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.
Tuesday January 28, 2014
Arbitration Signature Flowchart will guide you and your staff on
the signature options for your facility's arbitration agreement.
Monday February 3, 2014
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:
Thursday February 6, 2014
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
- 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.
Friday February 28, 2014
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
letter is attached below.
Tuesday February 18, 2014
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:
21 is the last day a Recovery Auditor may send a postpayment
Additional Documentation Request (ADR)
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
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.
Saturday February 1, 2014
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.
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.
Wednesday March 26, 2014
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.
H.R. 4302 now moves to the Senate for a vote. Senators are
expected to vote on the bill in the coming days.
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,
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.
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.
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
View the Video from the Office of Inspector
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
View Contract Requirements between Long Term Care
Facilities and Hospice Service Providers
Federal Register - Long term care-hospice contracts
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
Tuesday June 3, 2014
Adult Portable Bed Handles Recalled by Bed Handles Inc.
Due to Entrapment and Strangulation Hazards; Three Deaths
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
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
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.
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
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
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
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
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.
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
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
Read more about the Gallagher Billings E&O
Wednesday August 20, 2014
ALERT Nursing Home Providers
Handling Funds Following the Death of a Medicaid -
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
See attached document for complete ALERT and Administrator of
Estate Designation Form.
Wednesday September 24, 2014
ASHRM Continuing Education Credits Available!
AHA Solutions' Signature Learning Series
Friday, September 26
- 1:30 p.m. - 2:30 p.m. Eastern
- 12:30 p.m. - 1:30 p.m. Central
- 11:30 a.m. - 12:30 p.m. Mountain
- 10:30 a.m. - 11:30 a.m. Pacific
- Jim O'Brien, M.D., MSc
- Chairman, Board of Directors, Sepsis Alliance
- Vice President, Quality and Patient Safety, Ohio Health
Riverside Methodist Hospital
- Pamela Popp, MA, JD
- Executive Vice President & Chief Risk Officer
- Western Litigation, Inc.
- Tara Crockett, RN, BN, CHSE, Alumnus CCRN
- Director Clinical Delivery
- Medical Simulation Corp
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:
- The implications of sepsis to the health care industry
- The key challenges to sepsis identification and
- About a case study illustrating the difference between early
intervention and later intervention
- Recommended next Action Steps for a 'SuspectSepsis'
Click here to check out other live and online WLI
Friday October 10, 2014
EBOLA(This information was obtained from the CDC website:
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,
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
- 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.
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
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
- 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
- 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
For general information about Ebola, please use the
This information was obtained from the CDC website.
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.
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
or calling them at 205-823-5551.
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
Click here for Release of Medical Records Policy
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
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
Read The Article
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
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
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