• Active Shooter

    Tuesday January 7, 2014

    Active Shooter Preparedness - The potential for a shooting incident by an active shooter exists, unfortunately, in every workplace place throughout the United States. This article will help you and your staff create an emergency action plan to respond to an active shooter situation.    

    Active Shooter

  • This Arbitration Signature(s) Decision Tree

    Tuesday January 28, 2014

    This Arbitration Signature Flowchart will guide you and your staff on the signature options for your facility's arbitration agreement.     

    This Arbitration Signature(s) Decision Tree

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  • Using eHealth Data Solutions CareWatch to Enhance Your QAPI Activities (Free Webinar):

    Monday February 3, 2014

    The Long Term Care Community is waiting for CMS to release the final Quality Assurance and Performance Improvement (QAPI) regulations, but your team should be preparing today to build a systematic, comprehensive, data driven approach to care. This free webinar will provide an overview of the eHealth Data Solutions CareWatch features that can enhance your QAPI activities and will discuss real life examples of the way CareWatch data can be used in the Plan-Do-Study-Act Cycle and your performance improvement projects (PIPs). See the link below on how to register for this free webinar presented by eHealth Data Solutions:     

    https://www2.gotomeeting.com/register/602492442

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  • ICD-10 in 2014

    Thursday February 6, 2014

    ICD-10

    With less than one year to go until the October 1, 2014, ICD-10 compliance date, now is the time to assess your progress. CMS continues to work with health care organizations to develop and distribute a variety of resources to help you with your ICD-10 planning and preparation.

    No matter where you are in your transition, there are ICD-10 resources available to you. Check the  provider resources page on the CMS website frequently for news and information to help you prepare, and visit your professional organization's website for resources tailored specifically to your needs. These resources can help you:

    • Plan your journey - Look at the codes you use, prepare a budget, and build a team
    • Train your team - Many options and resources are available
    • Engage your partners - Talk to your software vendors, clearinghouses, and billing services
    • Test your systems and processes - Test within your practice and with your partners

    2014 is the year of ICD-10. The ICD-10 transition will affect every part of your practice, from software upgrades, to patient registration and referrals, to clinical documentation and billing. With everyone in health care working toward a successful transition, now is the time to make sure you are ready too.

    Keep Up to Date on ICD-10

    Visit the CMS  ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, compliance date. Sign up for  CMS ICD-10 Industry Email Updates and  follow us on Twitter.

    HHS GOVCMS Pictures

     

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  • CMS Revised Emergency Preparedness Checklist

    Friday February 28, 2014

    The Centers for Medicare & Medicaid Services (CMS) is alerting healthcare facilities that they have revised current emergency preparedness checklist information for health care facility planning. These updates provide more detailed guidance about patient/resident tracking, supplies and collaboration.

    CMS has updated the S&C Emergency Preparedness Checklist - Recommended Tool for Effective Health Care Facility Planning. This updated checklist can be found at their S&C Emergency Preparedness Websitehttp://www.cms.hhs.gov/SurveyCertEmergPrep/.

    CMS has stated that updates and new documents will be posted to the website as they become available.

    The S&C letter is attached below.

    CMS Emergency Prepardness Initiative Feb. 2014

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  • AUDIT HOLIDAY

    Tuesday February 18, 2014

    CMS- February 18, 2014 - CMS is in the procurement process for the next round of Recovery Audit Program contracts. It is important that CMS transition down the current contracts so that the Recovery Auditors can complete all outstanding claim reviews and other processes by the end date of the current contracts. In addition, a pause in operations will allow CMS to continue to refine and improve the Medicare Recovery Audit Program. Several years ago, CMS made substantial changes to improve the Medicare Recovery Audit program. CMS will continue to review and refine the process as necessary. For example, CMS is reviewing the Additional Documentation Request (ADR) limits, timeframes for review and communications between Recovery Auditors and providers. CMS has proven it is committed to constantly improving the program and listening to feedback from providers and other stakeholders. Providers should note the important dates below:

    • February 21 is the last day a Recovery Auditor may send a postpayment Additional Documentation Request (ADR)

    • February 28 is the last day a MAC may send prepayment ADRs for the Recovery Auditor Prepayment Review Demonstration

    • June 1 is the last day a Recovery Auditor may send improper payment files to the MACs for adjustment

    CMS will continue to update this Website with more information on the procurement and awards as information is available. Providers should contact RAC@cms.hhs.gov for additional questions.

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  • ADVERSE EVENTS IN SKILLED NURSING FACILITIES: NATIONAL INCIDENCE AMONG MEDICARE BENEFICIARIES

    Saturday February 1, 2014

    From 2008-2012, the OIG conducted a series of studies about hospital adverse events, defined as harm resulting from medical care. This work included a Congressionally mandated study to determine a national incidence rate for adverse events in hospitals. As part of this work, they developed methods to identify adverse events, determine the extent to which events are preventable, and measure the cost of events to the Medicare program. This study continues that work by evaluating post-acute care provided in skilled nursing facilities (SNF). SNF post-acute care is intended to help beneficiaries improve health and functioning following a hospitalization and is second only to hospital care among inpatient costs to Medicare. Although various health care stakeholders have in recent years paid substantial attention to patient safety in hospitals, less is known about resident safety in SNFs.

    Because many of the events identified were preventable, our study confirms the need and opportunity for SNFs to significantly reduce the incidence of resident harm events. Therefore, the OIG recommends that the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) raise awareness of nursing home safety and seek to reduce resident harm through methods used to promote hospital safety efforts. This would include collaborating to create and promote a list of potential nursing home events-including events we found that are not commonly associated with SNF care-to help nursing home staff better recognize harm. CMS should also instruct State agency surveyors to review nursing home practices for identifying and reducing adverse events. AHRQ and CMS concurred with our recommendations.

    To read the complete OIG report, click on the attachment below.

    Adverse Events in SNF 2014

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  • Congress Vote To Delay ICD-10

    Wednesday March 26, 2014

    UPDATE: On Thursday, March 27, 2014, the US House of Representatives passed a bill that would delay the implementation of ICD-10-CM/PCS to October 1, 2015.  Bill, H.R. 4302, Protecting Access to Medicare, mainly adjusts the Sustainable Growth Rate (SGR) for Medicare payments.  The SGR outlines how much physicians get paid for their services.  However, the bill includes a seven line section (Section 212) which delays the implementation of ICD-10-CM/PCS to October 1, 2015. 

    Action on H.R. 4302 now moves to the Senate for a vote.  Senators are expected to vote on the bill in the coming days.   

    The bill,  which would amend the Social Security Act to extend Medicare Payments to physicians and change other provisions of the Medicare and Medicaid programs and adjust the Sustainable Growth Rate (SGR), also includes a section that would delay ICD-10 to October 1, 2015. 

      

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  • Senate Passes Bill that Delays ICD-10-CM/PCS Implementation

    Monday March 31, 2014

    On Monday, March 31, 2014, the Senate passed H.R. 4302, Protecting Access to Medicare Act of 2014, which included a section delaying the implementation of ICD-10-CM/PCS by at least one year.  The bill will now go before President Obama, who is expected to sign the bill into law.  

    The bill, H.R. 4302 states that the Department of Health and Human Services (HHS) cannot adopt the ICD-10 code set as the mandatory standard until at least October 1, 2015.  ICD-10 was originally set to be implemented on October 1, 2014.  

     

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  • Office of Inspector General (OIG) - Outlook 2014

    Monday May 19, 2014

    In this video senior executives from OIG will discuss the emerging trends in combating fraud, waste, and abuse in Federal Health Care Programs and upcoming projects in the newly released OIG Work Plan. OIG is a sister agency to the Centers for Medicare and Medicaid Services within the Health and Human Services Department. This podcast goes over how data is mined to direct audit resources and conduct investigations such as RAC Audits. 

    View the Video from the Office of Inspector General

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  • Federal Register - Long term care-hospice contracts

    Tuesday May 20, 2014

    In the attached documents you will find the issues that must be addressed in contracts between Long Term Care Facilities and Hospice Service Providers and the contract provisions that should be considered for inclusion from a risk management perspective.      

    View Contract Requirements between Long Term Care Facilities and Hospice Service Providers

    View Federal Register - Long term care-hospice contracts

  • How to Protect Your Facility by Having Third Party Contracts in Place

    Monday June 2, 2014

    Every contract has risks that must be reviewed from the perspective of protecting your entity and assets. This document is designed to provide you with guidelines and tools to help you manage those risks and to consider the regulatory and liability implications from contracted services.

    To learn more about Third Party Contracts click on the icon below.

    Third Party Contracts

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  • Adult Portable Bed Handles Recalled by Bed Handles Inc.

    Tuesday June 3, 2014

    Adult Portable Bed Handles Recalled by Bed Handles Inc. Due to Entrapment and Strangulation Hazards; Three Deaths Reported


    Description

    WASHINGTON, D.C. - The U.S. Consumer Product Safety Commission (CPSC) and Bed Handles Inc., of Blue Springs, Mo., are announcing the voluntary recall of about 113,000 adult portable bed handles. When attached to an adult's bed without the use of safety retention straps, the handle can shift out of place creating a dangerous gap between the bed handle and the side of the mattress. This poses a serious risk of entrapment, strangulation and
    death.

    Three women died after becoming entrapped between the mattress and the bed handles. They include an elderly woman, age unknown, who died in an Edina, Minn. assisted living facility; a 41-year-old disabled woman who died in a Renton, Wash. adult family home; and an 81-year-old woman who died in a Vancouver, Wash. managed care facility.

    The recall involves adult portable bed handles sold by Bed Handles Inc. from 1994 through 2007 that do not have safety retention straps to secure the bed handle to the bed frame to keep the bed handle from shifting out of place and creating a dangerous gap. Recalled models include the Original Bedside Assistant® (BA10W), the Travel Handles™ (BA11W) which is sold as a set of two bed handles, and the Adjustable Bedside Assistant® (AJ1).

    For more information, including contact information and a photo of the Bed Handles click on the attachment below.

     

     Third Party Contracts

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  • Cyber and Privacy Liability Insurance

    Thursday June 12, 2014

    Cyber and Privacy Liability Insurance provides coverage when data is breached within your business. Traditional insurance policies such as property and general liability generally have gaps which may not cover losses from a data breach at your organization. This article will introduce you to cyber and privacy liability insurance and examples of coverage that it may provide.

    Download the  Cyber and Privacy Liability Insurance Article

  • Adverse Events In Skilled Nursing Facilities

    Wednesday July 23, 2014



    The Office of the Inspector General recently released their findings of a study they conducted from 2009-2011. In this study they found an estimated 22 percent of Medicare beneficiaries experienced adverse events during their SNF stays. An additional 11 percent of Medicare beneficiaries experienced temporary harm events during their SNF stays. Physician reviewers determined that 59 percent of these adverse events and temporary harm events were clearly or likely preventable. They attributed much of the preventable harm to substandard treatment, inadequate resident monitoring, and failure or delay of necessary care. Over half of the residents who experienced harm returned to a hospital for treatment, with an estimated cost to Medicare of $208 million in August 2011.

    Because many of the events that were identified were preventable, their study confirms the need and opportunity for SNFs to significantly reduce the incidence of resident harm events.
    Therefore, the OIG recommended that the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) raise awareness of nursing home safety and seek to reduce resident harm through methods used to promote hospital safety efforts. This would include collaborating to create and promote a list of potential nursing home events-including events that were found that are not commonly associated with SNF care-to help nursing home staff better recognize harm. The OIG stated that CMS should also instruct State agency surveyors to review nursing home practices for identifying and reducing
    adverse events. AHRQ and CMS concurred with our recommendations.

    Adverse Events in Skilled Nursing Facilities

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  • QAPI Quick Start Kit

    Tuesday July 29, 2014

    Recently CMS proposed new rules combining F-250 Quality Assurance (QA) with additional ACA provisions of Performance Improvement (PI). In response, The Compliance Store developed the QAPI Quick Start Tool Kit. The link below contains all of the resources that you will need and outlines each step to help you get your QAPI Program up and running quickly. Staff improvements through QAPI equals decreased turnover, which leads to better quality of care.

    Read More

     

     

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  • CNA Webcast: Admissions and Transfers – Challenges Facing Aging Services Facilities

    Friday August 1, 2014

    CNA will be broadcasting a Webcast on Thursday August 7, 2014 at 12:00 Central Time on the admissions and transfer challenges facing aging services facilities. Facilities work with residents and their families on numerous sensitive issues that arise in this healthcare delivery setting. Appropriate identification of those residents who may be safely admitted and those who should be transferred poses a significant challenge. This webcast will address the admission and transfer issue, as well as resident behavior and health issues, and resident assessment tools. To register for this webcast please view this attachment.

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  • Billing Errors & Omissions Liability Program

    Friday August 8, 2014

    Healthcare is one of the most regulated industries in the U.S. and healthcare providers are extremely vulnerable to allegations of improper billing by both governmental payers and private commercial payers. The Gallagher Billings E&O Program provides important protection to healthcare providers against such allegations. 

    Read more about the Gallagher Billings E&O Program

  • Handling Funds Following the Death of a Medicaid Eligible Resident

    Wednesday August 20, 2014

    ALERT Nursing Home Providers

    Regarding

    Handling Funds Following the Death of a Medicaid - Eligible Resident

    The purpose of this alert is to clarify the procedures associated with handling  funds following
    the death of a Medicaid-eligible nursing home resident. 42 CFR § 483.10(c)(6), the Medicaid Administrative Code 560-X-10.-14(3)(f) and 560-X-22-.25(5)(e) and the Social Security Administration Guide for Representative Payees require that nursing homes, upon the death of a resident, release any funds being held at the facility in the resident's name to the individual or probate jurisdiction designated to administer the deceased resident's estate.

    Attached to this alert is a newly developed Administrator of Estate Designation Form which will provide a resident the opportunity to designate who should receive the remaining personal funds. Upon the death of the resident, the completed form in the patient's record will allow a nursing home facility to turn over any remaining funds to the designated Administrator of the Estate.

    See attached document for complete ALERT and Administrator of Estate Designation Form.

      Handling Funds Following the Death of a Medicaid - Eligible Resident

     

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  • Webinar: Understanding Sepsis: Recognizing the Risk

    Wednesday September 24, 2014

    ASHRM Continuing Education Credits Available!

     AHA Solutions' Signature Learning Series

    Friday, September 26

    1. 1:30 p.m. - 2:30 p.m. Eastern
    2. 12:30 p.m. - 1:30 p.m. Central
    3. 11:30 a.m. - 12:30 p.m. Mountain
    4. 10:30 a.m. - 11:30 a.m. Pacific

    SPEAKERS:

    1. Jim O'Brien,  M.D., MSc
    2. Chairman, Board of Directors, Sepsis Alliance
    3. Vice President, Quality and Patient Safety, Ohio Health Riverside Methodist Hospital
    4. Pamela Popp, MA, JD
    5.  Executive Vice President & Chief Risk Officer
    6.  Western Litigation, Inc.
    7. Tara Crockett, RN, BN, CHSE, Alumnus CCRN
    8. Director Clinical Delivery
    9.  Medical Simulation Corp

    REGISTER NOW!

    Sepsis can arise from any underlying infection, affecting anyone at any time. The symptoms can be easily missed, allowing the disease process to move quickly through the body, resulting in disability, loss of limbs or death.

    Hospitals must move quickly and effectively to address this complex condition. This webinar illustrates the risks of  misdiagnosis, the challenges of treatment, and provides practical solutions that providers can undertake to increase early recognition, response and recovery.

    Discover the key elements of successful sepsis performance improvement initiatives that improve patient outcomes, lower mortality and reduce health care cost.

    You Will Learn:

    1. The implications of sepsis to the health care industry
    2.  The key challenges to sepsis identification and management
    3. About a case study illustrating the difference between early intervention and later intervention
    4.  Recommended next Action Steps for a 'SuspectSepsis' initiative

     

    Click here to check out other live and online WLI events!

  • What should we know about Ebola?

    Friday October 10, 2014

    EBOLA(This information was obtained from the CDC website: www.cdc.gov)

    Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).

    Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus.

    A severe, often fatal disease, Ebola can be spread in several ways to others: through direct contact (through broken skin or mucous membranes) with a sick person's blood or body fluids or objects that have been contaminated with infected body fluids. Ebola symptoms usually begin after an incubation period ranging from 2 days to 21 days.

    Symptoms of Ebola include:

    • Fever (greater than 38.6°C or 101.5°F)
    • Severe headache
    • Muscle pain
    • Weakness
    • Diarrhea
    • Vomiting
    • Abdominal (stomach) pain
    • Unexplained hemorrhage (bleeding or bruising)

    Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

    Recovery from Ebola depends on good supportive clinical care and the patient's immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

    Transmission

    When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with

    • blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
    • objects (like needles and syringes) that have been contaminated with the virus
    • infected animals
    • Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.

    Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients.

    During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.

    Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. People who recover from Ebola are advised to abstain from sex or use condoms for 3 months.

    Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospital

    Standard, contact, and droplet precautions are recommended for management of hospitalized patients with known or suspected Ebola virus disease.

    How do I protect myself against Ebola?

    If you must travel to an area affected by the 2014 Ebola outbreak, protect yourself by doing the following:

    • Wash hands frequently or use an alcohol-based hand sanitizer.
    • Avoid contact with blood and body fluids of any person, particularly someone who is sick.
    • Do not handle items that may have come in contact with an infected person's blood or body fluids.
    • Do not touch the body of someone who has died from Ebola.
    • Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
    • Avoid hospitals in West Africa where Ebola patients are being treated. The U.S. Embassy or consulate is often able to provide advice on medical facilities.
    • Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
      • Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility.

    For general information about Ebola, please use the links below:

     This information was obtained from the CDC website.

  • Your Medical Record is worth 10 times more to hackers than your credit card

    Wednesday November 12, 2014

    You medical record is worth 10 times more to hackers than your credit. The attachment below contains an article from the New York Daily News that provides information on how cyber criminals are breaking into healthcare computer networks to steal the personal information of patients.

    Click here to read more.

  • Running Annual Background Checks on Employees

    Monday December 1, 2014

    Recently, the Gallagher Risk Management Services Claims Department has seen an increase in allegations relating to a facility's negligent hiring, training, and supervision of its employees.  Claims relating to the hiring, training, and supervision of employees are often tied to incidents where an employee of a facility has been accused of abuse / neglect of a resident and terminated.  While there is no requirement to perform intermittent background checks, running a background check once a year for every employee could potentially reduce the likelihood that a facility may be susceptible to a claim of negligent hiring, training, and supervision.  Bullet Screening Services provides comprehensive employment screening services.  Through a partnership with Bullet Screening Services, ALTC's clients are able to purchase discounted special employment screening packages, including a $7.00 per employee charge for a background check.  The investment of performing an annual background check on each employee would be an investment in quality control for residents and possibly reduce the significance of a claim for negligent hiring, training, and supervision. You can learn more about the services that Bullet Screening Services provides tor the Senior Care Industry by going to their website at www.bulletscreening.com or calling them at 205-823-5551.

  • Medical Records Release Policy Procedures for Senior Living Facilities

    Tuesday December 2, 2014


    It is the policy of the facility to safeguard the privacy and security of protected health information (PHI) and to protect the resident's right to confidentiality of clinical information by releasing resident information or protected health information (PHI) only to authorized persons/agencies, in compliance with state and federal regulations covering treatment, payment, health care operations and/or other mandatory reporting requirements and in accordance with facility policy. The attached link is a sample Release of Medical Records Policy that may help you and your staff comply with these requirements.          

    Click here for Release of Medical Records Policy sample.

  • Recognizing the Role of Delirium in Preventing Rehospitalization

    Wednesday December 3, 2014

    Delirium will complicate a hospital stay for more than 2.2 million Americans this year, with estimated costs of as much as $8 billion annually. The attached white paper from Relias Learning provides you and your staff with information on how to recognize the role of delirium in preventing Rehospitalization.  

    View the Whitepaper

  • Disaster Management Services Insurance Coverage

    Thursday December 4, 2014

    New insurance coverage for Disaster Management Services is available through Arthur J. Gallagher and underwritten by Lloyds of London. This coverage will respond in the event of a sudden, unforeseen natural disaster or man-made catastrophe which affects five or more lives, results in multiple fatalities and/or injuries, and/or where the company is directly responsible for the population which is directly affected by the event. To learn more about this coverage and how to obtain a quote you can open the article in the link below.

    Read The Article

  • Violent Malicious Acts Insurance Coverage

    Thursday December 4, 2014

    New insurance coverage for Violent Malicious Acts is now available through Arthur J Gallagher and is designed to help you and your facility move forward after a tragedy. Violent Malicious Acts coverage insures the necessary Extended Loss of Revenue and Extra Expense you incur in order to continue the normal conduct of the facility's operations following a Violent Malicious Act. To learn more about this coverage and how to obtain a quote you can open the article in the link below.

    Read The Article

  • Gaps Continue to Exist in Nursing Home Emergency Preparedness and Response During Disasters

    Thursday December 18, 2014

    This study from the Department of Health and Human Services (OIG) found that even though most nursing homes met Federal requirements for written emergency plans and preparedness training there were many gaps in these plans. These emergency plans lacked relevant information, including only about half of their tasks on the CMS checklist. Nursing Homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents that developed health problems. The attachment below contains the entire study from the OIG.

    Nursing Home Disaster Prepardness and Response during Disasters 2007-201.pdf

  • Emerging Environmental Risks in the Healthcare Industry

    Thursday December 18, 2014

    This report was published by Advisen and sponsored by Ace Insurance. Healthcare in the United States is in the midst of unparalleled transformation, driven in large measure by the Patient Protection and Affordable Care Act. Many of the environmental exposures of healthcare organizations may fall under core EPA programs or similar state regulations, making it important that healthcare organizations maintain a sharp focus on environmental compliance. Maintaining this focus and identifying emerging environmental exposures while in a period of growth and rapid change will be a continuing challenge for risk managers, compliance officers, and administrators. The attachment below contains the report on these merging environmental risks.

     

    Advisen Emerging Healthcare Environment Risk WhitePaper.pdf