Tag: OIG

OIG report suggests CERT data could identify ‘high-risk’ home health agencies

A report from the Department of Health & Human Services (HHS) Office of Inspector General (OIG) recommends using Comprehensive Error Rate Testing Data (CERT) to identify “high-risk” home health agencies to help reduce improper payments and agency error rates. CMS didn’t agree with the recommendation, however. Instead CMS points to CMS’ fraud prevention system, targeted […]

Background checks for long-term workers needs more attention from states

Several states are running behind on implementation of a national background check program covering home health agencies and hospice providers, among others. Only two out of 11 states that concluded their participation in the program in 2017 and 2018 implemented all the requirements, according to a report from the Office of Inspector General (OIG). The report contends the […]

OIG recommends changes for home health, hospice, personal care services to reduce fraud

In a July report, the Department of Health and Human Services Office of Inspector General (OIG) revisited its top 25 unimplemented recommendations for reducing fraud, waste and abuse. Several of the recommendations involve home health, hospice or personal care services. The OIG recommends the implementation of a statutory mandate requiring surety bonds for home health […]

OIG reports address deficiencies, abuse in hospice care

Two reports were released last week by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) demonstrating the results of in-depth studies of Medicare hospice recertification and complaint survey data from state agencies and accredited organizations between 2012 and 2016. The reports examine issues of deficiencies and abuse in hospice care. […]

OIG report looks at abuse and neglect of Medicare beneficiaries

The Department of Health and Human Services Office of Inspector General issued two new reports that address the identification, reporting and investigation of incidents of potential abuse and neglect of our nation’s most vulnerable populations, including seniors and individuals with developmental disabilities. OIG issued an early alert in 2017 based on the preliminary findings of […]

New OIG report once again hammers hospice industry about general inpatient care

Brought to you by Home Health Line. A new report from the HHS Office of Inspector General (OIG) contends that while hospice care can provide great comfort to patients and their loved ones, the industry has vulnerabilities that affect program integrity and the quality of care. While recommendations within the July 31 report come in […]

CMS: Hospice election statements lack required information or have other vulnerabilities

After a stratified random sample review of hospice election statements and certifications of terminal illness, the Office of the Inspector General (OIG) reports that more than one-third of hospice General Inpatient (GIP) stays lack required information or had other vulnerabilities. Hospice election statements did not always mention – as required – that the beneficiary was […]

New OIG report highlights vulnerability in how home health surveys are conducted

Source: Home Health Line A new study from the HHS Office of Inspector General (OIG) shows that some of the patient lists home health agencies supplied to surveyors were missing Medicare beneficiaries. Relying on agencies to supply the lists exposed a vulnerability that beneficiaries could be excluded from surveyors’ reviews. “We also found that surveyors […]

OIG reports increase in immediate jeopardy and high priority complaints in nursing homes

In a recent report published by the Office of Inspector General (OIG), the agency found that states received one-third more nursing home complaints in 2015 than in 2011, despite a decrease in occupancy. States prioritized more than half of complaints into the most serious categories—immediate jeopardy and high priority—which require onsite investigations within two or […]

Nursing Home Compare lacks relevant information for short-stay patients, evidence suggests

Evidence collected by Harvard researchers Brian E. McGarry and David Grabowski suggests that information provided on the Nursing Home Compare website, a tool created by CMS to inform consumers about the quality of care and services being delivered by skilled nursing facilities and nursing homes through a data-driven, five-star ranking system, is more applicable to […]