Contract Therapy Compliance
Common False Assumptions About Contract Therapy Compliance and Quality

Common False AssumptionsMany facilities assume that because they are obtaining service under arrangement (under contract), that the risk of problems with therapy has been shed to the contract therapy vendor. But, as the facility is the provider of service, the risk remains with the facility, which left unchecked, could leave big holes in your cash and reputation, and residents with too little or too much service.

The best that the vendor can do is assist in managing that risk through its contractual obligations to the facility and business approach. To assist with risk assessment, some of the more common misconceptions about contract therapy risk management are listed below. For help in managing risk, click here or simply contact Marden.

A Quality Program Is In Place. Adequate adherence to compliance and quality therapy practices is more than a set of rules – it’s a business approach. Organizational size is no indication of business ethics or quality. Throughout these sections, we review specific areas of interest, taking the mystery out of contract therapy services so that any skilled nursing facility can be an informed consumer.

Insurance Coverage Is Adequate. “My vendor is insured so we are covered.” Not quite. One of the bigger risks is the one that comes with credentialing – an unlicensed or ineligible person treating in the facility. If non-licensed or otherwise ineligible service is delivered, that service and all related services are non-billable and must be refunded. That means for example, the RUGs rate may be adjusted for all patients who received treatments, and that can quickly add to the hundreds of thousands of dollars, not to mention the civil lawsuits. Malpractice insurance does not cover treatments by unlicensed or ineligible staff.

Contractual Obligations Will Suffice. While in many instances this is true, if a facility’s repayment to the government is in the six figures, such as the occurrence described above, the vendor may not have adequate resources to contribute to the settlement.

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