https://www.cms.gov/files/document/qso-23-05-nh-adjusting-quality-measure-ratings-based-erroneous-schizophrenia-coding-and-posting.pdf

“OIG recommendations, which aim to prevent fraud and promote efficiency in federal programs, should be treated like rules, according to Alicia Cantinieri, managing director of clinical reimbursement and regulatory compliance at Zimmet Healthcare. She outlined features of a more airtight compliance program for nursing homes that meets CMS requirements while incorporating OIG guidance during a…

https://oig.hhs.gov/documents/evaluation/9808/OEI-02-20-00492.pdf

OIG message for Medical Directors – Engagement https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000921.asp  

https://acrobat.adobe.com/id/urn:aaid:sc:US:e8d20324-d5c0-4e8f-96ea-ea918a44669e

The Centers for Medicare & Medicaid Services (CMS) is taking steps to rescind the controversial federal staffing mandate for nursing homes.

On May 10, 2024, CMS published new regulations under §483.71, Facility Assessment, as part of the Medicare and Medicaid Programs; Minimum Staffing Standards for Long Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting final rule (89 FR 40876). These new provisions become effective 90 days after publication and must be implemented by August…

file:///E:/CMS%20Episodes/Resources/OEI-04-22-00550-highlights_OIG_CMS_Staffing%20Data%20Report.pdf

ʻNeed to Tell the Storyʼ: CMS Survey Changes and Coding Mistakes Drive Tighter Documentation, Dedicated Audit Role

OIG refers to the COSO framework as a reference point when evaluating an agency’s risk managment program. The framework provides a structured approach to deal with complex healthcare facility problems. https://www.coso.org/erm-framework