tci Medicare Compliance & Reimbursement - 2004 Issue 23

LONG-TERM CARE: New Admits Are Tricky For Some SNFs

Admissions on or after the effective date of a denial of payment remedy pose big problems for skilled nursing facilities if federal funds are in play. Yet uniform application of the sanction is turning out to be less than foolproof. A May 5 HHS Office of InspectorGeneral audit of the denial of payment remedy for new admissions in Ohio nursing facilities showed that 9 facilities in 46 collected $25,976 in unallowable reimbursement between 1999 and 2001 after sanctions were in place. However, the estimate was downgraded to $17, 796 after Ohio countered that over $10,000 in payments...

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