ED Coding & Reimbursement Alert - 2003 Issue 14
Quality of Care: FOR NURSING HOMES, QUALITY IS JOB ONE
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Article Overview
This article addresses how nursing homes can face state and federal enforcement when quality-of-care problems are alleged, and how settlements may require formal compliance and quality-improvement measures. It is relevant to compliance officers, administrators, and healthcare managers who oversee long-term care operations, training, safety, and payer compliance.
Why This Topic Matters
It highlights the increasing connection between quality-of-care performance and compliance risk in nursing facilities, especially where Medicare and Medicaid payments are implicated. Readers can use it to understand the compliance environment and the operational areas commonly targeted in enforcement-related quality agreements.
What You Will Learn
- How quality-of-care concerns can lead to enforcement activity in nursing homes
- Why settlement agreements may include quality-oriented compliance measures
- What operational areas in long-term care facilities are commonly affected by quality programs
- How Medicare and Medicaid compliance can intersect with care quality oversight
Who Should Read This
- Compliance officers
- Nursing home administrators
- Long-term care managers
- Healthcare compliance professionals
- Risk management staff
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