Inspection follow-up finds all recommendations implemented

A recent follow-up inspection of the skilled nursing facility Mira Vista Court found that previous issues with accounting for direct care hours had been resolved.

In August of 2022, the OIG conducted an inspection of Mira Vista Court and found that 23% of the 799 reviewed payroll records inaccurately reported the number of direct care licensed nursing hours. OIG determined the error occurred because the facility was not accounting for all required meal breaks, resulting in overreported time spent with patients.

Mira Vista reported it used the Kronos timekeeping system to capture staff hours via fingerprint. If the employee failed to check in or the system malfunctioned, the payroll coordinator would manually enter hours as approved by the supervisor. This information is shared electronically with the Centers for Medicare and Medicaid Services each quarter.

During the follow-up inspection, it was found that Mira Vista had fully implemented the agency's recommendation to program Kronos to deduct one hour for meal breaks when a staff member works a shift of 16 hours or more to conform to the CMS requirement. Inspectors noted this change allowed the facility to report accurate and complete direct care licensed nursing hours more effectively and reduce the risk of noncompliance.