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Compliance in LTC/SNF

presented by Jane Snecinski

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Disclosure Statement:

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.

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Video Runtime: 59 Minutes; Learning Assessment Runtime: 33 Minutes

Having a “living” and customized compliance plan in the long-term care (LTC)/skilled nursing facility (SNF) setting is necessary to receive and maintain operations in line with regulation and accurate reimbursement. Understanding how the components of this plan are implemented to become a program is critical. Since all staff have a role in successful implementation, providing all staff with compliance education specific to LTC/SNF will have a significant impact on the success of the program.

Meet Your Instructor

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,…

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Chapters & Learning Objectives

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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.

More Courses in this Series

Overview of Medicare Regulations for Long-Term Care

Presented by Jane Snecinski, FACHE, MBA

Overview of Medicare Regulations for Long-Term Care

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 47 Minutes; Learning Assessment Runtime: 32 Minutes

The regulations governing Long-Term Care (LTC)/Skilled Nursing Facilities (SNF) are unique and clarify the place that LTC/SNF play in the Medicare/Medicaid continuum of care. Despite these specific regulations, the role of and care delivered within the regulatory structure is not always well understood by administrative and clinical staff, especially if new to this level of care. This course will define the LTC/SNF setting and review the coverage guidelines for SNF, provide an overview of the Prospective Payment System and Minimum Data Set tool and schedule, and the assignment of reimbursement categories.

View full course details

The Quality Measures for LTC/SNF

Presented by Jane Snecinski, FACHE, MBA

The Quality Measures for LTC/SNF

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 47 Minutes; Learning Assessment Runtime: 24 Minutes

The Centers for Medicare and Medicaid Services (CMS) have developed and required specific quality measures for each level of care, including long-term care/skilled nursing facilities. These quality measures provide a framework for care and prepare organizations for moving to a value-based payment system. Understanding the measures, how to quantify them, and the value of using the data from the measures is critical for all long-term care providers.

View full course details

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