Medicare Compliance & Reimbursement

 "Operation Spot Check" in Florida leads to big citations.

Your compliance efforts could pay off when you least expect it.
     
That's what many Florida long-term care facilities are discovering through "Operation Spot Check," an initiative that conducts unannounced compliance inspections across the state.
     
Here's why you can't afford to let compliance take a vacation: A surprise visit to Pensacola, FL-based Willow Grove Assisted Living Facility - owned by North Florida Living Facilities Inc. - allegedly turned up three problems: staffing levels below the minimum requirement, Medicaid claims for days when recipients were absent from the facility, and convicted felons on the payroll providing personal services to disabled beneficiaries.
     
According to state Attorney General Charlie Crist, a civil complaint was filed Oct. 21 under the Florida False Claims Act seeking more than $15,000 in damages.
     
"Although criminal charges have resulted from previous Spot Check operations around the state, this is the first lawsuit generated," Crist said. "It is also the first time monetary penalties have been sought to remedy violations of law," he added. Lesson Learned: More unannounced check-ups from law enforcement may justify the cost of maintaining compliance.