OIG inspectors recently reviewed payroll records from a skilled nursing facility to determine if the hours of direct care provided by licensed nursing staff were accurately reported. During the inspection, it was determined that Winchester Lodge Healthcare Center had accurately reported hours worked on 88 percent of the 514 records under review. However, there was a concern that the facility did not have documented processes for reporting complete and accurate direct care licensed nursing hours to the U.S. Centers for Medicare and Medicaid (CMS) through the Payroll-Based Journal reporting system. As a result, Winchester:
- Overreported and underreported some direct care licensed nursing hours worked.
- Inconsistently accounted for required meal break deductions.
Additionally, Winchester did not consistently maintain complete payroll records to document all direct care licensed nursing hours worked or the number of direct care hours worked by administrative staff.
