presented by Jane Snecinski
Financial Post Acute Advisors is a consulting firm that may be engaged to work with a SNF on a project involving compliance Nonfinancial Jane Snecinski/Post Acute Advisors has no nonfinancial conflicts to disclose
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
Jane Snecinski, FACHE, MBA
Ms. Snecinski has bachelor's and master's degrees in music and an MBA in health care administration from the University of Miami, Coral Gables, FL. She has had seventeen years of hospital administration and management experience and more than seventeen years of consulting experience in post-acute levels of care, including inpatient and outpatient therapy, sports medicine,…Read full bio
1. History of Compliance in LTC/SNF
While a compliance program is a prudent operational practice in all levels of care, the Office of Inspector General (OIG) only recently published guidelines for the implementation of an effective compliance program in the SNF setting. This chapter will help staff to understand the comprehensive scope of the compliance guidelines published by the OIG.
2. Implementation of an Effective Compliance Program in LTC/SNF
The guidelines for an effective compliance program do not appear to differ for different levels of care. However, the implementation of the guidelines can vary greatly. For that reason, this chapter will help LTC/SNF providers to understand the unique focus of efforts for the LTC/SNF level of care.
3. Accurate Reimbursement as an Outcome of an Effective Compliance Program (Part One)
After a medically necessary admission to a skilled nursing facility, resource utilization groups (RUGs) are the basis for the reimbursement system. Accurate documentation is necessary to demonstrate medical necessity and ensure the accurate RUG assignment. This chapter will review the details of the RUGs in order to facilitate documentation to support accurate RUG assignment and compliance.
4. Accurate Reimbursement as an Outcome of an Effective Compliance Program (Part Two)
Receiving accurate reimbursement is a key indicator of a compliant service. This chapter will provide actual case studies to demonstrate when documentation may or may not support the medical necessity of an admission to skilled nursing and/or an accurate RUG assignment/reimbursement and compliance.