Kelly Simonelli

The Basics: 7 Elements of a Compliance Program: Part 2

With the General Compliance Program Guidance updates released in November 2023, we wanted to take the 7 elements of a compliance program and break it down. What are the 7 elements? Why are they important and how can these elements be implemented? Recap elements 1-4 on Part 1 & elements 5-7 will be reviewed below. 5. Enforcing Standards: Consequences and Incentives Part of a compliance program includes creating and applying uniform disciplinary actions for non-compliance…

What Can You Do if You Are Targeted as a Special Focused Facility?

It is challenging being a Skilled Nursing Facility (SNF) in 2024! Not that it has ever been easy, but there are so many regulations, and the increased challenges of staffing and infection control since COVID and the PHE have really raised the bar. The Centers for Medicare & Medicaid Services (CMS) monitors quality issues and has devised a terminology for those facilities deemed high risk with a history of serious quality issues. These facilities are…

The Schizophrenia Diagnosis in a Skilled Nursing Facility

There is so much going on in the Long Term Care (LTC) market in 2024 related to Centers for Medicare and Medicaid (CMS) initiatives it is easy to overlook one or think that it is complete.  This might be the case with the CMS roll out of audits to monitor accurate coding and documentation of the diagnosis of schizophrenia. CMS initiated these audits, announced on January 18, 2023, in QSO-23-05-NH, in an attempt to identify…