Case Studies

Compliance Audit of a Skilled Nursing Facility (SNF) Chain

SITUATION
Nationwide group of skilled nursing facilities (SNFs) and assisted living facilities (ALFs) headquartered in southern California.

SOLUTIONS
HFS Consultants acted as the Independent Review Organization (IRO) to report to the federal government on this group's compliance with Medicare regulations. Over a three-year period, HFS Consultants performed claims reviews, systems reviews and compliance reviews and reported the results to the US Department of Health and Human Services Office of the Inspector General (OIG). HFS Consultants worked closely with the client to minimize demands on their staff time while still fulfilling the role of an IRO.

RESULTS
The client was in almost full compliance with the regulations and appreciated the reasonable fees charged by HFS Consultants.