Long Term Care

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HEADS UP! Check the Fed Reg!

  • 1.  HEADS UP! Check the Fed Reg!

    Posted 07-18-2019 07:14 AM
    For those who I taught how to check the Fed Reg and you work for a LTC...today is a good time to check the Fed Reg...if you are not doing so daily.  There are some proposed rules that are directly related to compliance programs.

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    ► Week 4 of the 66ers...Sessions Coming Up! ◄
    --------Frank Ruelas---------
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    HCCA Membership


  • 2.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-18-2019 11:06 AM

    Frank:

     

    Thank you for the reminder.  There is a lot going on with the proposed changes.  It is interesting what they chose to remove and how they calculated to costs/savings related to those changes.

     

    Joseph Zielinski, JD, CHC, CHRC

    Corporate Compliance Program Director

     

    4logos-01

     

    3838 North Rural Street

    Indianapolis, IN 46205

     

    720 Eskenazi Ave

    Fifth Third Bank Building, Fifth Floor

    Indianapolis, IN 46202

     

    P: 317-221-2478

    C: 317-766-1838

    E: Joseph.Zielinski@eskenazihealth.edu

     

    Hotline-Logo-Transparent

    P: 1-855-895-8555

    O: www.hhc.ethicspoint.com

     

    "To achieve mutual understanding you must understand what information your colleagues need from you to perform their function, and they must understand what you need from them." Peter Drucker

     


    This E-mail transmission may contain confidential or legally privileged information that is intended only for the individual or entity named in the E-mail address. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or reliance upon the contents of this E-mail is strictly prohibited. If you have received this E-mail transmission in error, please reply to the sender so arrangements can be made for proper delivery, and then delete the message from your system.



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  • 3.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-19-2019 04:51 AM
    Thanks Frank

    I've read the proposed changes surrounding a compliance and ethics program and find them to be both interesting and confusing at the same time!

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    Dr. Yolunda Dockett, OTD, MOTR/L, RAC-CT, CHC, CHPC
    Corporate Compliance Officer
    Lorien Health Services
    Ellicott City, MD
    ydockett@lorienhealth.com
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    HCCA Membership


  • 4.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-19-2019 06:55 AM
    Yolunda...Wonderful to hear from you...nice meeting you at the CI. You raise a few points that I think are worth sharing on a new thread...stand by.

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    ► Week 4 of the 66ers...Sessions Coming Up! ◄
    --------Frank Ruelas---------
    ------------------------------

    HCCA Membership


  • 5.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-19-2019 07:52 AM
    ​Thank You.  I'm on it.

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    Jeff Johnson
    Compliance Director
    Ascension Health
    St. Louis, MO
    jeff.johnson1@ascension.org
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    HCCA Membership


  • 6.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-19-2019 09:46 PM
    Joseph - you are absolutely right.  I have worked hard for the last 6 years promoting that LTC needs compliance and all its resources.  I'm hoping they will reconsider some of the proposed changes and the value of compliance in the LTC sector will not become a minor player.

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    Barbara Naimark
    Compliance Official
    Collington
    Severna Park,MD
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    HCCA Membership


  • 7.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-22-2019 07:16 AM
    Edited by Bethanne VanderMolen 07-22-2019 07:18 AM
    Does the HCCA (or will the HCCA) involve themselves in the open discussion period? Since this is a proposed rule, their commentary may be influential. In addition, I wonder if HCCA is working directly with AHCA. 

    I was discussing this with another CO last week (Yolunda!) and we went line by line through the Federal Register. There are a couple of things that operationally will help SNF's. Resources are scare and reducing that burden in specific areas will be useful. For example, changing review of the compliance plan to every 2 years versus one. This is probably pretty reasonable and lightens the operational burden. However, there a couple of proposed changes that are awkward at best in their wording and they leave an unsettling impression that you have pointed out. If operations 'interprets' this guidance as a means to reduce costs via reducing the compliance department I think they will quickly find themselves out of sync with the intentions of the OIG. And with the source document being referenced in the federal register, it's hard to argue that those rules don't apply. But interestingly, the proposed rules would put the survey process out of alignment with those same guidelines.

    One of my thoughts was that this proposed change was in small part due to CMS having difficulty creating a functional survey pathway for state surveyors. Our state surveyors have been honest throughout the phased implementation (as this compliance part was coming) that they were not appropriately trained and had concerns over how they would survey this regulation. They have been awaiting CMS guidance for this piece for quite some time. 

    I do hope that HCCA has SNF compliance officers working with AHCA. Each setting is unique and SNF always presents some interesting challenges. I had seen this phase 3 implementation as a beginning to cement the importance of compliance in the SNF. I would hate to lose that opportunity.

    Just some thoughts.


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    Bethanne VanderMolen
    Chief Compliance Officer/Director of Risk Management
    Choice Health Management Services, LLC
    HICKORY,NC
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    HCCA Membership


  • 8.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-22-2019 07:23 AM
    A good question that comes up periodically when regulatory changes (proposed or final) like this are published.

    HCCA's position is to provide information or a forum for the free exchange of ideas/comments/opinions.  It does not get involved in submitting responses or replies to these changes such as during comment periods.

    Now...is it possible that the HCCA/SCCE might get involved if something came up that its leadership felt was of such a nature that it might take on a different position...well...I think that possibility certainly does exist.  However, as seen in the past, this has not occurred...yet.

    ------------------------------
    ► Week 4 of the 66ers...Sessions Coming Up! ◄
    --------Frank Ruelas---------
    ------------------------------

    HCCA Membership


  • 9.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-22-2019 08:15 AM

    I would think HCCA should provide comment.  This is an issue that could drastically affect some its members.  There is a need for a unified and loud voice on this topic in my opinion.

     

    Joseph Zielinski, JD, CHC, CHRC

    Corporate Compliance Program Director

     

    4logos-01

     

    3838 North Rural Street

    Indianapolis, IN 46205

     

    720 Eskenazi Ave

    Fifth Third Bank Building, Fifth Floor

    Indianapolis, IN 46202

     

    P: 317-221-2478

    C: 317-766-1838

    E: Joseph.Zielinski@eskenazihealth.edu

     

    Hotline-Logo-Transparent

    P: 1-855-895-8555

    O: www.hhc.ethicspoint.com

     

    "To achieve mutual understanding you must understand what information your colleagues need from you to perform their function, and they must understand what you need from them." Peter Drucker

     


    This E-mail transmission may contain confidential or legally privileged information that is intended only for the individual or entity named in the E-mail address. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or reliance upon the contents of this E-mail is strictly prohibited. If you have received this E-mail transmission in error, please reply to the sender so arrangements can be made for proper delivery, and then delete the message from your system.



    HCCA Membership


  • 10.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-22-2019 08:16 AM
    Indeed...this is the same position that others have offered as well.  One thing is certain...HCCAnet/SCCEnet provides a forum where folks can come together and perhaps join forces in providing some type of response.

    ------------------------------
    ► Week 4 of the 66ers...Sessions Coming Up! ◄
    --------Frank Ruelas---------
    ------------------------------

    HCCA Membership


  • 11.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-22-2019 07:24 AM
    By the way...connecting with Yolunda...it doesn't get much better than that!

    ------------------------------
    ► Week 4 of the 66ers...Sessions Coming Up! ◄
    --------Frank Ruelas---------
    ------------------------------

    HCCA Membership


  • 12.  RE: HEADS UP! Check the Fed Reg!

    Posted 07-23-2019 08:41 AM
    Beth Anne

    I appreciate your summary below. Providers must keep in mind that very rarely does the LTC SOM reference a source document, which they have in this proposed rule (73 FR 56832). I personally believe that doing this, has given state surveyors a very "general" basis to apply an F895 tag (C&E program) on practically every identified deficiency. If we consider the referenced " OIG Supplemental Compliance Program Guidance For Nursing Facilities" and its comprehensive list of identified risk areas, F895 tags are subsequent to tags related to abuse and neglect, elopement, and the development of a comprehensive care plan. 

    The requirements for operating organizations with 5 or more facilities still requires a compliance officer and interestingly enough, entities with multi-unit nursing homes and corporate level management now have a requirement for a "more formal program". What ever that is?!?! :-) 


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    ~Opinions expressed are solely my own and do not express the views or opinions of my employer.

    Dr. Yolunda Dockett, OTD, MOTR/L, RAC-CT, CHC, CHPC
    Corporate Compliance Officer
    Lorien Health Services
    Ellicott City, MD
    ydockett@lorienhealth.com
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    HCCA Membership