OIG inspectors discover errors in reported nursing home staff hours

A recent OIG inspection of Westchase Health and Rehabilitation Center found the facility accurately reported 85 percent of reviewed records; however, the facility lacked standard timekeeping procedures. 

The inspection, which reviewed 964 payroll records dating from January 1, 2021, through June 30, 2021, determined that the facility did not have a consistent process for documenting direct care hours provided by licensed nurses. When questioned about the process, Westchase managers outlined the facility's multiple methods to register hours spent with clients. However, each of the outlined methods resulted in errors when tested, resulting in the OIG being unable to verify the accuracy of presented reports. This inconsistent documentation method resulted in over-reporting and under-reporting direct care hours spent with clients, leading to errors in claims sent for payment. To address concerns with Westchase's documentation, OIG inspectors recommended the facility implement a quality review process to verify that submitted records are complete and all information is correct.

Inspectors also noted that Westchase did not keep records of daily staffing for nurses with required information, including the facility name, date, total number of nursing hours, staff schedule and resident census. The facility is required to post this information in a location accessible to residents, staff and visitors and maintain this record for no less than two years. OIG inspectors recommended the facility develop a process to collect this data and post the information as required. Staffing accountability and documentation are essential for the OIG to verify that the facility is compensated correctly for delivered services. 

Upon providing the inspection results, Westchase management agreed with all OIG inspector's recommendations, indicating corrective actions would be completed in September 2022.