Changes to ACFI validation - how to reduce your risk
We don’t over-claim, so we should be okay? Right?
Our position is that national downgrade rate is not because of fraudulent activity, but largely because of administration, lack of supporting evidence or a misinterpretation of the guidelines… and that it’s entirely preventable.
Below are some system related issues that might help identify if there’s any risk that should be addressed:
- Residents eat their meals in their rooms
- There is no living document of all residents receiving complex health care procedures
- There is no documented process regarding a specific order of charting and clinical assessments
- Care plans are not reviewed in their entirety and updated prior to submission
- Q11 Medication and Q12 Complex Health Care claims are a mathematical impossibility
- Assessments and supporting evidence are not printed out at the time of appraisal
- Pain management claims include application of heat packs for 20 minutes per week
- There’s been previous question downgrades (even if there was no financial decrease)
One single-category downgrade in the ADLs domain can be a reduction in annual funding of over $15,000 (and could be entirely preventable).
If you are looking to reinforce your ACFI skills and give yourself or your team a refresher without too much hassle, you might want to consider our ACFI Bundle of online courses which include the following 13 modules.
- ACFI Basics
- ACFI Activities of Daily Living
- ACFI Cognition and Behaviours
- How to accurately complete the PAS (Psychogeriatric Assessment Scales)
- ACFI Cornell Scale for Depression in Dementia (CSSD)
- ACFI Complex Health Care
- ACFI Recording and Documentation for Carers and Enrolled Nurses
- ACFI Business Rules and Planning
- How to complete an ACFI Appraisal Pack
- ACFI Validation Trends and Changes
- Safe and Effective use of Heat Packs
- Test Your ACFI Knowledge Part 1 – Clinician
- Test Your ACFI Knowledge part 2 – Coordinator