Simplify your claims management

When it comes to claims management, nothing is more exhausting and labor-intensive than jumping between portals to gather information and cross-reference the data you need. Healthcare providers with disparate systems report bigger issues with denials than those using one revenue cycle management solution.1 The ongoing back-and-forth from one vendor platform to another is where manual errors are often introduced, slowing your revenue cycle with denials and additional research. Reports show that having multiple vendors makes it more challenging to identify billing errors or keep up with data variances.2

Plus, if your claims management also involves tools from a vendor whose software lacks integration, you’re probably experiencing fragmentation that can be avoided.

As an ABILITY customer, you know the value of an application that automates your work and adds convenience with a single sign-on for all team members. Imagine replicating that efficiency across your entire claims management process, whether you’re focusing on reimbursement from Medicare or pursuing revenue from private insurers.

How to simplify your processes for better results

Eliminating disjointed platforms not only removes frustration for you and your team, but it also saves money through increased efficiency. With integrated applications for eligibility, claims processing, remits, audits and additional documentation requests (ADRs), you can truly streamline your data and workflow from end to end.

Although integrated software remains a goal for some vendors, ABILITY has a long track record of delivering this technology. Our end-to-end applications work together seamlessly, allowing healthcare providers to easily connect directly with all their payers – from private insurance companies to Medicare – to collect payment quickly and efficiently.

Discover how consolidating to a single platform can help you save labor, accelerate revenue and take control of your processes.

 

1. HIMSS RCM Survey: Understanding Health Systems’ Revenue Cycle Management and Challenges, Dimensional Insight, May 8, 2018, https://www.dimins.com/white-papers/himss-rcm-survey/

2. “Want to reduce denials? Slim down your RCM solutions” Samantha Meyer, Becker’s Hospital CFO Report, July 12, 2018, https://www.beckershospitalreview.com/finance/want-to-reduce-denials-slim-down-your-rcm-solutions.html#link_tab

ABILITY and design®, ABILITY® and ABILITY EASE® are trademarks of ABILITY Network, Inc.

All claims management isn’t created equal: what you should know

Jarred by a once-in-a-century global pandemic, market volatility and other challenges, 2020 will almost certainly be remembered for widespread uncertainty. Healthcare providers navigating this environment may have the additional burden of outdated or underperforming claims management solutions that contribute to rework and high denial rates.

Unplanned changes can take a heavy toll on organizations struggling to make ends meet, particularly as budgets are strained by increased spending on PPE and other supplies. Faced with so much turmoil, the last thing you need is disruption to your revenue. Adding to the uncertainty is consolidation among software vendors, which may cause disruption and lead many healthcare providers to re-evaluate partnerships.

Is it time to reconsider?

When comparing your current claims management platform to other options, several questions should be top of mind:

  • Is your relationship with your software vendor meeting your needs?
  • Do you have to alter your workflows to accommodate for limited software capability?
  • Are your rejections and denials increasing or improving?

ABILITY’s single sign-on platform trusted for 20 years

As you research the topic, look for technology that enables one stop for smoothly handling claims for Medicare and Medicaid, as well as all private insurers. With ABILITY, your entire team can enjoy single sign-on efficiency and the convenience of integrated applications. Our all-payer claims platform works directly with Medicare to provide real-time data at your fingertips.

You’re not alone with the issues you’re facing. Remember, 2020 has been challenging for healthcare providers of all sizes and in all locations. For two decades, ABILITY has helped organizations like yours simplify administrative complexities through easy-to-use applications and data analytics. Discover how you can save labor, accelerate revenue and take control of your billing with a single platform.

 

ABILITY and design® and ABILITY® are trademarks of ABILITY Network, Inc.

How to prepare for the impact of MDS 3.0 for FY 2021

The Centers for Medicare & Medicaid Services (CMS) was set to release the Minimum Data Set (MDS) 3.0 version 1.18.1 on October 1, 2020. However, the COVID-19 public health emergency upended that plan.

Prior to the pandemic, CMS intended to eliminate Section G along with making some changes to other sections of the MDS. Then in March, as part of the blanket 1135 waiver, the regulatory agency delayed the release of the planned version of the MDS to give skilled nursing facilities more flexibility in their response to COVID-19.

With a new scaled-down MDS 3.0 going into effect on October 1, it’s crucial for facilities to understand the impact of the changes and take the necessary steps to manage Medicaid revenue for FY 2021.

Understanding the impact

The interim MDS 3.0 version 1.17.2 is designed to facilitate the calculation of Patient Driven Payment Model (PDPM) payments on all Omnibus Budget Reconciliation Act (OBRA) assessments.

Each state has the option of requiring PDPM data on OBRA comprehensive and quarterly assessments. New item sets include section GG, item I0020B ICD-10 for the primary medical condition and J2100 recent surgery requiring active SNF care.

The key takeaway here is knowing where your state has landed regarding the collection of PDPM data on the OBRA assessments, and if you will be required to complete an Optional State Assessment (OSA).

Tips for success

First and foremost, there’s no need to panic. While your state may require PDPM data beginning October 1, your payments on that data will not be affected. Keep in mind that the purpose of these changes is to inform future Medicaid models.

Here are several steps your facility can take to adapt to the new MDS for FY 2021:

  • Contact the RAI Coordinator for your state to find out the new requirements
  • Educate your team on how to accurately code for the new section and items on MDS version 1.17.2
  • Make sure your Electronic Health Record (EHR) is updated to align with the October 1 changes
  • Implement a robust process for collecting PDPM data across all payers

How ABILITY can help

ABILITY CAREWATCH equips you with software tools that will enable your facility to be ready for any quality management changes coming its way. With updated logics, you can create real-time reports to closely monitor quality and revenue and comply with state and federal requirements.

Specific to MDS 3.0, you’ll have access to:

  • An MDS Detail Report and ADL Report to improve data accuracy on Sections GG and J
  • Diagnosis Watch and PDPM tools to help manage Section I and boost reimbursement
  • Restorative Watch to improve resident outcomes via a robust restorative nursing program

Discover firsthand how to put this application to work for your facility by requesting a demo today.

 

“MDS 3.0 Technical Information,” CMS, accessed September 21, 2020, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation

ABILITY and design®, ABILITY® and CAREWATCH® are trademarks of ABILITY Network, Inc.

Avoid postal delays with paperless claims and statements

The U.S. Postal Service is experiencing delays in mail delivery across the country. At the same time, Americans everywhere – especially vulnerable populations, such as elderly people and those living with comorbidities – are being asked to stay home. As a result, many of your patients have very real anxiety over when (or whether) they’ll receive their medications.

According to a recent article from NPR, “Nationally, an Ipsos poll found that 1 in 5 Americans got medication through the mail in the past week, and 1 in 4 of them experienced a delay or nondelivery.”1 And patients aren’t the only ones impacted by lagging deliveries. Commercial and private mail services have been affected, creating concerns for small and medium-sized businesses that rely on mail delivery services.2

If your organization relies on paper claims submissions and patient statements, you could be facing longer A/R days and more work resubmitting lost claims. Likewise, with delivery delays, paper statements and bills may not reach patients in a timely manner, making it more difficult to capture patient payments.

Postmaster General Louis DeJoy has told the U.S. Senate that the Postal Service will not implement any changes in service until after the election.1 This could mean that more delays are on the horizon. Even if you have not yet experienced issues with lost or late mail, upcoming changes to U.S. Postal Service delivery programs may lead to more delivery issues in the coming months.

So, what can you do? Instead of bracing yourself for longer days in A/R, why not take advantage of this time to go paperless? With the right technology, you can:

  • Give patients the option to receive their statements online via email
  • Electronically upload claims attachments
  • Submit claims online instead of by mail

Want to learn more about applications that can help you accelerate A/R and avoid postal delays? Read about ABILITY CHOICE All-Payer Claims and ABILITY EASE All-Payer, or request a demo today.

 

Sources:

  1. “Postal Service Slowdowns Cause Dangerous Delays In Medication Delivery,” Paige Pfleger, NPR, August 25, 2020. Accessed September 10, 2020, https://www.npr.org/sections/health-shots/2020/08/25/905666119/postal-service-slowdowns-cause-dangerous-delays-in-medication-delivery
  2. “Are postal service delays hampering small business?” KTTN News, August 13, 2020. Accessed September 10, 2020, https://www.kttn.com/are-postal-service-delays-hampering-small-business/

ABILITY and design®, ABILITY®, CHOICE® and ABILITY EASE® are trademarks of ABILITY Network, Inc.

Insurance discovery: The revenue recovery tool your organization needs

For many healthcare organizations, strong financial performance requires more than clean claims and efficient patient payment processes. A commitment to efficiency, accuracy and ongoing innovation are also essential for a healthy bottom line.

To help capture every dollar earned, many healthcare leaders are adding coverage discovery software to their revenue cycle management toolbox. When executed well, this can lead to better financial outcomes – just one of the many benefits possible with an effective discovery approach.

The following is a closer look at three key results available by implementing a strong coverage determination strategy.

Maximize reimbursements

It’s no secret that having multiple streams of income supports positive financial performance. By better identifying additional billable insurance coverage from third-party payers, providers can create an innovative new way to realize revenue.

To best leverage this channel, it’s worth going beyond the traditional practice of tracking down missed revenue opportunities manually after the point-of-service. Instead, a technology-driven approach can uncover missed insurance on self-pay patients, charity or bad debt in a more simple, effective way.

In fact, providers using ABILITY COMPLETE Coverage Discovery, on average, receive an additional 20% of insurance identification1 to maximize reimbursements. They’re better able to identify additional coverage for Medicaid, Medicare and commercially insured patients, capitalizing on both primary and secondary coverage to most accurately bill for – and receive – payment.

Simplify the intake process

As beneficial as coverage discovery can be for recovering bad debt, it’s also effective for front-end improvements. When staff is better equipped to identify all applicable coverage – primary and secondary, public or commercial – the lifecycle of each claim is likely to be shorter and smoother.

Additionally, the time that would have been spent re-working each inaccurate claim or tracking down the potentially lost revenue afterward, is now saved.

Improve the patient experience

By easing the financial burden on patients, better coverage determination allows healthcare providers to improve the overall care experience.

Identifying coverage helps providers create relief for patients who may be dealing with personal financial challenges. It’s a welcomed addition, considering 14% of Americans live in a household facing challenges with paying healthcare bills2 and an estimated 39% of Americans aren’t able to pay a $400 emergency expense without taking out a loan.3

Take the first step to better results

When viewed holistically, effective insurance discovery is about much more than improving short-term finances. It’s a strategic method to ensure better long-term outcomes across your entire organization, from care delivery to revenue cycle management

To learn how ABILITY COMPLETE Coverage Discovery can help your organization succeed, contact our team at 866.662.0512.

 

Sources:
1ABILITY internal reporting; average of customer results.
2 “Problems Paying Medical Bills, 2018,” Amy E. Cha and Robin A. Cohen, National Center for Health Statistics at the Centers
for Disease Control and Prevention, February 2020, https://www.cdc.gov/nchs/data/databriefs/db357-h.pdf
3 “2 ways hospitals can help Covid-19 patients with their bills (without suspending billing),” Rachel Matthews, Advisory Board, March 30, 2020, https://www.advisory.com/research/revenue-cycle-advancement-center/at-the-margins/2020/03/covid-19-billing

 

ABILITY and design®, ABILITY® are trademarks of ABILITY Network, Inc.

Desperate to trim your labor budget? Start with overtime.

Labor costs consume most of a healthcare organization’s operating budget, so when it’s time to reduce costs, that’s usually the first place to look for savings. In fact, nearly half (44%) of CFOs and executives say reducing labor expenses is their No. 1 priority, according to a joint survey from the Healthcare Financial Management Association and Navigant.

Yet, for many healthcare organizations, typical cost-cutting measures, like layoffs or widespread hour reductions, just aren’t possible because they’re already short-staffed. For years, the healthcare industry has been up against a pretty critical staffing shortage. A lack of nurses, which make up the largest segment of the health profession, is a big driver behind the shortage. So much so that the U.S. Bureau of Labor Statistics projects 11 million additional nurses are needed to avoid a further shortage.

As a result, more nurses are working more overtime, as are physicians, mental health providers and support staff, and it’s pushing healthcare organizations’ labor budgets to the brink.

Overtime is a budget and quality killer

It’s simple math: In most cases, an hour of overtime costs more than a regular work hour, and an increase in overtime is undoubtedly contributing to the rise in labor costs. That’s why it has become a key metric for executives to monitor and why managers feel pressured to rein it in.

It makes sense to do so. Overtime is expensive and it’s been tied to employee fatigue and burnout, medical errors and lower patient satisfaction, all of which cost the organization in some way, even if it’s hard to quantify the losses. To look at it another way, it means your organization could be paying much more for lower quality work that could have a long-term impact on the bottom line.

All that said, decreasing your reliance on overtime is often the most effective way to drive down labor costs. That requires taking a closer look at scheduling practices, and more specifically, how overtime is being used – and misused.

Offer managers more visibility and insight to curb overtime

Sometimes overtime is unavoidable. Often, however, it is a mistake that occurs because managers don’t have real-time visibility into what’s happening within their departments. They’re working with spreadsheets or other outdated scheduling processes, and they’re making split-second decisions without much data to go on when staff calls off or a unit is full.

That’s where a tool like ABILITY SMARTFORCE Scheduler can be invaluable, offering overtime management with real-time, pervasive staffing visibility. For example, with a few taps on any mobile device, a manager can immediately see which employees are already in or nearing overtime. That insight can help inform initial scheduling decisions, fill open shifts and even prioritize who to send home during a slow shift.

By tapping on the employee’s schedule, the user can drill down further and receive a breakdown of the employee’s shifts. In some cases, a shift that will push an employee into overtime may be on the schedule, but it hasn’t yet occurred. That offers managers an opportunity to find a replacement for any hours that exceed 40 before the employee racks up overtime.

Overall, it offers managers more control over their schedules and a simpler, quicker way to manage shifts.

Gain the insight required to address overtime misuse

With ABILITY SMARTFORCE Scheduler, your managers have at their fingertips the data they need to make better staffing decisions and reduce costly overtime.

In addition, the executive team also benefits from in-depth overtime reports that break down both overtime hours and costs, by location or region, on a weekly, monthly, quarterly or year-to-date basis. That insight can allow you to pinpoint where overtime is costing too much, so you can troubleshoot the issue. Plus, the report will also forecast expenses for the next month, so you can proactively work with managers to reduce potential costs.

Keep overtime costs in check

With the highly affordable ABILITY SMARTFORCE Scheduler, you gain the visibility and insight to dramatically reduce overtime.  If you want to see firsthand how much time ABILITY SMARTFORCE Scheduler can save you, request a demo now.

Telehealthvisit

Is telehealth right for your practice? Key considerations for physicians interested in virtual care

The rising use of telehealth over the course of this year has signaled a loud and clear message across the healthcare landscape: telehealth is the future of patient/provider interactions.

However, how telehealth works and for what purpose varies widely among providers. Some prefer to use virtual visits only when necessary or for routine appointments such as checkups and pre-ops, while other providers use telehealth throughout their treatment process.

If you’ve started to assess the possibilities of offering telehealth but are not yet sure whether it’s right for your practice, here are 5 key things to consider.CC

1. Consumer-centric industry shifts

As emphasis on value-based care and high-deductible health plans continues to increase, patients are seeking more than just the kind of care they need – they’re shopping for the best possible match. They’re researching the reviews and accomplishments of providers, comparing costs of care and searching for the most convenient appointment location.

What could be more convenient than going to a medical appointment without leaving the house (or office)? With 81% of patients being more likely to select a medical provider who offers telemedicine over one who does not1, telemedicine can not only give your practice more flexibility, but potentially attract more patients.

It’s important to be competitive and to position your practice for success in an increasingly consumer-focused market, in addition to offering quality care.

2. Your patient population

While industry trends are good indicators of how to evolve your practice, so is your patient population.

Do you mostly treat elderly patients? Do you typically see a mix of young to senior adults in a day? Is your specialty something that needs to be done hands-on, or can you provide consultative conversations without an in-person visit?

These are critical questions to consider as you assess the opportunity to offer telehealth. You need to be confident that this kind of care is well-received by your patients and that it can uphold your standards of care.

If your patients are mostly older adults, telehealth could be a great way to routinely check in with them regarding their treatment plans vs. requiring them to come in for in-person visits. Patients who are younger may be more engaged in the treatment suggested simply because it is convenient and technology-driven interactions are familiar to them.

Telehealth can also provide a way for health-conscious individuals – those who are highly aware of the risk of contracting COVID-19 or even the flu – to receive the care they need without having to leave their home. The more you consider the needs and habits of your average patient, the easier you can identify where telehealth best fits into their care journey.

3. Practice processes

Another factor to help determine if telehealth is right for you is to consider your practice processes. From patient intake and scheduling to how you prepare for and conduct each visit, the right telehealth strategy can simplify and streamline your daily operations.

When patients complete their forms online, they’re better prepared to be on time for their in-person or virtual appointment. When you’re able to review documents within your telehealth portal instead of relying on paper forms, there’s less friction in the pre-appointment steps needed to prepare for seeing a patient.

Similarly, telehealth can make the tasks of your team easier by better organizing patient claims, payments and prescription details. When everything is one place, there’s less time spent by all parties sharing or finding key information – and more time spent focused on the root cause of each patient’s health needs.

4. Potential ROI

The next aspect of telehealth to consider is the possible ROI it could provide your practice, both financially and in terms of patient outcomes.

Many factors influence financial ROI. Upfront, there are the costs of purchasing and implementing your telehealth platform of choice, time to train staff and ensuring your practice insurance covers telehealth. In the long-term, investing in telehealth may result in lower costs to maintain your physical practice, reduced no-shows and potentially increase billable hours as a result of flexible scheduling.

Additionally, telehealth can help increase patient retention and satisfaction, while also reducing acuity levels.

5. Acting vs reacting

The final indicator to determine if telehealth is right for you is the choice between leading the way now or mimicking the success of others later. Telehealth is currently growing in popularity but not yet the norm. However, that’s where telehealth is headed; it’s set to become a standard part of providing healthcare.

The opportunity to help shape telehealth is still available, but as it is more widely adopted, there will be a transition from defining standard processes and metrics of success to simply adhering to what those are.

To start offering telehealth now is about more than giving patients a physically distant option or creating a bit of scheduling flexibility, it is the time to decide if you want to leave a lasting impact on healthcare – and your own practice.

Finding the right partner for your practice’s telehealth strategy

Ready to implement telehealth in your practice? Take the first step to establishing a strong telehealth strategy by choosing your virtual visit platform. Learn more about our new telehealth application today!

 

Sources:

1 “Should You Offer Telemedicine Services? Patients Weigh In” , Lisa Hedges, Software Advice, Inc, August 5, 2019, https://www.softwareadvice.com/resources/should-you-offer-telemedicine-services/

 

ABILITY and design®, ABILITY® are trademarks of ABILITY Network, Inc.

telehealth visit

Looking beyond COVID-19: the top 3 telehealth challenges to start combatting now

The use of telehealth has rapidly expanded across the healthcare landscape this year as a response to COVID-19, and this growth is not expected to slow down any time soon. In fact, Frost & Sullivan forecasts, “a sevenfold growth in telehealth by 2025 – a five-year compound annual growth rate of 38.2%.”1

However, new opportunities to deliver and receive care come with new challenges. Most providers and patients have been flexible this year, each party doing the best they can to engage in safe, efficient healthcare interactions in their new settings. But as we look beyond the circumstances we’re in, now is the time to seriously consider offering telehealth long term.

Here are three of the top telehealth challenges to be aware of so you can best provide virtual care for years to come.

1. Patient adaptation

Although patient demand for telehealth is increasing across healthcare, some age groups are more prone to pursue virtual care than others. A recent survey found that young patients (ages 18 to 24) are more receptive to telehealth, while those aged 35-45 said COVID-19 has not increased their use of telehealth services.2

For providers who have largely elder patient populations, there will likely be a need to familiarize patients with telehealth. Patients may have trouble requesting a visit online, entering their virtual visit room, updating forms online and/or accessing their post-meeting treatment plans. Physicians and their team should be ready and patiently willing to demonstrate how their telehealth platform works, to build patients’ comfort level with this form of care and to persuade those who are hesitant to try telehealth.

2. Staff proficiency and efficiency

Just as some patients will need more telehealth support than others at first, some staff members may need a bit of extra support to operate telehealth efficiently as well.

It’s important to stress telehealth training with every person on your team. Whether for online scheduling, ensuring patient information is provided and up to date, or billing and payment processing, your front-office team needs to be fully proficient with your telehealth service. Otherwise, there’s risk of double work being done at various points of the telehealth treatment cycle, not to mention a decrease in patient satisfaction.

To best ensure staff efficiency while offering telehealth, schedule regular trainings with your team, conduct a feedback survey with your patients to best understand how they are enjoying their experience, and most importantly, make sure you’re using the right telehealth tools.

Your platform should be more than simply HIPAA-compliant. It should be easy for staff and patients to use, and its connection needs to be reliable during every encounter, no matter where you or your patient are.

3. Telehealth compliance and regulations

The final post-COVID-19 telehealth challenge is to prepare for the changes in regulations and compliance that are likely to come. The requirements around communication devices3 and in-state licensure4 for telehealth have been lenient to promote physical distance and safety during COVID-19. As we better combat the virus, these leniencies will be replaced by more stringent requirements.

This will affect both pre- and post-visit operations, and the sooner you and your staff are up to speed, the better. Continue to keep an eye on CMS regulations for further updates regarding telehealth, but also be mindful of local guidelines. As new requirements are released, ensure your telehealth process is HIPAA-compliant, use the appropriate billing and reimbursement codes, and train your team on non-COVID-related codes, tools and processes to use going forward.

Navigating the new normal together

The good news about all the post-COVID-19 telehealth challenges is that they are common challenges many healthcare providers will face – and overcome – together. Healthcare has never been more united and forward-thinking than it is today, and while there are still many issues to resolve, there are even more accomplishments to be proud of and opportunities to seize, particularly in terms of implementing telehealth.

To continue learning how to best succeed with telehealth long term, click here.

 

Sources:

1 “Telehealth set for ‘tsunami of growth’, says Frost & Sullivan,” Mike Miliard, Healthcare IT News, Accessed July 28, 2020 https://www.healthcareitnews.com/news/telehealth-set-tsunami-growth-says-frost-sullivan
2 ”Survey: Americans’ perceptions of telehealth in the COVID-19 era,” Bill Siwicki, Accessed July 28, 2020 https://www.healthcareitnews.com/news/survey-americans-perceptions-telehealth-covid-19-era
3 “OCR Announces Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency,” HHS Press Office, Accessed July 28, 2020 https://www.hhs.gov/about/news/2020/03/17/ocr-announces-notification-of-enforcement-discretion-for-telehealth-remote-communications-during-the-covid-19.html
4 “U.S. States and Territories Modifying Requirements for Telehealth in Response to COVID-19,” FSMB, Accessed July 28, 2020 https://www.fsmb.org/siteassets/advocacy/pdf/states-waiving-licensure-requirements-for-telehealth-in-response-to-covid-19.pdf

 

ABILITY and design®, ABILITY® are trademarks of ABILITY Network, Inc.

Study shows disconnect between CMS infection control surveys and COVID outbreaks

A recent study of data from the Centers for Medicare & Medicaid Services (CMS) by the Center for Medicare Advocacy (CMA) has shown a disconnect between the results of CMS infection control surveys and outbreaks of COVID-19 within skilled nursing facilities.

Infection control citations

In mid-March, CMS announced that inspections would focus on infection control programs – in addition to cases of immediate resident danger – to help suppress the spread of COVID-19 within SNFs. A review of CMS inspection data by CMA showed that a very small portion of infection control surveys resulted in citations. Out of 5,724 infection control surveys performed from the March announcement through June 24, only 99 resulted in citations.1

Of the citations, 93 were marked as having minimal harm or potential for minimal harm, and three were marked as having a potential for minimal harm. The remaining three were marked as putting residents’ health and safety in immediate jeopardy. Thirty-five of the citations resulted in fines.

The disconnect between citations and infections

The concern raised by CMA has been raised by officials in many states, as well as by families of afflicted nursing home residents: With the high rate of COVID-19 cases in nursing homes, the low amount of citations – which translates to 2.4 percent of surveys – seems “implausible,” according to CMA officials. Through the end of June, more than 40 percent of COVID-19 deaths in the United States were related to skilled nursing facilities.2

The CMA’s review showed that several of the CMS infection control surveys that did not result in citations took place even as SNFs were in the middle of COVID-19 outbreaks. Three days after a passing survey at one California facility, there were 68 diagnosed COVID-19 cases documented. The staff refused to return to work over concerns for their safety, and members of the California National Guard were deployed to care for residents.3

Those eyeing the survey results give different causes for the disconnect between passing surveys and COVID-19 infections. Some say SNFs lacked access to the personal protective equipment needed to keep staff and residents safe. Others called out a lack of regular testing among residents and staff. One CMS administrator said the disparity between survey results and infection rates likely shows that SNF staff demonstrated compliance during surveys but failed to follow protocols when they were not under scrutiny.

Maintaining infection control programs

Amidst the COVID-19 pandemic, maintaining infection control protocol has become more important than ever in keeping residents and staff safe. The number of SNF deaths due to the pandemic and the results of the CMA’s data review could lead to further scrutiny of infection control programs or more stringent infection control program requirements.

SNFs can stay on top of regulations, infection control protocol and patient data with ABILITY INFECTIONWATCH. The application allows for easy tracking of McGeer criteria, infection reports and infection control measures. SNFs can tighten their vigilance against infections by customizing infection thresholds; when those thresholds are reached, an alert appears on the ABILITY INFECTIONWATCH dashboard so staff won’t miss the signs of an outbreak.

 

Sources:

1. “Special Report Additional Infection Control Surveys at Nursing Facilities Show Same Results: Few Deficiencies, Most Called ‘No Harm’; Poor Ratings on Nursing Home Compare,” Miriam Edelman, July 9, 2020, https://medicareadvocacy.org/wp-content/uploads/2020/07/Report-Coronavirus-Infection-Controls-Second-Batch-.pdf?emci=0f6236c7-f5c1-ea11-9b05-00155d03bda0&emdi=526f3f5a-0dc2-ea11-9b05-00155d03bda0&ceid=7801066.

2 “More than 40 Percent of U.S. Coronavirus Deaths are to Nursing Homes,” The New York Times, July 23, 2020, https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html.

3 “As Coronavirus Raged Through Nursing Homes, Inspectors Found Nothing Wrong,” Jack Dolan & Brittny Mejia, June 28, 2020, https://www.latimes.com/california/story/2020-06-28/coronavirus-nursing-homes-state-inspector-covid-19.

 

ABILITY and design® and ABILITY® and ABILITY INFECTIONWATCH® are trademarks of ABILITY Network, Inc.

CMS issues millions in infection control penalties to SNFs

The Centers for Medicare & Medicaid Services (CMS) has imposed more than $15 million in penalties on 3,400 skilled nursing facilities for failure to comply with infection control regulations in the midst of the COVID-19 pandemic. The announcement of the penalties comes with a warning to SNFs to stay vigilant in monitoring their infection control programs.

“Now more than ever, nursing homes must be vigilant in adhering to federal guidelines related to infection control to prevent the spread of infection disease, including COVID-19,” said CMS Administrator Seema Verma. “We will continue to hold nursing homes accountable and work with state and local leaders to protect the vulnerable population residing in America’s nursing homes.”1

Avoid CMS penalties

ABILITY INFECTIONWATCH can help your facility avoid costly CMS penalties with better infection control monitoring. This valuable application makes it easier for your facility to meet all CMS Requirements of Participation, and it allows you to quickly pull reports to meet the requests of surveyors. Using built-in national infection criteria, infection control administrators align facility data with reporting requirements consistently and efficiently.

Accurately track symptoms and infections

As COVID-19 continues to spread throughout the U.S., ABILITY INFECTIONWATCH helps you to protect against outbreaks utilizing your facility’s data. Monitor symptoms, track and report infections, oversee facility visitors and identify the sources of infections through the application. The convenient dashboard allows you to customize alerts so you are notified when your preset data points are reached.

Protect your facility

COVID-19 poses a real danger to SNF residents and staff. And never before have facilities been placed under such scrutiny. ABILITY INFECTIONWATCH provides the tools you need to protect your facility from a coronavirus outbreak. It also allows you to track, access and report the data required by CMS to reduce the risk of survey deficiencies and costly penalties.

Protect your facility from a potential outbreak – and potential financial penalties. Learn more about ABILITY INFECTIONWATCH now.

 

1. “Trump Administration Has Issued More Than $15 Million in Fines to Nursing Homes During COVID-19 Pandemic,” Centers for Medicare & Medicaid Services, August 14, 2020, https://www.cms.gov/newsroom/press-releases/trump-administration-has-issued-more-15-million-fines-nursing-homes-during-covid-19-pandemic

 

ABILITY and design®, ABILITY® and ABILITY INFECTIONWATCH® are trademarks of ABILITY Network, Inc.