Ohio nursing homes get a check-up
Healthcare Auditing Weekly, June 1, 2004
Although Ohio is able to identify the skilled nursing facilities (SNFs) that warrant payment denials there, the state lacks the controls to prevent payments from actually reaching those facilities, according to an OIG audit report released May 20. The report evaluated Ohio's controls for denial of payment remedies for substandard care.
To reach its determination, the OIG audit team took the following measures:
- Obtained a list of all SNFs identified as providers of substandard care
- Reviewed annual surveys for all facilities on the list for the current audit period, and for the two years prior to find any facilities not properly denied payment or not in compliance three months after the final survey day
- Reconciled the state's list of sanctioned SNFs with CMS' long term care denial of payment remedies
- Used paid claims to compile a list of those sanctioned SNFs that received Medicaid payments during the audit period
The OIG may have investigated the state-but the SNFs accepting payments under sanction will certainly not do so for long. Don't let this compliance issue land your nursing home in hot water.
Click here to read the audit report called "Audit of Nursing Homes and Denial of Payment Remedies - State of Ohio."
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