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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
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
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
QAPI Program Requirements
Jeannine LeCompte, Publishing and Research Coordinator A Quality Assurance and Performance
QAPI vs Compliance and Ethics: What’s the Difference?
Jeannine LeCompte, Publishing and Research Coordinator All long-term care facilities (LTCs)
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
The Purpose of a Compliance and Ethics Program
Jeannine LeCompte, Compliance Research Specialist The Office of the Inspector General
Employee Verification: Part of the Mandated Compliance and Ethics Requirement
Jeannine LeCompte, Compliance Research Specialist Employee verification in the long-term care
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
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
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
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
Avoiding and Disclosing Possible Conflicts of Interest
Avoiding and Disclosing Possible Conflicts of Interest Jeannine LeCompte; Compliance Research Specialist A
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
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
Nursing Home Visitor Sexually Assaulted Resident
QAPI Perspective Skilled nursing facilities are entrusted with maintaining resident
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
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
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
Lawsuit Filed Against Nursing Home Where Elderly Resident Died After Being Attacked by Another Resident
Healthcare Compliance Alert - Elderly Resident: The Compliance Officer should review
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
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
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
Hidden Camera in A Nursing Home Captures Staff Berating Resident on the Floor after Fall
Healthcare Compliance Perspective - Hidden Cameras : The Compliance Officer should
Nursing Home Miscalculated Resident’s Fall Risk, Possibly Contributing to Her Death
Healthcare Compliance Perspective - Fall Risk: CMS regulation F689 Accidents requires
Neglect of Elder Abuse Cases ‘Deep and Pervasive’ in the State of Minnesota
Healthcare Compliance Perspective - Elder Abuse Cases: While states provide broad
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,
How to Detect Drug Diversion in a Facility
All long-term care facilities are obligated to implement the new
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
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
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
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
Colorado Nursing Home Deaths Lead to 5 Homicide Charges
Healthcare Compliance Perspective: The Residents' Bill of Rights ensures that every
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
Training Staff to Avoid Sexual Harassment Incidents
The best way an institution can avoid damaging sexual discrimination
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
Resident Died and No Defibrillator (AED) Was Used
A resident notified a nurse that she would like to
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,
Pennsylvania DOH Fines Nursing Home Nearly $800,000
Healthcare Compliance Perspective: When compliance violations are originally detected, it is
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
Connecticut Nursing Home Fined
Healthcare Compliance Perspective: Substandard quality of care arising from ineffective
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
Nurse Charged in Resident’s Death for Medication Errors
Healthcare Compliance Perspective: Each resident's drug regimen must be free from
Home Healthcare Company Settles EEOC Disability Discrimination Suit for $25,000
Healthcare Compliance Perspective: Healthcare providers, under the Americans with Disabilities Act,
Initial Pool: The First Stage of the CMS’s New Survey Process
The “Initial Pool Process” (IPP) forms the first major component
CNA Accused of Credit Card Theft Has License Placed Under Emergency Restriction
Healthcare Compliance Perspective: Healthcare providers must ensure that employed individuals have
Sensitive Medical Records Carelessly Dumped in Public Recycling Bin
Healthcare Compliance Perspective: Healthcare providers must ensure that any documentation containing
Nursing Home Resident Dies After Van Accident
Healthcare Compliance Perspective: Employees can only perform at the level of
The New Survey Process: What is it, and Why?
November 28, 2017 was the Centers for Medicare & Medicaid
Social Media and HIPAA Violations: A Risk for Healthcare Providers
Social Media and HIPAA The time when social media involved only
Woman Pleads Guilty to Stealing from Nursing Home Residents
Charged with 20 criminal counts of "theft and receiving stolen
Operator of Purported Durable Medical Equipment Providers Pleads Guilty
Healthcare Compliance Perspective: Compliance Officers must focus on ensuring that products
Lawsuit Accuses Senior Living Facility of Elder Abuse and Negligence
Healthcare Compliance Perspective: Healthcare Providers can work in partnership with local
Creating the “Systematic Analysis and Systemic Action” Element of a QAPI
The “Systematic Analysis and Systemic Action” element of the Centers
Doctor Pleads Guilty to Billing Health Care Programs with No Medical License or Office
Healthcare Compliance Perspective: It is the obligation of the employee to
Nursing Home Companies Settle Allegations of Poor Care
Healthcare Compliance Perspective: Knowingly submitting claims for services provided that are
Setting up the “Performance Improvement Project” Element of a QAPI
The “Performance Improvement Project” (PIP) element of the Centers for
Federal Agents Investigating Exposure of Patient Data
Healthcare Compliance Perspective: If a breach of protected
Hospital and Heart Specialists’ Practice Settle Lawsuit for $20.7 Million
Healthcare Compliance Perspective: Compliance Officers must emphasize with management to refrain
Feedback, Data Systems, and Monitoring: The Third Element of QAPI
The “Feedback, Data Systems, and Monitoring” element of the Centers
San Diego Pharmacy to Pay $60,000 to Settle Equal Pay Discrimination Suit
Healthcare Compliance Perspective: Healthcare providers are prohibited from basing pay rates,
Bed Rails Cited as Cause in Nursing Home Death
Healthcare Compliance Perspective: The inappropriate use of restraints constitutes substandard quality
Physician Sentenced to Prison for Fraudulent Prescriptions
Healthcare Compliance Perspective: Civil penalties for violating the Federal False Claims
Nurse Sentenced to 2 Years in Prison for Misappropriating Residents’ Pain Pills
Healthcare Compliance Perspective: Quality Assurance and Performance Improvement studies can be
Preparing the “Governance and Leadership” Element of QAPI
The “Governance and Leadership” element of the Centers for Medicare
Nursing and Rehabilitation Center Fined for Financial Abuse of Resident
Healthcare Compliance Perspective: Compliance Officers need to monitor their staff for
Bomb Threat Causes Evacuation of Assisted Living and Rehab Facility
Healthcare Compliance Perspective: It is required by law for all healthcare
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
Preparing the “Design and Scope” Element of QAPI
The “Design and Scope” element of the Centers for Medicare
Class Action Suits Still a Gray Area in the Nursing Home Environment
By: David Barmak, Esq. Three recent class action suits involving long-term-care
QAPI: Engaging the Interdisciplinary Team Around Quality
By: Marianna Kern Grachek, MSN, RN, NHA, FACHCA, CDONA, FACDONNA
QAPI Deadline Approaching: Is Your Facility Ready?
All long-term-care (LTC) facilities must, by law, have a “Quality
SNF Emergency Preparedness: A Communication Plan
A critical element of the legally-required emergency preparedness procedures at
Caretaker to plead guilty after elderly patient dies from bed bug bites
Healthcare Compliance Alert: Compliance and Ethics Committees must verify that exterminators
Prescription Painkillers from Adult Care Homes Are Being Diverted to the Black Market
Healthcare Compliance Perspective: Compliance Officers must ensure that their provider is
Robbers Steal Medications from Iowa Nursing Home at Gunpoint
Healthcare Compliance Perspectives: Compliance and Ethics Committees must ensure facility access
Former Nurse Convicted of Stealing Patient Information, Files over $1M in Fraudulent Claims with IRS
Healthcare Compliance Perspective: Compliance and Ethics Committees must be cognizant of
Former President of Harris County Medical Society and Affiliated Facilities Settle Allegations of Medicare Fraud
Healthcare Compliance Perspective: If sidestepping standard medical procedures to boost profits
Former Nursing Home Biller Charged With Medicaid Fraud
Healthcare Compliance Perspective: An effective Compliance and Ethics Program
SNF Emergency Preparedness: Emergency Power Supplies
While it might seem obvious that all skilled or long-term
Pharmacy Chain Agrees to Pay Almost $2.7M to Settle Claims It Recycled Drugs
Healthcare Compliance Perspective: Skilled nursing facilities and long-term care pharmacies must
Pleas in Freezing Death of Alzheimer’s Patient
Healthcare Compliance Perspective: Failure to provide adequate supervision and response to
Modifications to the Quality of Patient Care Star Rating Algorithm for Home Health Agencies
By ShirleyAnn Janulewicz RN, BSN, PHN Patient Care Star Rating is an important tool
Succeeding with the New Home Health Agency CoP’s
By ShirleyAnn Janulewicz RN, BSN, PHN As per a webinar I
SNF Emergency Preparedness: Training and Testing
Once a skilled or long-term nursing facility has an Emergency
Attorney General Announces Jail Time for Home Health Care Agency Owner Convicted of Wage Theft
Healthcare Compliance Perspective: Violation of wage and hour laws potentially create
Hurricanes and Other Disasters: Is Your Facility Really Compliant?
By: Jeannine LeCompte, Compliance Research Specialist, Med-Net Compliance, LLC The destruction
Skilled Nursing Facility Disaster Preparedness – Survive Financially and Physically
At least 25 percent of all businesses that close due
Attorney General Announces Jail Time for Home Health Care Agency Owner Convicted of Wage Theft
Healthcare Compliance Perspective: Compliance Officers must ensure that Human Resources and
Massachusetts Nursing Home Required to Pay $350,000 in Elopement Case
In a settlement one-week prior to trial, a nursing home
SNF Emergency Preparedness: “All-Hazards” Planning Requirements
On November 15, 2017, the Emergency Preparedness Requirements for Medicare
Nine Arrested for Abusing an Elderly Patient in Connecticut Psychiatric Hospital
Healthcare Compliance Perspective: Patient Abuse violates Medicare Conditions of Participation which,
Resident Injured when Care Plan Not Followed
A resident reported pain in her shoulder. Bruising was present,
78 Year-Old-Woman Missing Since August 24 from Bethlehem Nursing Home Found September 19 in Allentown
Last August, a woman with Alzheimer’s disease was reported missing
Nursing Home Resident Died After Improper Feeding through Gastric Tube
Healthcare Compliance Perspective: Failure to observe a resident's plan of care
E-Mail Breached the Personal Health Information of Over 26,000 Patients in Arkansas Medical Facility
Healthcare Compliance Perspective: False claims may result when a healthcare provider
NY Husband Admitted Attacking Wife with Hammer While Visiting at Nursing Home
Healthcare Compliance Perspective: Skilled nursing facilities are required to provide adequate
Two Shootings in Two Hospitals Emphasize Emergency Preparedness Need
By: Louise Lindsey, B.S., M.A., D.Div. Editor Last week, there were
State Imposes Admissions Freeze After Inspections Find Problems at Massachusetts Nursing Home
Compliance Perspective: It is the Compliance Officer's responsibility when a
86-Year-Old Man with Dementia in Massachusetts Nursing Home Allegedly Killed by Roommate
Healthcare Compliance Perspective: Prompt response and corrective action is required when
Three Former Hospice Nurses Charged in 5-year-old Felony Drug Diversion Case
Healthcare Compliance Perspective: Deliberately dispensing an incorrect medication, strength, or dosage
Nursing Home Workers Often Fail to Change Medical Gloves
The September 2017, issue of the American Journal of Infection
Lawsuit against Nursing Home by Families and Residents Alleging Powerful Drugs Prescribed without Consent Is Settled
Compliance Perspective: Deliberately ignoring or failing to obtain a resident's or
Oklahoma Doctor Agrees to Pay $580,000 to Settle Allegations of Submitting False Claims to Medicare
Healthcare Compliance Perspective: The Compliance Officer is responsible for developing and
Chicago Family Suing Nursing Home for Alleged Failure to Resuscitate
Compliance Perspective: Failure to follow advance directives can result in significant
Oceans and Borders Do Not Constrain Greed and Healthcare Fraud
“Man’s inhumanity to man” has no boundaries as evidenced by
Despite Federal Law, Nursing Homes Failing to Report Abuse
Compliance Perspective: The compliance officer shall commence an investigation as soon
Nursing Home Social Worker Sentenced in Medicaid Fraud, Financial Exploitation of Patients
Compliance Perspective: Audits must be performed to ensure that nursing home
Hospital Calls Man, 70, Leaping to His Death from Eighth Floor of Fresno Hospital an “Unfortunate Accident”
Last week, a 70-year-old man was able to break a
Home Health Agency Owner Receives Lengthy Sentence for Conspiring to Defraud Medicare & Medicaid Fraud of $17 million
Healthcare Compliance Perspective: Kickbacks paid to referral sources and/or Medicare beneficiaries
Nursing Home Finds More Water Tainted with Legionella Bacteria
Healthcare Compliance Perspective: Providing patients with services that do not meet
Healthcare Worker Steals Over $70,000 from Elderly Woman
Healthcare Compliance Perspective: A Compliance Officer must ensure that families understand
New Owners Say Facility’s Downgraded Rating Is Due to Residents Now Getting Better Care—True? or False?
The new CEO and vice president of the company that
Massachusetts Parties Reach Settlement in Wrongful Termination/Retaliation Suit Against Nursing Home
A woman who worked as a CNA, accused her employer,
Fentanyl Poses a Responder Safety Concern for Healthcare Providers
Healthcare Compliance Perspective: Compliance Officer needs to audit their provider's policy/procedure
Palm Harbor Oncologist Sentenced to Nearly Six Years for Treating Patients with Unapproved Cancer Drugs
Healthcare Compliance Perspective: A culture of compliance and ethics requires manager/owner's
New Jersey Gov. Signs ‘Peggy’s Law’ Protecting Seniors in Nursing Homes and Assisted Living Facilities from Abuse
Healthcare Compliance Perspective: This new statute applies to New Jersey only;
Operators of Bogus Medical Clinics Charged in Conspiracy to Divert Massive Amounts of Prescription Narcotics to the Black Market
Healthcare Compliance Perspective: License, exclusion, credentialing checks are essential to detect
CA nursing home fined $100,000 fine for resident’s death and false documentation
Healthcare Compliance Perspective: Worthless services coupled with intentionally falsified documentation lead
Atlanta Pain Clinic and its owner agree to pay $250,000 to resolve allegations that they violated the False Claims Act
Healthcare Compliance Perspective: Excluded providers shall not participate in federally funded
Texas Couple Who Stole/Unlawfully Obtained Patient Identification Information Sentenced to Federal Prison Terms
Healthcare Compliance Perspective: Auditors must not only look at pink and
Former Caregivers at Michigan Vets Home Charged for Not Doing Room Checks, Falsifying Information
Healthcare Compliance Perspective: False documentation creates harm on multiple levels -
Nursing home settles with deceased estate for $270,000 in wrongful death suit
A 70-year-old woman, who had been a family physician, was
Ransomware Attack Affects 300,000 Patients of Women’s Clinic
Healthcare Compliance Perspective: If Compliance Officers are faced with an actual
Woman sentenced in Medicaid fraud case related to a minor’s death
Healthcare Compliance Perspective: Healthcare fraud may at times pale by comparison
Becoming a Special Focus Facility is not a Cause for Celebration!
Becoming a Special Focus Facility is not a Cause for
Number of nursing home fines in Pennsylvania jump since 2014, total $774,750 so far this year
Healthcare Compliance Perspective: The Office of Inspector General developed new approaches
Oklahoma nursing home resident found dead in creek
Healthcare Compliance Perspective: Any nursing facility can decrease their risk of
Becoming a Special Focus Facility is not a Cause for Celebration!
By: Betty Frandsen, MHA, RN, NHA, CDONA, FACDONA, C-NE, IP-BC
California issues most severe penalty possible to Bakersfield skilled-nursing facility
Healthcare Compliance Perspective: An effective Compliance and Ethics Program to a
State and Federal Attorneys Announce $4.4 Million Settlement with NY Visiting Nurse Service and Managed Long-Term Care Plan
Healthcare Compliance Perspective: Overpayments, received for whatever reason, must not only
Assisted Living Facility Owners Sentenced to Federal Prison for Receipt of Health Care Kickbacks
Healthcare Compliance Perspective: The most challenging compliance exposure to root out
Florissant nursing home patient with Alzheimer’s dies after being left in tub for 8 hours, lawsuit claims
Healthcare Compliance Perspective: Professional liability exists regardless of the challenges involved
Doctor pleads guilty in $1.5M toenail clipping fraud scheme
Healthcare Compliance Perspective: Compliance Officers must ensure that the services billed
Brooklyn Pharmacy Owner/Operator Charged With Defrauding Medicare and Medicaid Programs of Approximately $9 Million
The defendant is accused of submitting approximately $9 million
Oklahoma City Mother and Son Sentenced to Prison for $770,000 Fraud against Medicaid
Healthcare Compliance Perspective: The recurring theme of fraud as a slippery
Preventing Ransomware Attacks: IT Education in the Healthcare Industry
By: Betty Frandsen, MHA, RN, NHA, CDONA, FACDONA, C-NE, IP-BC and Jeannine
Woman Pleads Guilty in Nursing Home Identity Theft Case
Healthcare Compliance Perspective: Healthcare providers must continuously remind themselves of the
Massachusetts Nursing Home Settles Complaint of Negligence for $700,000
A 59-year-old woman underwent a total right hip replacement, and
Newbury Park nursing home pays in class-action settlement
A highly-rated Catholic nursing home in Newbury Park has agreed
Hospice to pay $2.4 Million to resolve False Claims Act Allegations
Healthcare Compliance Perspective: The Federal Anti-Kickback Statute 42 U.S.C. § 1320a-7(b)
Unsafe Wandering Scenario
By: Linda Winston An 83-year-old resident, identified as an elopement risk
Financial Motives Triggering Many Wrongful Eviction Complaints against Nursing Homes
By: Betty Frandsen, MHA, RN, NHA, CDONA, FACDONA, C-NE, IP-BC
Nursing Home Responsible for Resident’s Choking Death
A 57-year-old male resident at a Chicago Hispanic nursing home
Preventing Abuse and Fraud with Antibiotic Stewardship Programs
Preventing Abuse and Fraud with Antibiotic Stewardship Programs By: Betty Frandsen, MHA,
Jury awards $5 million to family for facility’s negligence in woman with dementia’s care
An elderly, 90-year-old woman, with dementia and suffering from severe
Meeting the Psychosocial Needs of the Home Health Patient
By ShirleyAnn Janulewicz RN, BSN, PHN As a home health nurse,
Tips on Maintaining Personal Safety when Working in Home Health
By: ShirleyAnn Janulewicz RN, BSN, PHN When working in home health,
Ice Cubes Show Detail Required for Legal Compliance
By: Jeannine LeCompte An injury caused by a dropped ice cube
New Jersey Expands Hidden Camera Monitoring of Healthcare Providers
By: Jo Ann Halberstadter, Esq. and Jeannine LeCompte New Jersey's existing "Safe Cam"
Nursing Home Staff Are Being Held Liable for Abuse and Neglect of Residents
By: David Barmak, Esq. A recent news headline in Grand Rapids,
Training Program Reduces Catheter-Related UTIs by 54%
By: Betty Frandsen and Jeannine LeCompte A newly-developed nursing staff training program
Why I Choose Home Health as a Specialty?
By ShirleyAnn Janulewicz RN, BSN, PHN Becoming a home health nurse
Case Study: Employee Misconduct – Exploitation
A resident who was hospitalized told her daughter she wanted
HHS Memo on Staff Communication with Congress “Illegal”
A Department of Health and Human Services (HSS) memo instructing
HIPAA Violation: Employee Fired Over Social Media Post
A dramatic reminder has come with the news that a
CMS Emergency Preparedness Rule Implementation Deadline Is Fast Approaching
CMS Emergency Preparedness Rule Implementation Deadline Is Fast Approaching By: Louise
WHISTLEBLOWERS: Key to Supporting a Culture of Compliance under the False Claims Act (FCA)
By: David S. Barmak, Esq. The Department of Justice (DOJ) announced
Marijuana in the Skilled Nursing Facility Environment
By: David S. Barmak, JD, CEO More states in the United
Wound Care Is a Serious Concern for Skilled Nursing Facilities
By: Louise Lindsey, B.S., M.A., D.Div. According to the Centers for
HHS OIG Hotline Telephone Number Used in Scam
The U.S. Department of Health and Human Services (HHS) Office
Improper Disposal of Private Health Information (PHI)
By: Louise Lindsey, B.S., M.A., D.Div. A recent article in the
Case Study: Bullying – It Can Happen Anywhere
Bullying does not just exist out in the world, but
Case Study: Resident Smoking
Resident smoking is a high-risk area. When staff are required
Healthcare Industry Suffers 62% Increase in Data Breaches
The healthcare industry has suffered a 62 percent increase in
Nursing Home Intrusion: Not On Your Watch?
Nursing Home Intrusion: Not On Your Watch? By: David S. Barmak,
Healthcare Fraud: A Safe and Profitable Return on Criminal Investment
Healthcare Fraud: A Safe and Profitable Return on Criminal Investment By:
False Imprisonment: A Legal Cause of Action
False Imprisonment: A Legal Cause of Action By: Betty Frandsen, MHA, RN,
Negligence in Long Term Care: Avoiding Potential Liability
Negligence in Long Term Care: Avoiding Potential Liability By: Betty Frandsen, MHA,
