On November 22nd, 2013, the New York State Office of the Medicaid Inspector General (OMIG) released a set of audit protocols to provide Assisted Living Programs (ALPs) with evaluating their compliance with Medicaid requirements. The audit tool contains guidance on:
- Missing Patient Record
- Missing Medical Evaluation
- Missing/Invalid Signature on Medical Evaluation
- Missing Interim Assessment
- Missing/Invalid Signature on Interim Assessment
- Missing Plan of Care
- Missing Date and/or Signature on Plan of Care
- Missing Nursing/Functional/Social Assessment
- Missing Date and/or Signature on Nursing/Functional/Social Assessment
- Missing Patient Review Instrument (PRI)
- Missing Date and/or Signature on Patient Review Instrument (PRI)
- Incorrect PRI Level Claimed – Determined by PRI Certified Nurse
- No Service Rendered
- Missing Service Documentation
- Incorrect Rate Code Billed
- Billed for Services While Inpatient at Another Facility
- Failure to Complete Minimum Training Requirements
- Missing Certificate of Immunization
- Failure to Complete Required Health Assessment
- Missing Documentation of a PPD (Mantoux) Skin Test or Follow-Up
- Missing Personnel Records
- Failure to Complete Annual Performance Evaluation
This protocol is effective November 22, 2013.
