Amid alleged failures of skilled nursing facilities to meet care and discharge planning requirements, OIG identifies substantial payment errors.On February 27, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) issued a report on skilled nursing facilities (SNFs). The report, “Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements” (Report), focuses on evaluating compliance with requirements pertaining to quality of care, care planning, and discharge planning. The Report attempts to fiscally quantify alleged deficiencies for 190 Part A SNF stays exceeding 21 days in 2009, and it estimates payment errors of $5.1 billion.The context of the Report’s conclusion is a very limited survey of SNF stays. In 2009, there were 1,104,692 SNF stays exceeding 21 days in the United States and 15,884 Medicare, Medicaid, or dually certified nursing facilities in operation. For purposes of the Report, OIG reviewed a stratified simple random sample of 190 Part A SNF stays exceeding 21 days from calendar year 2009. The records reviewed included the care plans, post-discharge plans, Minimum Data Sets (MDSs), Resident Assessment Protocols (RAPs), progress notes, therapy records, and other documentation of services provided.Whether these limited records justify the extrapolated… Read full this story
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