OIG Work Plan to Focus on Communicable Disease Care in Nursing Homes

December 30, 2013    |   By: Calevir

The HHS Office of Inspector General announces a plan every year, identifying specific concerns to be addressed with Medicare and Medicaid providers.   This year’s plan identifies the quality of nursing home care for communicable diseases and the underlying systems for infection control.     The plan also indicates that the OIG will disallow claims for care resulting from insufficient infection control processes.   The following language is from the plan:

We will review claims by nursing facilities for communicable disease care to determine whether they complied with Federal and State requirements. We will also examine patient safety consequences associated with nursing homes’ failure to comply with related communicable disease requirements. Nursing facilities are required to establish and maintain infection control programs designed to provide safe, sanitary, and comfortable environments and to help prevent the development and transmission of diseases and infections. The facilities’ infection control programs, under which they investigate, control, and prevent infections, decide what procedures, such as isolation, should be applied to individual residents and maintain records of incidents and corrective actions related to infections. (42 CFR § 483.65). A prior audit indicated that States are paying nursing facilities for unallowable claims related   to communicable disease care. (OAS; W-00-13-31466; various reviews; expected issue date: FY 2014; new   start)

CPS’ programs can support a robust effort to implement effective infection control.   Call (888.935.8272 or 314.540.4910) or email Kathy Wire for more information.

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