Nursing Home Compliance

Key Components of Nursing Home Compliance

There are federal minimum standards for skilled nursing home compliance that define residents’ rights. Effective compliance programs address resident safety and quality reporting to reduce an organization’s financial and legal risk.

Nursing homes have various challenges regarding regulatory compliance. Facilities violating requirements could face the following consequences:

  • Denial of Medicare and Medicaid funds
  • Monetary penalties
  • Loss of licensure

A comprehensive compliance program addresses the following elements:

Oversight Management

Designate qualified individuals, such as board members, managers or the chief executive officer, to provide program oversight and oversee anonymous reporting of suspected violations. Management must establish a culture of compliance.

Education and Training

Effectively communicate program standards to staff members, vendors and volunteers. Make training and orientation programs mandatory.

Monitoring and Auditing

Develop ongoing auditing and monitoring to detect and prevent noncompliance. Focus on high-risk areas to minimize your organization’s risk.

Enforcement of Standards

Consistently enforce the set standards with appropriate disciplinary actions. Include consequences for failure to report violations as well. If you discover a breach, respond appropriately to prevent future problems.

Perform an annual risk assessment and ensure your liability insurance policies provide adequate coverage to meet risks. Communication, training and up-to-date insurance are vital components in achieving skilled nursing home compliance and optimal health care experience for residents.