By Walter S. Wheeler III, Esq. and Carey F. Kalmowitz, Esq.

Presented to the Michigan Association of Homes and Services to the Aging, October 2008.

On September 30, 2008, United States Department of Health and Human Services Office of Inspector General (the ?OIG?) published further recommendations in its Supplemental Compliance Program Guidance for Nursing Facilities (the ?Supplemental Guidance? or ?2008 Guidance?). The Supplemental Guidance reflects the above-noted transformations in the way nursing facilities deliver, and receive reimbursement for, health care services, as well as the intensification of federal enforcement activity and increased concerns about quality of care in nursing facilities. Together, the original and supplemental guidelines identify risk areas that will assist to nursing facilities to evaluate and refine their current compliance program, or develop a new program.

This article reviews the Supplemental Guidance with an emphasis on the areas of risk identified by the OIG, the need for compliance programs in nursing facilities, and the recommendations for reducing risks. This article also will discuss certain practical steps which, while not specifically addressed in the 2008 Guidance, can substantially increase the likelihood of a nursing facility remaining compliant, especially if adopted as part of a comprehensive compliance plan that also incorporates the OIG?s recommendations.

Download Article