claims: The Compliance Officer will involve

Hidden Camera Footage Supports $1.2 Million Awarded in Nursing Home Abuse Case

Healthcare Compliance Perspective -Nursing Home Abuse: The Compliance Officer should involve

VA Hospital Worker Pleads Guilty to Identity Theft of More Than 1,000 Patients

Healthcare Compliance Perspective - Identity Theft: The Privacy Officer needs to

Woman Sentenced to Five Years for Setting Nursing Home Fire Two Years Ago

Healthcare Compliance Perspective Nursing Home Fire: The Compliance Officer should ask

Guidance for the Installation and Maintenance of Bed Rails

Guidance for the Installation and Maintenance of Bed Rails The correct

Snapchat Used by Nursing Home Employees to Post Videos of Elder Abuse

Compliance Perspective - Elder Abuse: The Privacy Officer should investigate the

Charlottesville Nursing Home Resident Dies After Falling into Creek

Healthcare Compliance Perspective: The Compliance Officer should review with the Compliance

North Carolina Nursing Homes Fined $567,976 by Medicare for Resident Abuse

Healthcare Compliance Perspective - Resident Abuse: The Compliance Officer together with

Healthcare Company to Pay More Than $30 Million to Resolve False Claims Act Allegations Related to Rehabilitation Therapy

Compliance Perspective - False Claims: The Compliance Officer should work with

Resident of Assisted Living Center Files Suit Over Staff Accusations She Hallucinated About Bedbug Infestation

Healthcare Compliance Perspective - Bedbugs: The Compliance Officer should investigate any

Legal Considerations When Using Bed Rails

Apart from considerations of resident comfort, there are a number

Underinflated Air Mattress May Have Contributed to a Resident’s Fall and Injury

A resident who was alert and who did not normally

Former Nursing Home Owner and Manager Charged with Multiple Felonies

Healthcare Compliance Perspective - Multiple Felonies: The Compliance Officer should be

Deaf Resident Sues Nursing Home for Lack of Access to Interpreter

Healthcare Compliance Perspective - Resident Sues Nursing Home: The Compliance Officer

Facility Blamed in Death of Former Presidential Adviser’s Father

Healthcare Compliance Perspective: A Compliance Officer faced with multiple concerns, e.g.,

Former Employee Files Suit Claiming Wrongful Discharge and Unlawful Retaliation

Healthcare Compliance Perspective - Wrongful Discharge: The "Ethics" of a Compliance

Bed Rails in a SNF Environment: Physical Restraint or Resident Aid

Bed Rails in a SNF Environment: Physical Restraint or Resident

Nurses and the Opioid Prescription Drug Epidemic

The news media is full of articles about what the

Middle Tennessee Podiatrist Sentenced to Federal Prison for Health Care Fraud Scheme

Healthcare Compliance Perspective - Healthcare Fraud Scheme: Compliance Officers should develop

Walmart, Sam’s Club to Pay $825,000 to Resolve Fraud Allegations Concerning Auto Refilling Medicaid Prescriptions

Healthcare Compliance Alert - Fraud Allegations: The Compliance Officer should audit

Florida Nursing Homes Get Ready for 2018 Hurricane Season

Healthcare Compliance Perspective - Hurricane Season: The Compliance Officer needs to

Man in New York Recovery Center Found Dead and Decomposing

Compliance Perspective: A Compliance Officer's primary role is to be available

Med-Net News & Views (May Edition)

Two-Year Investigation of Medicaid Transportation Fraud Based in Essex County Results in the Arrest of 12 Individuals

Healthcare Compliance Perspective - Medicaid Transportation Fraud: Compliance Officers must audit

Nursing Home Resident Indicted and Committed to Mental Health Facility for Raping Another Resident

Healthcare Compliance Perspective: A reasonable suspicion of a crime must be

Former Employee of Speech Recognition Software Company Accesses Thousands of the Company’s Healthcare Provider Clients’ HIPAA Protected Health Information

Healthcare Compliance Perspective - HIPAA Protection: What should a healthcare provider

CNA Accused of Stealing Money and Using Personal Identity Information of Elderly Couple to Defraud

Healthcare Compliance Perspective - Defraud: A healthcare provider which uses independent

The Importance of the I-9 Form and Compliance

With Immigration and Customs Enforcement (ICE) increasing actions to curb

Nursing Home Miscalculated Resident’s Fall Risk, Possibly Contributing to Her Death

Healthcare Compliance Perspective - Fall Risk: CMS regulation F689 Accidents requires

Georgia Man Gets 5-Year Sentence for Filing Fraudulent Income Tax Returns and Cashing U.S. Treasury and Other Checks

Healthcare Compliance Perspective - Fraud: Under the HIPAA privacy rule a

Massachusetts Skilled Nursing Facility Agrees to Settlement of Government Suit Alleging Disability Discrimination Involving Patient

Healthcare Compliance Perspective - Disability Discrimination: In light of growing concern

The Development of a Resident Privacy Policy

An HIV-positive patient asked an office manager to fax his

Family Practitioner and Orthopedic Surgeon Convicted of Healthcare Fraud

Healthcare Compliance Perspective - Healthcare Fraud: Knowingly making false statements and

Woman Convicted and Sentenced for Healthcare Fraud

Healthcare Compliance Perspective - Healthcare Fraud: Knowingly billing Medicare for services

Missouri Nursing Home Being Investigated for Providing Sub-Standard Care to Residents

Healthcare Compliance Perspective In general, all reported or filed complaints

Chicago Area Physician Indicted for Allegedly Pocketing Nearly $1 Million in Medicare and Insurer Payments for Nonexistent False Claim Treatment

Healthcare Compliance Perspective: The submission of a false claim based on

Skilled Nursing Will See Medicare Pay Raise

Come 2019, skilled nursing facilities could see significant increases in

Massachusetts Doctor Convicted by Jury of Illegally Sharing Patient Medical Files

Healthcare Compliance Perspective: Although the initial act of allowing unauthorized individuals

Athens County Home Health Care Agency Owner Sentenced for Committing $2M Fraud

Healthcare Compliance Perspective: Fraudulent behavior often involves all opportunities available

Internal Structural Requirements for HIPAA Compliance

A medical employee was fired in 2017 after she violated

Congressional Democrats Propose Legislation that Would Ban Noncompete Agreements

Democratic senators helped reign in the new month with proposed

Three Deaths and Numerous Incidents of Alleged Abuse and Neglect Result in Iowa Nursing Home’s Fines of $45,750

Healthcare Compliance Perspective - Abuse and Neglect: Compliance Officers should be

Northeast Texas Hospital Self-Discloses and Resolves Healthcare Compliance Concerns

Healthcare Compliance Perspective: A Compliance Officer, with guidance from Compliance Attorney,

Medical Records Leaked by Transcription Service

A medical transcription service provider was notified last week by

Case Study: Failure to Observe Narcotic Medication Protocol and Missing Fentanyl Patches

Failure to Observe Narcotic Medication Protocol and Missing Fentanyl Patches A

Nursing Home Fighting $25,000 State Fine

Healthcare Compliance Perspective - Nursing Home State Fine: Policies and procedures

Med-Net News & Views (April Edition)

New CMS Rules on the Management of Controlled Substances

In response to a growing problem in drug diversion in

Owner of Assisted Living Home in Florida Accused of Elder Abuse Charges, Arrested and Jailed

Healthcare Compliance Perspective / Elder Abuse Charges: Unresolved citations for substandard

Oahu Physical Therapist Pleads Guilty to Healthcare Fraud

Healthcare Compliance Perspective - Healthcare Fraud: Services provided by non-licensed persons

Pittsburgh Pharmacist Sentenced to Prison for Misbranded Drug Scheme

A federal district court judge has sentenced a resident of

New CMS Controlled Substance Control Guidelines

The Centers for Medicare & Medicaid Services (CMS) set the

Tennessee Nursing Home Fined and Admissions Suspended After Annual Survey

Healthcare Compliance Perspective: Failure to investigate and prevent the continuing

No Water and a Faulty Sprinkler Alarm Cited in Nursing Home Fire

Healthcare Compliance Perspective: Emergency preparedness auditing requires a hands on

U.S. DOJ Charges Missouri Nursing Home’s Social Services Director with Identity Theft from Elderly Residents

Healthcare Compliance Perspective: Suspicious activity that could potentially alert staff to

Scenario: Medication Error

A resident was given the wrong IV medication by a

Exclusion List/License Checks

Exclusion List/License Checks Case A certified nursing assistant had been working at

Doctor Lands in Prison for Unlicensed Staff

Anthony Enrico, a Passaic County Podiatrist, was sentenced to three

Med-New News & Views (March Edition)

Scenario: Needle Stick

A nurse gave a resident her insulin injection and accidentally

VA OIG Report Reveals New York VA Medical Center Personnel Failed to Try and Resuscitate a Dying Patient

Healthcare Compliance Perspective: Licensed employees must not only refrain from acting

Nurse Accused of Removing Fentanyl Patches from Nursing Home Residents

Healthcare Compliance Perspective: The Compliance Officer will work with the Pharmacy,

Heart Pump Manufacturer Agrees to Pay $3.1 Million to Resolve Kickback Allegations

Healthcare Compliance Perspective: Light meals may be offered in conjunction with

Justice Department Launches Initiative to Fight Sexual Harassment in the Workplace

Healthcare Compliance Perspective: Healthcare providers must develop a written policy and

Academic Medical Center Employees Fired for Snooping into Patients’ Private Health Information

Healthcare Compliance Perspective: It is essential for skilled nursing facilities to

Internet Robots (Spiders, Crawlers and Web Bots) May Put Healthcare Organizations at Risk for HIPAA Violations

Healthcare Compliance Perspective: Inappropriate use of healthcare provider computers increases the

Employee Screening in Skilled Nursing Facilities: An Introduction

Most SNF employers are aware of the necessity of screening

Getting Compliance Right: Disciplinary Steps and Procedure Reassessment

Skilled nursing facilities (SNF) receiving federal funds are obligated to

U.S. Files False Claims Act Complaint Against Compounding Pharmacy, Private Equity Firm, and Two Pharmacy Executives Alleging Payment of Kickbacks

Healthcare Compliance Perspective: Fraud, based upon kickbacks, always involves an emphasis

Former Long-Term Care Ombudsman Pleads Guilty to Stealing from Nursing Home Resident

Healthcare Compliance Perspective: Public officials must maintain integrity for our

Springfield Nursing Home Residents Take Narcotics from Unsecured Medication Drawer

Healthcare Compliance Perspective: Audits must address medication diversion must account

California Nursing Home Sued for Injury to Former Resident’s Eye

Healthcare Compliance Perspective: Individual occurrences, in an of themselves, are

3 New Cases of Legionnaires at Illinois Veterans’ Home

Healthcare Compliance Perspective: An effective Compliance and Ethics Program requires

Woman Found Dead Inside Speedway Nursing Home Leads to Licensing Complaint

Healthcare Compliance Perspective: A licensed healthcare professional is responsible, not only

Cousins Committing $2.6 Million in Healthcare Fraud Get Suspended

Healthcare Compliance Perspective: An effective Compliance and Ethics Program requires a

Navigating Alternative payment models (APM) and the Data in 2018 for Home Care Agencies:

By ShirleyAnn Janulewicz RN, BSN, PHN Competing in today’s healthcare market

Wisconsin Nursing Homes Close as Costs Rise and Reimbursement Rates Can’t Keep Up

Healthcare Compliance Perspective: In situations of financial distress, it is important

Getting Compliance Right: Training and Auditing

Skilled nursing facilities (SNFs) receiving federal funds are obligated to

Elopement Assessment After Hospitalization

A resident was readmitted from the hospital, and staff did

Resident’s Death Raises Alarm About Security

Healthcare Compliance Perspective: It is essential to develop elopement risk prevention

Getting Compliance Right: Structure and Policies

Skilled nursing facilities (SNFs) receiving federal funds are obligated to

Physician Admits Guilt in Conspiring to Unlawfully Distribute and Dispense Controlled Substances and Health Care Fraud

Healthcare Compliance Perspective: It is essential that healthcare providers conduct background

Pathologist Testifies Nursing Home Staff Had Chance to Save Lives

Healthcare Compliance Perspective: It is essential to have clear policies and

Attorney General Sues Fentanyl Maker for Deceptive Promotion of Prescription Opioid

Healthcare Compliance Perspective: Prescription drug off-label marketing potentially injures many people

Home Health Care Provider to Pay $6.4 Million to Settle Allegations of False Medicaid Billing

Healthcare Compliance Perspective: Medicare Fraud and Abuse is serious problem that

U.S. Obtains $16.2 Million Judgment Against MRI Provider for Submitting False Claims

Healthcare Compliance Perspective: Medicare reimbursement requires medical services be performed in

Hospital Agrees to Pay $89,000 to Settle EEOC Religious Discrimination Suit

Healthcare Compliance Perspective: A Compliance Program assists a healthcare provider in

Doctor and Patient Recruiters Charged in $18 Million Illegal Distribution of Prescription Drugs Scheme

Healthcare Compliance Perspective: All offers of employment for any position within

Dealing with an EEOC Charge Relating to Sexual Harassment/Discrimination

If all attempts to settle a complaint of sexual harassment

Georgia State Authorities Dismantle Systematic Elder Abuse and Medicaid Fraud Scheme

Healthcare Compliance Perspective: Sometimes a fraud comes along that is just

Healthcare Provider to Pay $2.3 Million to Settle Potential HIPAA Violations

Healthcare Compliance Perspective: When a potential breach of Protected Health Information

Kmart Corporation to Pay U.S. $32.3 Million to Resolve False Claims Act Allegations

Kmart Corporation, a wholly owned subsidiary of Sears Holdings Corporation

California Healthcare Corporation Agrees to $325K Settlement in Disability Discrimination Class Action Suit

Healthcare Compliance Perspective: All employees in the workplace are responsible for

Medicaid Fraud Complaint Filed Against Former Physicians and Their Business Entities for Filing False Claims

Healthcare Compliance Perspective: Compliance Perspective: False claims and billing fraud may

Former Nursing Home Executives Plead Guilty in Kickback Scheme

Healthcare Compliance Perspective: It is essential that all current employees and

Nursing Home Resident Received a Wound Possibly from a Cigarette Burn

A resident has a wound that he claims is related

U.S. Sues Diagnostics Company for Allegedly Billing Medicare for Unnecessary Home Sleep Tests

Healthcare Compliance Perspective: Each employee and vendor of a healthcare provider

Virginia Doctor Sentenced to 30 Years for Oxycodone Distribution Conspiracy

Healthcare Compliance Perspective: Vendors must be screened prior to conducting business

Developing the Correct Procedure to Deal with Sexual Harassment Claims

Once a sexual discrimination or harassment claim has been made,

Arrests Made in Alleged Cover Up of Neglect and Abuse in Nursing Home

Healthcare Compliance Perspective: Intentional and/or reckless false documentation is a crime,

Three New York Diagnostic Testing Facility Owners Charged for Fraud Scheme

Healthcare Compliance Perspective: Physicians, employees, diagnostic testing facilities, and various other

Defining Sexual Harassment and Discrimination

Having a clear definition of what constitutes sexual harassment and

Imaging Companies and Owners Resolve Swapping and Medicare Fraud Allegations

Healthcare Compliance Perspective: The Anti-Kickback Statute makes it a crime to

Oncology Company Agrees to Pay $26 Million to Settle False Claims Act Allegations

Healthcare Compliance Perspective: Facilities should consistently audit various aspects of their

Med-Net News & Views 2017 (December Edition)

Connecticut Nursing Home Fined

Healthcare Compliance Perspective: Substandard quality of care arising from ineffective

Scenario: Medication Error

A resident with a history of pulmonary embolism did not

Medical Center Agrees to Settle ADA Claim with Individual Who Is Deaf

Healthcare Compliance Perspective: Residents/patients have the right to be fully informed

Investigation: The Third Stage of the CMS New Survey Process

The “Investigative Process” forms the third major component of the

Facility Evacuation Due to Area Fire Danger

Case Study: Emergency Preparedness A fire in the vicinity caused

Hospital Pharmacy Technician Suspended for Diversion of Medications and Compounding Medication Errors

Healthcare Compliance Perspective: Employees for healthcare companies shall adhere to a

Sample Selection: The Second Stage of the CMS’s New Survey Process

“Sample Selection” forms the second major component of the Centers

DPH Assesses Fines on Nursing Homes for Care Infractions

Healthcare Compliance Perspective: A pattern of submitting claims to Medicare or

EEOC Sues Foundation for Race and Age Discrimination

Healthcare Compliance Perspective: Healthcare providers must be committed to equal opportunity

Former Owner and Co-Conspirator of Sleep Study Clinics Charged With Estimated $200 Million in Health Care Fraud and Tax Evasion

Healthcare Compliance Perspective: Under federal law, directors, officers, and physicians who

Employee’s Claims of Sexual Harassment by Patients Is Not Severe Enough to Support Her Claim of a Hostile Working Environment

Compliance Perspective: Harassment occurs when the unwanted conduct is a condition

VA Nursing Assistant Sentenced for Making False Statements About Providing A Resident’s Care to Federal Agents
Minnesota Nursing Home Employee Stabbed at Work by Ex-Boyfriend

Have you seen . . .

North Carolina Nursing Home Being Sued by Family of Resident After COVID-19 Outbreak
April 23, 2020
U.S. Obtains $16.2 Million Judgment Against MRI Provider for Submitting False Claims
February 2, 2018
Former Connecticut Nursing Home Owner Sentenced to Federal Prison for Embezzlement and Tax Offenses
April 27, 2021
Massachusetts Nursing Home Nurse Charged with Drug Tampering
March 22, 2019
Woman Pleads Guilty to Stealing from Nursing Home Residents
December 4, 2017
Colorado Nursing Home Sued a Second Time Over Resident’s Alleged Assaults on Other Residents
June 28, 2019
Nursing Home Fined after Resident Left Outside 11 Hours Overnight
August 2, 2022
Nursing Home Visitor Sexually Assaulted Resident
January 9, 2019
Michigan Registered Nurse Pleads Guilty in COVID-19 Vaccination Record Card Fraud
June 22, 2022
ICAR Tool Updated
January 11, 2022

Med-Net Concepts Letter (November Edition)

North Carolina Nursing Home Being Sued by Family of Resident After COVID-19 Outbreak

U.S. Obtains $16.2 Million Judgment Against MRI Provider for Submitting False Claims

Former Connecticut Nursing Home Owner Sentenced to Federal Prison for Embezzlement and Tax Offenses

Massachusetts Nursing Home Nurse Charged with Drug Tampering

Woman Pleads Guilty to Stealing from Nursing Home Residents

Colorado Nursing Home Sued a Second Time Over Resident’s Alleged Assaults on Other Residents

Nursing Home Fined after Resident Left Outside 11 Hours Overnight

Nursing Home Visitor Sexually Assaulted Resident

Michigan Registered Nurse Pleads Guilty in COVID-19 Vaccination Record Card Fraud

ICAR Tool Updated

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