decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Nursing Home Model Compliance Plan / Essentials of OIG's Nursing Home Model Compliance Plan
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Article Overview
This article summarizes the core elements of the OIG’s model compliance plan for nursing facilities. It is aimed at compliance officers, facility administrators, and coding or billing professionals who need a high-level understanding of compliance program structure, internal reporting, training, auditing, and response mechanisms discussed in the nursing home context. The content is a general guidance overview and does not provide code-level billing instruction.
Why This Topic Matters
Nursing facilities are expected to maintain effective compliance programs and internal controls, and this article outlines the major components commonly used to evaluate readiness and oversight. It helps readers understand the broad compliance framework that supports proper operations and risk management.
What You Will Learn
- The core elements of a nursing facility compliance program
- How internal reporting and investigation processes are framed in the OIG model
- The roles of compliance leadership and oversight functions
- Common compliance activities such as training, auditing, and corrective action
- General risk-area monitoring concepts relevant to nursing homes
Who Should Read This
- Nursing home administrators
- Compliance officers
- Billing and coding staff
- Healthcare operations managers
- Revenue integrity staff
- Healthcare counsel and consultants
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