Celebrating Nurse Assistants

Let’s take a moment to celebrate some of the unsung heroes of our healthcare industry! Let’s celebrate Nurse Assistants! 

We have been celebrating Nurse Assistants for the past couple months due to Covid-19, but did you know there is a true nurse assistant holiday that has been alive since 1977? It starts with a day of appreciation on the Thursday of the second full week of June followed by celebration for another 6 days. 

How did this celebration start? The CNA profession started the same time that World War I started. These CNA’s served alongside Army Nurses and helped in many areas such as hospitals, the army field and reserve, and the bases as well. It wasn’t until six decades later that CNA’s really blossomed as President Ronald Regan signed the Omnibus Reconciliation Act of 1987 which was an act to improve nursing homes. Now we see CNA’s everywhere and because of their hard work, they get a whole week dedicated to them every year.  

What positions or titles count as nurses assistants? There are many different titles and positions given and all of them are equally important to one another. We all know the Nursing Assistant, but do we think about Nurse Aides? Other titles include Direct Care Worker, Health Care Assistant, Personal Care Assistant, Hospice Aide, and many other titles. They all have one purpose which is to take care of people so be sure to remember these titles and go show your appreciation to someone you know. 

How can we celebrate these nurses? How can we show that we see them and know how important their role is? If you work in a hospital or somewhere alongside CNA’s, host a hospital wide event for them. Get the whole staff involved by making pins or buttons for everyone’s uniforms. Bring your local city leaders to their workplace and let the CNA’s know how much they help the community. Doing these things let them know we care about them and it will motivate them to perform even better. 

What are some ways we can say “Thank You” to the CNA’s? A great way to do that is on social media. Post an appreciation post or photo for someone you know who is a CNA or just about CNA’s in general. Getting the word out like that will make everyone want to thank them. You can also have your clubs, workplace, or other groups take a little time to write thank you notes and letters. Let them know you really care and are grateful for all they do. 

There are many other things I could talk about, but I just want everyone to remember CNA’s and what they do for us. If you take anything away from this, I hope you take these 3 things: 

  • Go learn about THEM and their history
  • Make time to recognize THEM and the hard work they do every day
  • Say “Thank You” to THEM every chance you get

They deserve our love because without THEM, our healthcare would be affected immensely.

https://www.joincake.com/blog/national-nursing-assistants-week/
https://cna-network.org/2020/04/25/42nd-annual-national-nursing-assistants-week/

Anatomy of an OIG Record Part II

From the oig.hhs.gov website.

“OIG is required by law to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: Medicare or Medicaid fraud, as well as other offenses related to the delivery of items or services under Medicare, Medicaid, SCHIP, or other State health care programs; patient abuse or neglect;  felony convictions for other health care-related fraud, theft, or other financial misconduct; and felony convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances.”

Sometimes an individual who has been in trouble will move to another state and attempt to resume or practice their medical profession. Such was the case with Laura Lynn Bell, who also went by the name Sukanlaya Hughes.

Laura Bell was a nurse in Arizona when her license was suspended in 2015 for domestic violence arrest among other things. From there she went on to defraud Veteran Affairs of almost $800,000. Without a license, and with charges against her, Laura attempted to steal an identity, forging documents and papers in the name of Alicia Houston. This was a skill she was already adept with since she stole identities of nurse practitioners and former patients to bill for medical services while working for VA.

A quick glance on nursys shows Laura Bell was able to practice nursing in six different states with a seventh as an applicant for a nurse practitioner in North Dakota before she was caught and her licenses revoked.

People like Laura Bell must be carefully scrutinized because they do what they can to slip under the radar and emerge somewhere else where they can continue to harm the people they look after. This makes it essential to check against databases such as the Federal OIG because these databases allow checks by SSN. Undoubtedly there will be those who find a way to change their social security numbers, but the extra precaution might unearth clues to things behind the scenes.

Sources

https://www.azfamily.com/archives/arizona-nurse-indicted-after-scamming-thousands-of-dollars-from-insurance-companies/article_fdc4eec5-1678-572d-8441-2dcbc0f691fc.html

https://www.bizjournals.com/phoenix/news/2019/01/02/chandler-nurse-practitioner-indicted-over-alleged.html

https://www.nursys.com/

Anatomy of an OIG Record

The responsibility of the Office of the Inspector General (OIG) is the following:

  • Oversee the economy, efficiency, and effectiveness of the administration of SSA programs.
  • Prevent and detect fraud, waste, and abuse in SSA programs and operations.
  • Inform SSA and Congress about agency problems and deficiencies and recommend corrective action*

At TyphoonDATA, we use the exclusion database provided by the United States Department of Health and Human Services (HHS) to search for those who may have had disciplinary actions in the past and are no longer eligible for SSA programs.

Let’s take a look at two people on the exclusion list.

Charles Esechie worked at Baptist Home Care Providers (Baptist) in the Houston area for a man named Godwin Oriakhi. While there, Esechie knew Oriakhi was operating an illegal kickback scheme. In fact, he also knew a few of the patients there were homeless and were referred to Baptist by recruiters.

Not only did he know, but eventually Esechie became part of the schemes when he defrauded Medicare by submitting fraudulent claims. Sometimes, he’d claim to be working Baptist when in reality he was working at a hospital. To cover for this, Esechie copied patient information from set templates given to him by Oriakhi and by others working at Baptist.

By the time Esechie and Oriakhi were caught, they had defrauded approximately $4,792,199 in false claims.

Many similar cases exist and it is up to departments like the OIG to discover, report, and exclude these individuals who are working the system to their advantage. 

Evelyn Mokwuah of Pearland, Texas was caught in a similar scheme. She worked at Beechwood Home Health and Criseven Health Management Corporation where evidence at trial showed she defrauded Medicare of millions in fraudulent claims. Like Esechie, Evelyn was involved with recruiters who went out to find Medicare beneficiaries, claimed falsified information on patients, and billed for patients who did not qualify for services.

All total, Mokwuah was convicted of $20 million in the scheme.

As seen above, one or two individuals alone could cost Medicare millions. These are just two examples among the many that occur each year not including those who have not been discovered.

Both Charles Esechie and Evelyn Mokwuah are on the federal OIG exclusion list and because TyphoonDATA checks these lists as well as other databases such as System for Award Mangement (SAM),  these individuals will get flagged and marked.


 *    https://oig.ssa.gov/about-oig

The Effects of COVID-19 on Our Industry

It seems like right about now, just about everything in our lives has some sort of interruption–from laundromats, to restaurants, to background screening companies. We’re all feeling the effects of COVID-19. 

Typhoon Data has been making sure to stay aware of any interruptions this may cause for us and our partners. And, we’re happy to report, there aren’t many. 

What we’ve found is that many state boards are closed to the public, many others are available by appointment only, and others are processing applications from home. The effects of these closures are felt mostly by the providers trying to receive licensure. The boards understand that. That is why just about every state (with very minimal exceptions) is allowing emergency licenses to be issued with less waiting time, as well as extending expiration dates for 3-6 months. To review a full list of these waivers, please go here. In addition, the CMS has released several “blanket waivers” giving more healthcare providers the ability to treat patients to the fullest extent of their license. View more details about this blanket waiver here

All states are still having hearings and releasing actions for major issues, while allowing the smaller, non-status affecting issues (i.e., fines, citations, etc.) to wait for later. The boards are still working, but most are working on a skeleton staff, because of this, it’s harder to renew licenses in a timely manner. That’s why they are leaning on extensions of license expirations. 

More good news is that our processing times are not being affected. The boards are still releasing board actions, they are still updating licenses so we can have the most up-to-date view. Most license check sources are still available for license checks, with the exception of Puerto Rico. 

We’ll be here, continuing to keep our eyes open for interruptions in our normal work flow during this time of great distress for our country. Whether you’re on day 14 or 42 of Quarantine/Social Distancing/a brave new world, we’re with you. Reach out to us with any questions, concerns, or quandaries. We’ll be happy to hear from you. 

Contact us at customersupport@typhoondata.com

CMS Updates Amid COVID-19 Pandemic

CMS announced that they will allow providers to practice across state lines, to the fullest extent of their license. 

Amid the COVID-19 Pandemic, CMS has relaxed it’s guidelines several times. In March, the Centers for Medicare and Medicaid Services expanded their telehealth coverage to enable more patients to get virtual care services from their providers.

On Thursday of last week (April 9th), the CMS temporarily suspended a number of rules and regulations, making it possible for providers to practice across state lines at the top of their license. “These changes affect doctors, nurses, and other clinicians nationwide, and focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses.”

“It’s all hands on deck during this crisis,” said CMS Administrator Seema Verma. “All frontline medical professionals need to be able to work at the highest level they were trained for. CMS is making sure there are no regulatory obstacles to increasing the medical workforce to handle the patient surge during the COVID pandemic.”

For more information, please review this press release from CMS detailing how this may affect you, your facility, and your clients and partners.

COVID-19 Update

We have received several inquiries regarding Typhoon Data’s status given the COVID-19 pandemic. We are therefore providing this update to our partners to put them at ease and to help them understand our current mode of operation.

Typhoon Data remains fully operational. All Typhoon Data employees were relocated to work from home when Utah Governor Herbert made the recommendation weeks ago. We were able to do this in a way that did not compromise our production, quality, or security. Our business continuity plan has always included work from home provisions and policies which have been followed with great success. Additionally, our employees have been provided technologies and tools to make their remote working environment collaborative and effective.

Thankfully, Utah has not yet been hit as hard as other areas of the country. Our hearts go out to those in New York and other areas where the spread of COVID-19 has been much more severe. We have had several partners inquire if we are able to take on additional work as they have had other avenues diminish in production capacity. We do have available bandwidth to assist in these circumstances and can be contacted to discuss any special needs.

Given the need to focus on COVID-19, we are seeing (and expect to see more) boards holding off on standard meetings and procedures to allow healthcare workers flexibility to adapt to the changing demands in healthcare. We are still seeing new records come to the system each day, however, we expect that overall numbers will be smaller than usual coming from healthcare boards.

Additionally, Typhoon Data has released special temporary products and pricing to assist Healthcare organizations in qualifying providers quickly during the demand COVID-19 has created. All customer, product, and strategic plans are continuing forward. Please feel free to reach out to us with any questions through your normal sales or customer service contacts.


Best Regards,
Typhoon Data Team

Coronavirus: A Tribute to the Good Guys

Typhoon Data’s primary function is to scrutinize healthcare workers and catch those who are creating problems. But we don’t often have the opportunity to say how grateful we are for the vast majority who are making our lives better. With COVID-19, they’ve taken it to the next level. 

With so many unanswered questions, and with so much speculative and incorrect information that has been propagated, I’d like to give a tribute to some who are doing their best to keep the earth spinning – the medical professionals who are the front line in keeping the rest of us safe. 

This includes the many doctors and nurses who have knowingly put themselves at great risk of contracting the virus themselves, the receptionists who are sometimes expected from a 30-second call to be able to tell you if you have Coronavirus or that everything is going to be okay. Many of us look to our healthcare providers as experts on a novel disease that we’ve gotten so much contradictory information about.

Our national and local leaders have adopted what we once might have considered severe strategies to slow the spread of COVID-19 and prevent the overwhelming our medical system. Overwhelming the system could mean running out of bed space, medicine, and other supplies. But it also means overworking the doctors, nurses, and support staff at these facilities. Long hours and high stress can contribute to being more vulnerable to infection and being less able to fight it off.

Even though we’ve “flattened the curve” significantly, the humans taking care of us have acutely felt the effects of this crisis, perhaps more than anyone. And we’re still in the beginning stages.

We can honor our healthcare workers and at the same time, help the cause by keeping level heads and doing the following:

  • Taking recommended precautions seriously – social distancing, washing hands effectively and often, covering coughs and sneezes, etc.
  • Avoiding the urge to panic and over consume products others need such as face masks, rubber gloves, and yes, toilet paper.
  • Being patient when seeking medical assistance. For example, waiting a little longer for appointments, postponing non-essential check-ups, accepting that you won’t likely be able to get tested for COVID-19.

To all healthcare workers currently running toward this disaster: Thank you for what you do. You are noticed and appreciated. Please take care of yourselves as well.

In addition, I’d like to make honorable mentions of a few other unsung groups of people who are steadying the ship: Store managers who are fighting to keep toilet paper on the shelves. Teachers who are struggling with unfamiliar technology to keep educating our children. Lastly, Typhoon Data’s great employees, who are continuing to get the job done from their homes and doing their part to help medical staffing move forward.

OIG Code Descriptions

How do we understand the Office of Inspector General (“OIG”) and the different codes that they use?  Codes are used for many purposes, and OIG uses many different codes for many different things. When we see codes, we look at it and say something like “what does that mean?”  We want to focus on codes that OIG uses for excluded individuals, or individuals who have been excluded from Medicare, Medicaid, and other state and federal healthcare programs. We hope this makes it so that the next time you see a code by someone’s name, you will understand why they have been excluded. There are 2 categories of exclusions we will talk about. Mandatory and Permissive exclusions.

Mandatory Exclusions: OIG is required by law to exclude the person or entity from all federal healthcare programs. Mandatory Exclusions can be imposed only for these 6 reasons:

  • 1128(a)(1): This code means that the person or entity has been convicted for a program related crime. The exclusion will last for a minimum of 5 years. 
  • 1128(a)(2): This code means that the person or entity has been convicted for something related to patient abuse or neglect. The exclusion will last for a minimum of 5 years.
  • 1128(a)(3): This code means that the person or entity has been convicted for something related to health care fraud. The exclusion will last for a minimum of 5 years. 
  • 1128(a)(4): This code means that the person or entity has been convicted for something related to a controlled substance. The exclusion will last for a minimum of 5 years.
  • 1128(c)(30(G)(i): This code means that the person or entity has been convicted for a 2nd time. The exclusion will last for a minimum of 10 years.
  • 1128(c)(3)(G)(ii): This code means the person or entity has been convicted 3 or more times. The exclusion will be permanent. 

Permissive Exclusions: OIG can choose for themselves to exclude people and entities. These are all the reasons they can choose to exclude an individual or entity: 

  • 1128(b)(1)(A): This code means that the person or entity has had a misdemeanor conviction that is related to health care fraud. The exclusion will have a Baseline period of 3 years (Starting point to check progress of the individual or entity).
  • 1128(b)(1)(B): This code means that the person or entity has been convicted for fraudulent activity in non-health care programs. The exclusion will have a Baseline period of 3 years (Starting point to check progress of the individual or entity).
  • 1128(b)(2) This code means that the person or entity has been convicted for obstruction of an audit or an investigation. The exclusion will have a Baseline period of 3 years (Starting point to check progress of the individual or entity).
  • 1128(b)(3) This code means that the person or entity has had a misdemeanor related to a controlled substance. The exclusion will have a Baseline period of 3 years (Starting point to check progress of the individual or entity).
  • 1128(b)(4) This code means that the person or entity’s license has been revoked, suspended, or surrendered. The exclusion will last however long the state license authority imposes.
  • 1128(b)(5) This code means that the person or entity has been excluded or suspended under a state or federal health care program. The exclusion will last no less than whatever the state or federal program imposes. 
  • 1128(b)(6) This code means that the person or entity claims for excessive charges, unnecessary services or services that fail to meet professionally recognized standards of healthcare, or failure of an HMO (Health Maintenance Organization) to furnish medically necessary services. The exclusion period will last for a minimum of 1 year. 
  • 1128(b)(7) This code means that the person or entity has commited fraud, kickback (bribery), or other activities that are prohibited. The exclusion period has no minimum.
  • 1128(b)(8) This code means that there is an entity that is being controlled by a sanctioned person. The exclusion period minimum is the same length as the exclusion of the individual. 
  • 1128(b)(8)(A) This code means that the entity is being controlled by a family or household member of an individual who has been excluded and the ownership or control of the entity has been transferred or passed to someone else. The exclusion period minimum is the same length as the exclusion of the individual. 
  • 1128(b)(9), (10), and (11) This code means that the person or entity failed to disclose required information, supply the requested information on suppliers and subcontractors, or supply the payment information. The exclusion period has no minimum. 
  • 1128(b)(12) This code means that the person or entity failed to grant immediate access. The exclusion period has no minimum.
  • 1128(b)(13) This code means that the person or entity failed to take corrective action. The exclusion period has no minimum.
  • 1128(b)(14) This code means that a person or entity defaulted on their education loans or scholarship obligations. The exclusion period minimum is until the default or obligation has been resolved. 
  • 1128(b)(15) This code means that a person is controlling a sanctioned entity. The exclusion period minimum is the same length as the exclusion of the entity. 
  • 1128(b)(16) This code means that a person or entity is making false statements or misrepresenting material facts. The exclusion period has no minimum. 
  • 1156 This code means that the person or entity failed to meet statutory obligations of practitioners and providers to provide medical services that meet professionally recognized standards of healthcare. The exclusion period minimum is 1 year. 

We hope that after reading this that OIG codes make more sense to you now. We don’t expect you to memorize them but we do hope that these help you when it comes to choosing an individual or entity for a job or other things related to healthcare. 

References:

  1. https://oig.hhs.gov/exclusions/authorities.asp
  2. https://oig.hhs.gov/exclusions/background.asp

Introducing Dave Rees

Dave Rees

Twenty-five feet off the ground trying to screw in a window frame with freezing, numb fingers, his ladder wedged into position on an icy slope, Dave realized he was more of a people person.

Typhoon Data is firmly rooted in the belief that the people working here are the company. And we’re an interesting group of people. For many, the face and voice of Typhoon Data is Dave Rees. He’s our VP of Business Development and some might say our mascot.

“I like people — not crowds — I like people,” Dave said. “I enjoy connecting, collaborating, working together.”

Truthfully, Dave only worked framing houses to put himself through college. He graduated from Brigham Young University in 1999 expecting to become a counselor. Somehow he found his way into real estate and realized he quite enjoyed the relationships he built through sales and marketing.

Since he came to Typhoon Data, Dave has had many opportunities to make these connections and it’s served everyone involved very well.

“The goal with potential customers is not to sell at all costs, it’s to figure out if we can solve their problems.” Dave said, “If we can, great. If not, we’ll try to send them to someone who can.”

This approach makes for effortless relationships when prospects become customers and good impressions with those who may need our products down the road. Dave is a big believer that you reap what you sow.

Anyone who has been responsible to keep promises made by a salesman, knows how crucial good team communication is.

“Dave is exceptionally good with our clients.” said Erin Kerr, Director of Partner Relations at Typhoon Data. “He sets realistic expectations because he understands our capabilities and he speaks authentically. I think this comes through to clients and helps them feel comfortable.”

Though he isn’t one to seek the spotlight, Dave’s passion for social justice, his innate sense of responsibility, and his strong opinions on just about everything you can think of always seem to put him there. This explains how he reluctantly became the chair of his Republican Caucus precinct. He showed up and he was willing.

Dave is fiscally conservative, but he’s also a fearless advocate for underrepresented people and points of view — people like refugees, whom he supports through an organization called Helping Hands — points of view like his distaste for avocados and public libraries.

Besides his civic engagement, Dave has also involved himself in scouting, church, and is a frequent blood donor. He loves biking, basketball, and what he calls tinkering around his house and garden. Fortunately, most of these activities are great ways to spend time with his wife of 22 years, Lissa, and their six children.

While Dave is a keen people person, that’s not all that’s in it for him at Typhoon Data. He believes in what he sells.

“Our job is to build profits for our partners and the end users of our data, to make them more informed about their employees, and ultimately to raise the quality of healthcare for everyone.”

Who is Typhoon Data?

Ask anyone on the street, “Who or what is Typhoon Data ” and they’ll most likely give you the same answer. “Some kind of tropical storm, right?” Well they’re not wrong, but not exactly right either. Typhoon Data is “…an organization who aims to help any company who employs  healthcare workers make sure that they are in compliance with state and federal laws of regulation..” -Questin Francis, CEO of Typhoon Data. Basically, we make sure the providers that they hire, are clean and pose little threat to the public.

This might come to a surprise, but some healthcare providers don’t always tell the truth. “You want to know about your health care providers. You want to know about their past and you can’t always trust them to tell the truth, so you need people like us to dig a little deeper and see what is going on.”  -Cassidy Cooper, Customer Experience Manager. You want to know if your doctor has any stipulations or past disciplinary actions taken against them. When these Healthcare providers slip between the cracks and are allowed to continue working, it risks the general public. Now before you run for the hills as society seems to be collapsing around you after this revelation, there’s no need to worry. While these healthcare providers might have actions against them, it’s all recorded somewhere on official databases, emphasis on somewhere. There’s a lot of data, and it’s not easily accessible. That’s where we come in. We have built a system that technology assists hand in hand with human work so that there’s less potential for that human error to occur. With faster turn around and fewer errors, we are able to find these individuals and bring their misconduct to light.

While there are other companies like Typhoon Data that do a similar job; we by far outpace the competition. “You go from these other providers who do similar work, their processes are just not as well done, so their turnaround time and their possibility of errors are significantly worse. Instead of turning around a verification that requires humanized quality control in about two to three days, about 8-10 hours business wise, they’re turning around in a couple of weeks. They are slower…there’s just a lot more potential for human error. It also helps that the customer portals that we provide for our larger customers such as Bryce and T-Bone, are more user friendly as well.” -Derek Jackson, Infrastructure Administrator. Basically we process the data faster, which tends to be more accurate as there’s less potential for human error, and the overall experience is more friendly because the interface is more user friendly.

Our future is bright. With more and more clients looking for a trustworthy compliance data provider, and with the unfortunate reality that Healthcare Provider malpractice continues to be rampant, there’s a lot of work to be done. there’s a lot of places that we need to reach, a lot of new ways to solve problems. “…another core part of typhoon data, [is] to not only solve those problems but to solve them in a more efficient, more technologically savvy and integrated way.” Questin Francis, CEO.

So what is Typhoon Data? Some kind of tropical storm, right? 😉