Revised Guidance for Long-Term Care Surveyors: Important Information Regarding Third-Party Guarantees of Payment

The Centers for Medicare & Medicaid Services (CMS) has issued Memo QSO-25-14-NH, “Revised Long-Term Care (LTC) Surveyor Guidance: Significant revisions to enhance the quality and oversight of the LTC survey process,” with an effective date of April 28, 2025. One key revision pertains to the admission, transfer, and discharge agreement. In the memo, CMS clarified guidance prohibiting admission agreements from containing language that requests or requires a third-party guarantee of payment, adding examples of non-compliance.…

Navigating UPIC Audits: Strategies for Successful Appeals

Our latest whitepaper provides essential insights on how Unified Program Integrity Contractors (UPICs) operate and the potential risks they pose to healthcare providers. In this whitepaper, you’ll learn: Don’t let a UPIC audit catch you off guard—download the whitepaper today and arm your client with the knowledge to navigate these complex audits. LW Consulting, Inc. (LWCI) offers a comprehensive range of services that can assist your organization in maintaining compliance, identifying trends, providing education and…

Navigating the Latest CMS Surveyor Guidance Updates: Mental Health Disorders

New Surveyor Guidance is in effect and indicates that mental health disorders in nursing home facilities need to be diagnosed by a medical practitioner. Evidence-based criteria and professional standards, such as the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), must be used and supported by documentation in the resident’s medical record. Diagnoses such as Schizophrenia and schizoaffective disorder require supporting documentation such as a DSM assessment, like all other mental…