National Corporate Compliance Project Completed: A New Guide to Developing SNF Compliance Programs Is Now Available

In late 2008, the American Health Care Association (AHCA) hired our firm to revise and update AHCA’s Comprehensive Guide to Developing SNF Corporate Compliance Programs, published by AHCA in 2000 and updated in 2002. I suppose we were chosen because I had the dubious distinction of being the primary author of both the 2000 compliance manual and the 2002 updated version published by AHCA.

But this time, in tandem with AHCA staff, we decided to try something different. Rather than create another massive hard-copy manual containing everything you ever wanted to know about compliance, as we did in 2000 and 2002, we joined the 21st century and turned to technology.

Beginning in the late fall of 2008, we created, taught and then posted on the AHCA website a monthly series of webinars about compliance programs and accompanied each webinar session with detailed text about that month’s topic. We covered in an updated fashion all the key issues from the original AHCA compliance manual, including how to set up and operate the mechanical aspects of an SNF compliance program. Those sessions dealt with compliance officers and committees, systems for employees to report suspected compliance violations, employee training on applicable laws and the compliance program itself, and the other mechanical or process elements of a compliance program that actually make the program run.

Then we turned to the guts of the compliance program – an explanation of the federal laws with which SNFs must comply. Based on the Office of Inspector General’s 2008 Supplemental Compliance Guidance for Nursing Facilities, we summarized in detail each of the 18 risk areas identified by the OIG as its primary areas of focus in SNF operations, including such old favorites as the False Claims Act and kickbacks and newer focus areas like quality of care, privacy and hospice services, among others. For each risk area, we provided a sample “auditing and monitoring tool” to help SNFs assess their compliance level. This was phrased in a question-and-answer format which the facility can use to assign specific auditing inquiries and tasks to relevant staff. For each of these topics, we created an archived one-hour webinar taught by me and guest speakers from around the country experienced in SNF compliance issues (you can log on and listen to these), accompanied by the slides from that session and the detailed web text explaining the law and the sample auditing tool.

In November 2009, after a long year of planning, drafting and teaching, we completed the last monthly installment in the series. And, it seems, not a moment too soon, since both of the major health care reform bills pending in Congress propose mandatory corporate compliance programs for at least some SNF providers. How much of that will survive the health care reform debate, and whom it will cover, remains to be seen. But the OIG has been pushing for mandatory compliance programs for some time, and most D.C. pundits say they’ll get it now, at least in some format.

So, if you haven’t developed your compliance program yet, or you developed one, but stuck it on the bookshelf and haven’t reviewed or revised it in a while, now would be a good time to dust off the cobwebs. Many of the more than 700 people who attended our monthly webinar sessions appreciated this approach to teaching compliance. They found it easier both to grasp and to reteach at their facilities. That was precisely our goal.

The entire compliance series is available on the AHCA website at www.ahcancal.org and can be accessed there by AHCA members.