Healthcare Compliance perspective:
An ineffective Compliance and Ethics Program can have severe consequences including loss of Medicare and Medicaid certification.
Failing to comply with Medicare and Medicaid guidelines over an extended period has resulted in a Salisbury, NC nursing home’s loss of reimbursement for services starting September 11. This is based on information in a public notice from the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS).
Involuntary termination by the CMS is like a death knoll to a nursing home, and for this nursing home it means that they will not be paid for any healthcare services they provide that has previously been reimbursed by the CMS. Specifically it applies to residents who the nursing home admits after September 11, 2017. Those residents will be covered for only a 30-day period which will end on October 11, 2017.
The CMS reports the reason for this reimbursement cancellation is due to the large number of deficiencies that the nursing home received during the time between July 2016 and June 2017. During that year, they were cited by surveyors 28 times. It is notable that that is about 5.4 times the average number of healthcare compliance deficiencies throughout the entire state of North Carolina.
The healthcare compliance deficiencies covered a broad range of offenses. They involved mistreatment (1), quality of care (7), physical assessments (2), resident rights (5), pharmacy services (2), environmental issues (4), and administration (7). Most of the compliance deficiencies did not involve major harm to the residents and were rated at 2 on the scale of 1 to 4 that is used to determine the severity of the deficiency. All of the deficiencies were rectified by June 18 according to the CMS report.
The nursing home has been given a one-star rating on its overall healthcare provision by the CMS star rating system where the goal is 5-stars. It received a three-star rating regarding the quality of their patient care. The center is a for-profit organization with 185 certified beds and currently 125 residents.
