Accreditation Statement: AMDA – The Society for Post-Acute and Long-Term Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
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ABPLM Designation Statement: This Internet Enduring Material has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for a total of 1 management hour toward certification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. The CMD program is administered by the ABPLM. Each physician should claim only those hours of credit actually spent on the activity.
Session Description: Pennsylvania is the first state to prohibit long-term care providers from knowingly seeking payment for preventable serious adverse events that occur within their facilities. This session will explore Pennsylvania's new law, consider the recent report from the Office of Inspector General (OIG) regarding Serious Adverse Events, and discuss the implications for the potential expansion of these policies to other states and payers. In addition, the session will consider best practices for reducing the occurrence of adverse events.
Anticipate the development of non-payment policies for long term care serious adverse events based on recent legislation in Pennsylvania as implemented by the State's Bulletin on Preventable Serious Adverse Events
Compare Pennsylvania model to that of the Centers for Medicare and Medicaid (CMS) regulations for Medicare adverse events
Explain how Pennsylvania providers are proactively implementing changes to avoid adverse events in long term care setting
Analyze the types of serious adverse events considered to be preventable by the Pennsylvania Medicaid agency
Speaker(s): Paula G. Sanders, JD J. Kenneth Brubaker, MD, CMD
Reference(s): Office of Inspector General, Department of Health and Human Services. Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries, OEI-06-11-00370. (Feb. 27, 2014). Retrieved 7/16/2014 at https://oig.hhs.gov/oei/reports/oei-06-11-00370.pdf. Office of Inspector General, Department of Health and Human Services. Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements, OEI-02-09-00201. (Feb. 27, 2013). Retrieved 7/16/2014 at https://oig.hhs.gov/oei/reports/oei-02-09-00201.pdf. Office of Inspector General, Department of Health and Human Services. Compendium of Priority Recommendations. (March 2014). Retrieved 7/16/2014 at https://oig.hhs.gov/reports-and-publications/compendium/files/compendium2014.pdf. Office of Inspector General, Department of Health and Human Services. Inappropriate Payments to Skilled Nursing Facilities Cost Medicare More Than a Billion Dollars in 2009, OEI-02-09-00200. (Nov. 9, 2012). Retrieved 7/16/2014 General, Department of Health and Human Services, Work Plan for Fiscal Year 2014 (2014) Retrieved 7/16/2014 at https://oig.hhs.gov/reports-and-publications/archives/workplan/2014/Work-Plan-2014.pdf.