We map a systems approach to antipsychotic use in nursing homes, from admission screening to documentation, coding, and survey readiness. Our goal is a practical stewardship model that protects residents, preserves data integrity, and withstands CMS scrutiny.

• facility assessment confirming behavioral health capacity
• pre-admission screening and verified diagnoses
• CMS exclusions and how to document them
• pharmacy reconciliation and indication clarity
• ordered vs administered tracking with exception flags
• alignment of claims, MDS, and ICD coding
• nonpharmacologic strategies and target behavior tracking
• gradual dose reduction considerations for long-stay residents
• hospice-related use and how to explain it
• education plans for nurses, providers, and billing
• antipsychotic stewardship led by the compliance committee
• escalation to psychiatric and neurocognitive specialists

Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs

We unpack how CMS will monitor antipsychotic use in nursing homes, why the national average is changing, and what datasets will be cross-checked to produce public quality measures. We set the stage for part two, where we dig into practical steps to strengthen documentation, data integrity, and care processes.

• OIG findings and the CMS refocus 
• reasons for increased oversight and risk signals 
• how MDS and claims will be cross-referenced 
• shift in national average to 16.98% 
• implications for star ratings and care compare 
• focus on accurate capture, verification, and data integrity 
• preview of nuts-and-bolts actions in part two

Please feel free to reach out to Verity Consulting at Verity Team.com if you'd like further assistance with your healthcare compliance needs

We trace how OIG’s guidance elevates patient safety and quality from ideals to daily compliance work, and share lessons from Corporate Integrity Agreements that separate paper programs from living systems. Practical tools, clear dashboards, and a culture of “why” turn metrics into safer resident care.

• OIG focus on quality and patient safety as compliance outcomes
• Building a facility framework with clear indicators and thresholds
• Using dashboards to measure, share, and act on trends
• False claims risk tied to substandard care and billing
• Lessons from external monitoring and CIAs
• Culture of inquiry at board and frontline levels
• Resources from CMS, AHRQ, and NIH for frameworks
• Root cause analysis for falls and adverse events
• Competency alignment with acuity and specialized units
• Walking rounds for real-world validation of safe practice

Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs

We unpack the OIG’s nursing facility guidance on compliance education and show how to move from generic modules to risk‑based, competency‑driven training that protects residents. We connect risk assessments, CMS alignment, and real‑world methods like Gemba rounds to build proof of learning and safer care.

• annual, data‑driven risk assessment guiding training focus
• tailoring education to resident populations and high‑risk services
• aligning CMS requirements of participation with OIG expectations
• proving competence with skills checks and just‑in‑time coaching
• clear access to compliance officer, committee and safe reporting
• onboarding and validating temporary and contracted staff
• department‑specific and board‑level training needs
• multilingual, culturally aware materials for a diverse workforce
• enforcement, remediation and meaningful incentives for completion

Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs

We examine how the federal shutdown disrupts nursing home oversight, why CMS triaged surveys to emergencies, and the risks created by fewer inspectors and furloughed staff. We share steps facilities can take to protect residents, drawing lessons from the OIG’s pandemic report.

• status of the shutdown and date context 
• CMS priorities for complaint investigations and revisits 
• suspension of recertification and initial surveys 
• state surveyor staffing gaps and missed annual surveys 
• risks from reduced oversight, abuse and neglect concerns 
• lessons from the June 2024 OIG report 
• contingency planning for monitoring, QAPI and communication 
• expectations for future cause-and-effect reporting

Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs

We examine how CMS F841 and new OIG oversight raise expectations for nursing home medical directors, demanding visible engagement, better policies, and data-informed leadership. We share field lessons on antipsychotics, facility assessment, and building dashboards that support real accountability.

• CMS shifts from F501 to F841 and clarifies medical director duties
• OIG focus on engagement, visit frequency, and compensation integrity
• Risks of absent or passive medical directors in daily care
• Antipsychotics oversight, diagnostic accuracy, and documentation alignment
• Hands-on leadership beyond QAPI with nursing and administration
• Facility assessment that reflects the real resident mix and needs
• Data and AI dashboards to drive timely, targeted action
• Contracts, coverage, and accountability that sustain engagement

Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs

Accurate MDS completion has become a regulatory lightning rod as the OIG and CMS intensify their scrutiny of long-term care documentation. This shift isn't merely procedural—it signals a comprehensive effort to identify potential fraud and ensure residents receive appropriate care based on accurate assessments.

The recent OIG work plan specifically targets resident falls resulting in major injuries, with investigators cross-referencing hospital claims against facility MDS documentation. When surveyors identify three or more examples of inaccurate MDS completion—now defined as a "pattern"—these findings may trigger referrals to OIG regional offices for fraud investigations. Beyond falls, diagnoses like schizophrenia are receiving particular attention, as inaccurate coding can significantly impact care approaches and medication regimens.

For facility leaders, this heightened scrutiny demands a systematic response. Start by ensuring your MDS coordinators have proper certification and education, then verify that all staff contributing documentation understand what they're recording. Implement regular audits to catch discrepancies before they become patterns, and foster interdisciplinary communication so different departments use consistent language and observations. Your compliance committee should conduct risk assessments, particularly for resident populations with high fall risks or complex diagnoses, and report findings transparently during QAPI meetings.

The stakes couldn't be higher—inaccurate MDS completion affects not just regulatory compliance but also reimbursement rates, Five-Star ratings, and most importantly, resident care quality. By strengthening your documentation systems now, you'll protect both your residents and your organization from the consequences of this unprecedented regulatory focus. Need guidance navigating these changes? Reach out to Verity Consulting for specialized assistance with your healthcare compliance challenges.

OIG 2023-2024 Compliance Guidance for Long Term Care Facilities is summarized to highlight importance of a compliance committee and the responsibility to assist the chief compliance officer to develop a robust facility risk assessment. From that assessment the committee would need to develop meaningful and accessible policies and procedures to guide all levels of the facility staff and consultants of their roles and responsibilities in maintaining healthcare compliance.