MDS Alert
Beware--Auditors Can 'Stumble' Across Your OMRA Missteps
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Don't let undetected snafus wreak havoc.
An unintentional pattern of errant OMRAs that tip the payment scales in your facility's favor can turn into a major compliance headache. "For example, an FI selected one facility for a probe review due to its high volume of Medicare days and ultra-high rehab residents," says Theresa Lang, RN, BSN, PHN, RAC-C, WCC, a consultant with Specialized Medical Services in Milwaukee. "But the reviewers are identifying OMRAs that should have been done--or that were done incorrectly--in ways that benefited the facility," Lang tells Eli. "In another case, the OIG has gone onsite and copied charts related to inappropriate OMRAs."
A facility's problems with the OMRA are often due to a disconnect between the clinical and billing side, in the experience of Nancy Augustine, RN, MSN, a consultant with LTCQ Inc. in Lexington, MA, who has done audit work for the OIG. (For strategies to ensure your facility bills OMRAs correctly, see the April 2006 MDS Alert.)
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