The Danger of Ignoring Exclusions

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Did you know that employing someone currently excluded from federal health care programs can land your organization in serious trouble? A recent real-world case revealed that a Licensed Practical Nurse (LPN)—who was barred from participating in Medicare and Medicaid—was still employed and billed services to those programs. The consequence? The facility faced a staggering $243,000 settlement to resolve allegations stemming from this violation. This example underscores how critical it is to diligently screen all employees…

Understanding the CMS Signature Compliance for SNFs

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Signature compliance isn’t just about meeting a technical requirement. For Skilled Nursing Facilities (SNFs), it plays a direct role in ensuring Medicare reimbursement, defending claims during audits, and supporting timely, appropriate patient care. Facilities need to pay close attention to the Centers for Medicare & Medicaid Services (CMS) signature requirements. What CMS Requires: Timely, Accurate, and Verifiable Signatures CMS has long required that signatures on medical records be complete, legible, and timely. In most cases,…

Understanding Top Documentation Challenges for Therapy Providers with Outcomes Analysis

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In the ever-evolving world of Outpatient Therapy (OPT), understanding compliance trends is crucial for identifying risk and improving documentation quality and patient care. That’s where data becomes incredibly powerful. To showcase how data-driven insights can support Therapy Providers, LW Consulting, Inc. (LWCI) conducted an in-depth analysis of over 7,500 OPT documentation audits performed over the past five years using ChartVerify®—a powerful documentation auditing tool designed to track, analyze, and identify trends. What We Found By…