Managing Your Risk with HIPAA

There is a lot to unpack with HIPAA law. It may seem like it's more work than it's worth, but unfortunately, it needs to be addressed. HIPAA isn’t all bad. Did you know HIPAA can help you manage your risk in several ways?

  1. HIPAA Security Risk Assessments limit the likelihood of hacking incidents
  2. Policies and procedures limit the risk of improper use and disclosure of protected health information (PHI)
  3. Business associate agreements limit liability when your business associate violates HIPAA
  4. Implementing a HIPAA compliance program reduces the risk of fines

HIPAA Security Risk Assessments and Hacking

HIPAA Security Risk Assessments (SRAs) are important in improving your organization’s cybersecurity practices. While SRAs are an annual HIPAA requirement, there are other reasons to conduct yours.

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Meeting Residents Where They Are: Advocacy and Inclusion in Long-Term Care

Imagine a long-term care (LTC) facility that feels like home to everyone. A place where residents from all walks of life feel respected, valued, and comfortable expressing themselves authentically. This vision isn't just a feel-good aspiration; it's the foundation for delivering exceptional care.

LTC facilities can't afford to comply with minimum standards in today's diverse society. As an administrator and registered nurse, true quality care hinges on embracing diversity and fostering inclusion. This means going beyond regulations and creating a welcoming environment that celebrates each resident's unique needs and backgrounds.

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The Importance of Healthcare Compliance and Cybersecurity Training

Working in healthcare can be challenging for several reasons, but even more so when you’re not adequately trained on the various aspects of your job. When you’re heavily focused on training in the more technical aspects of your career, healthcare compliance and cybersecurity are often overlooked.

 Healthcare compliance and cybersecurity training are as essential to patient safety as clinical training. They ensure patient and employee safety through standardized processes.

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Show Me the Money: Understanding the link between MDS data and reimbursement

The MDS-Reimbursement Nexus

At its core, the MDS is a comprehensive assessment tool used to evaluate the health and functional status of residents in long-term care settings. However, its impact extends far beyond clinical evaluation. MDS data plays a central role in determining reimbursement levels for healthcare facilities, impacting funding from both government programs and insurance providers.

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Personality Change and Aging

According to the research, “Our personalities tend to change over time. This is inevitable and due, in part, to the aging process.” It can be observed with the shifting of our choices such as with music and culinary tastes. So why not take charge of it? The research further suggests that “with a determined approach, we can nudge ourselves toward healthy behaviors that keeps us sharp mentally and positive with age.” The key is in our power to imagine, to care and commit to a better life. The question, then, is it not at all possible to change a personality as we age and for the better? I believe that it’s possible if we choose to face the challenges that are ahead of us. The desire to change is, therefore, universal. The research declares, “that with intent and self-determination, a change in one’s personality can improve a relationship with family and friends, and with optimism and a view on life that is less pessimistic.”

Once again, the question is, who will you be in ten years? It is relatively easy to look back and note all of the “achievements” we have accomplished, then it is to look forward and try imagining how we can ever change or realize the possibility of achieving anything.

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Estate Sale Planning

Estate Sale Planning

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Navigating Change: The Journey of Software Implementation for SNFs

In today’s rapidly evolving healthcare landscape, skilled nursing facilities (SNFs) constantly seek innovative strategies to enhance resident care, streamline operations, and stay ahead of regulatory requirements. One significant step forward for SNFs is the decision to change software systems. While implementing new software can be daunting, it presents an opportunity to revolutionize how SNFs manage their daily operations. This blog post will highlight the considerations and best practices involved in transitioning from one software system to another and how your facility can navigate this change successfully. So, fasten your seatbelts as we embark on the journey of SNFs in changing software systems.

Needs Assessment & Vendor Selection
Start by identifying the specific needs and requirements of your SNF. Pinpoint the areas where the software can bring the most value, such as resident management, billing and financial, scheduling, clinical documentation, or reporting.

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Surviving Aging in a Graying America - (a societal look for surviving the crunch)

The title for this article asks two questions: can the elderly survive in a youth-oriented America? And does a healthy age exist in a growing older society?

America, a young and vibrant nation! Not necessarily so! We are young in years, 247 to be exact, but old with a prevailing and burgeoning aging population. We are, unquestionably, growing old. This can be validated by the following factors. One in particular is a major decline in the birth rate. This is, in part, attributed to (1) a delay in young couples getting married, (2) the high cost of living, (3) living in smaller dwellings, and (4) caring for an aging parent with complex medical issues. And let’s not forget an increase in a longer life expectancy, the rise of the baby boomer generation (1946-1964) and a vast growing elderly population, 65 and older.

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Ensuring Effective Compliance in Healthcare

On November 6, 2023, the Office of Inspector General (OIG) released an updated General Compliance Program Guidance (GCPG) manual, the first significant update in 15 years. The updates made provide clearer guidance on what an effective compliance program is, and how healthcare organizations can implement them.  The following seven elements make up an effective compliance program. 

  1. Written policies and procedures
  2. Compliance leadership and oversight
  3. Training and education
  4. Effective lines of communication with the Compliance Officer and disclosure program
  5. Enforcing standards with consequences and incentives
  6. Risk assessment, auditing, and monitoring
  7. Responding to detected offenses and developing corrective action initiatives

Written Policies and Procedures
Policies and procedures outline how your organization and employees are expected to behave. In healthcare, policies and procedures are essential for several reasons. They ensure that patient information is handled correctly and secured, help to create a safe work environment for employees while protecting patients, and ensure ethical billing practices by preventing fraud, waste, and abuse.

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Nutritional Awareness and Aging

According to current research, 1) “the elderly tend to overconsume empty calories, 2) remain undernourished and 3) can cause a biological imbalance with a selection of foods.” Nutritional patterns that are held by the elderly don’t always reflect healthy dietary practices regarding the choice of foods. Nutritional awareness involves 1) a proven learning process concerning the numerous varieties of appropriate foods that are readily available, and 2) can bolster the body’s response and ultimately, an improvement in nutrition.

Economic considerations and a lack of mobility can, unfortunately, place the older person in what dietitians call “a serious nutritional jeopardy.” Eating habits that evolve from early childhood tend to encourage specified dietary choices. Although these diets are primarily favored by the elderly, they don’t necessarily provide healthy meals. Store bought foods that are prepared as a “fast food” are often purchased for convenience instead of health. Fast foods may satisfy the palate but will also contain excessive salt, high saturated fats and refined sugars. In addition, caloric consumption also needs to be decreased while the need for healthy nutrients should not!

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SNFs, Start Playing Offense! How to Put CY24 Managed Care Changes into Action

January 1st kicked off a new year; and for skilled nursing facilities and Medicare Advantage beneficiaries, this new year offers big opportunities to get the access to care needed. Powerful changes included in the Medicare Advantage (MA) Contract Year (CY) 2024 Final Rule went into effect on 1/1/2024.

Biggest Changes Beginning 1/1/24

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Critical Decision-Making Within an Ever-Changing Market

With a shifted focus, facilities have begun to navigate the new normalcy of the Healthcare Staffing industry—a focus filled with a heightened sense of responsibility for priorities such as financial sustainability and clinician quality amidst an unbalanced, ever-evolving market.

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Rethinking our Open-Door Policy

In our dedication to being approachable leaders, many of us have adopted an open-door policy. However, is it always beneficial? Our role as administrators demands a blend of addressing urgent needs and strategic foresight, which can be disrupted by a constant stream of interruptions, negatively affecting our focus and decision-making capabilities.

Research suggests it takes over 20 minutes to fully regain concentration after a distraction. It’s a tough dilemma in our field, where every decision impacts lives. How can we balance this?

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Don’t Wait: UPS Holiday Shipping Deadlines Approaching


With only a few days left before the last day to ship deadline, it's not too late to get your shipments delivered before the holidays. Use the UPS Year-End Holiday Schedule to help get your packages to loved ones – or customers on time and intact with the speed you need.

Sign up for a new account or login to your existing account to make ensure you are taking advantage of your ACHCA UPS Savings Program discounts.


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TPE Is Here! Top 5 Tips to Prepare Now

Earlier this year, CMS announced the start of the Skilled Nursing Facility (SNF) 5-Claim Probe and Educate Review program. This is in response to a 15.1% increase in improper payments for 2022 services, as projected by the Comprehensive Error Rate Testing (CERT) program—likely driven by the change in payment model from Resource Utilization Group (RUG) IV to the PDPM (Patient-Driven Payment Model) in October 2019.

As a result, CMS has directed all Medicare Administrative Contractors (MACs) to conduct a pre-payment review of five SNF claims for all providers nationwide, with few exceptions. Unless your SNF is already under medical review or is considered a low-volume provider (fewer than five Part A claims per calendar year), you will be subject to the Targeted Probe and Educate (TPE) program and may have already received notification from your MAC.

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Understanding HIPAA Obligations Key to Preventing Fines

Healthcare organizations have an obligation to patients to protect their sensitive information, which is why HIPAA compliance is vital. Organizations that are HIPAA compliant not only protect their patients but also their business’ reputation. Two recent Office of Civil Rights (OCR) settlements highlight the importance of compliance.

In one case, a medical center came under fire for disclosing patient information to a news reporter. The other case involved poorly implemented security measures, ultimately leading to a ransomware attack that exposed sensitive patient information.

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19 Questions you need to ask to build a Generative AI Cybersecurity Policy

Are your employees putting your business at risk with AI?

At Model, we assist numerous clients with their Cybersecurity Compliance Frameworks and Policies. Model utilizes a leading vCISO Compliance tool that recently introduced a Generative AI Cybersecurity Control. I thought you might be interested in seeing the list of questions it raises:

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3 Tips for a Successful Holiday Shipping Season


Let our UPS Savings Program give you the tools you need to prepare and manage all of your shipments so that you can ensure your packages arrive on time and as expected.

Use these 3 tips to help optimize your holiday outcomes:


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Is Your Revenue At Risk With The New MDS?

To be frank, the implementation of the Minimum Data Set (MDS) 3.0 version 1.18.11 assessment did not go as smoothly as most had hoped. Even the most prepared providers could not have anticipated stumbling through continuous electronic medical record (EMR) glitches, overlapping with twenty-one (21) errors in the MDS RAI Manual version 1.18.11 identified by the Centers for Medicare and Medicaid Services (CMS), and issues submitting MDS assessments into Internet Quality Improvement & Evaluation System (iQIES).

How Did Errors Impact Providers?
EMR errors were not specific to any one vendor, CMS said all EMR vendors experienced problems. To illustrate the magnitude and complexity of errors providers encountered; one-month post-implementation of the MDS 3.0 version 1.18.11, one of the most prominent EMR software’s in the US continues to investigate unresolved errors, releasing a multi-page document detailing the status of resolutions. So, what’s going on? Across multiple software vendors, providers reported significant complications:

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Crisis, Stress and Aging

An 89-year-old woman told her daughter, “Please don’t hide the truth from me. At my age, I can cope with just about anything. It’s the uncertainty that I can’t understand.”

Crisis and stressful situations occur throughout life but are thought to be more devastating in the later years when one may begin experiencing a slowing and/or decline in mental reserve. Therefore, whenever a crisis is coupled with cumulative stress, it tends to stretch the limits of one’s coping capacity. What can emerge is helplessness, lack of self-control and eventually, dependence on others.

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