Corporate Compliance
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It is the intent of Daughters of Israel to uphold the business integrity and ethical conduct as a participant in governmentally funded healthcare programs and other contractual arrangements. Delivery of care must be in compliance with all laws and regulations applicable to such programs as well as all Federal, State and local laws and regulations which govern Daughters of Israel's operations. It is the responsibility of every Daughters of Israel employee, including affiliated providers operating at Daughters of Israel, Daughters of Israel physicians and other health care professionals, to proactively identify issues relating to potential fraud and abuse exposure, and to comply with the policies and procedures designed to minimize such exposure.
Compliance in this area is challenging because the regulatory requirements governing reimbursement are complex and changing. To underscore and enhance its continued pledge of compliance and to better assist all employees, including physicians and allied health professionals, in this area, Daughters of Israel is committed to this comprehensive Compliance Program.
Daughters of Israel has adopted the directives set forth in the Office of Inspector General's Compliance Program Guidance for skilled nursing facilities to prevent and detect potential violations of law. The adoption and implementation of our voluntary Compliance Program will significantly advance the prevention of potential fraud, abuse and waste and compliance with all governing State, Federal and local laws and regulations, while at the same time furthering the fundamental mission of Daughters of Israel.
Any questions as to the propriety of a particular situation should be reported anonymously to the Daughters of Israel toll-free hotline at 866-225-9900.
Excluded Individuals/Entities Policy
Policy
It is the policy of Daughters of Israel to ensure that any payments received for Federal and State funded health care programs are not for items or services that are directly or indirectly furnished, ordered, directed, managed or prescribed in whole or in part by an excluded, unlicensed or uncertified individual or entity. Excluded individuals or entities are those identified by the State or Federal government as not being allowed to participate in State of Federally funded health benefits programs, such as Medicaid, NJ Family Care or Pharmaceutical Assistant to the Aged or Disabled (PAAD).
Procedures
Daughters of Israel is responsible for verifying that current and prospective employees (regular or temporary)., contractors or subcontractors who directly or indirectly will be furnishing, ordering, directing, managing or prescribing items or services in whole or in part are not excluded, unlicensed or uncertified by searching the following databases:
- Federal Exclusions Database (OIG) – monthly;
- N. J. Treasurer's Exclusions Database – Vendors; - monthly
- Division of Consumer Affairs Licensure Databases: Nurses, Social Workers; - monthly
- N. J. Department of Health and Senior Services Licensure Database – Health Care Vendors; - monthly
- Certified Nurse Aide Registry (PSI) – CNA's. - monthly
An employee whose licensure has expired or has been revoked, will be removed from work schedules until such time that the license is renewed or reinstated in good standing. Daughters of Israel will cease to do business with Health Care vendors or entities that are listed on the above databases as being excluded, until such time that the exclusion is removed and the entity is reinstated in good standing.