Common Issue: Failing to include physician justification, diagnosis codes, or clinical notes proving why equipment is needed. How It Applies: 🏠 Assisted Living: Families often purchase or rent equipment privately. Facilities rarely maintain detailed documentation, leaving no record of medical necessity if auditors or insurers question usage. 🏥 Skilled Nursing / Acute: Must maintain medical necessity statements in patient charts — missing progress notes or MD orders cause Medicare denials. 🧑‍⚕️ Home Health Agencies (Visiting Angels, etc.): Must document need in OASIS assessments and coordinate with the DME provider’s order — missing this ties back to the agency during audits. 🏘️ Congregate Homes / Board & Care: Often overlooked because caregivers assume equipment is “resident property.” Still must document equipment necessity if it supports care tasks.

Common Issue: Using wrong or outdated billing codes for equipment. How It Applies: 🏥 Skilled Nursing / Acute: Staff often reuse old forms with outdated codes; improper use causes billing errors. 🏘️ Home Health Agencies: Caregivers aren’t trained in codes, so referrals to DME suppliers lack precise info, leading to wrong orders or denials. 🏠 Assisted Living / Congregate Homes: Usually not billing directly, but if referring patients to outside DME providers, inaccurate product descriptions delay delivery and increase liability.

Common Issue: Continuing to use the same equipment without reassessing patient needs. How It Applies: 🏥 Skilled Nursing / Acute: Must have re-evaluation notes (e.g., therapy reassessment every 30 days). Missing updates = red flag in audits. 🧑‍⚕️ Home Health: Required to reassess during each recertification period. Outdated equipment recommendations are considered non-compliant. 🏘️ Assisted Living / Congregate Homes: Rarely re-evaluate. If a resident’s condition changes (e.g., increased fall risk), failure to document a DME re-assessment can be cited as neglect or liability risk.

Common Issue: Lack of signed delivery receipts or setup confirmations. How It Applies: 🧑‍⚕️ Home Health Agencies: If the caregiver accepts equipment delivery without signature or training documentation, the DME provider is exposed to non-compliance. 🏥 Skilled Nursing / Acute: Must have delivery receipts and installation logs attached to the patient chart. 🏠 Assisted Living / Congregate Homes: Families often accept deliveries directly — but facilities should keep a photocopy of the delivery receipt to avoid future disputes.

Common Issue: Providing generic beds or cushions when patients meet criteria for advanced products (e.g., low-air-loss, rotation, or specialty positioning chairs). How It Applies: 🏥 Skilled Nursing: Often fails to upgrade surfaces for wound prevention despite clinical need — major citation risk. 🧑‍⚕️ Home Health: Caregivers unaware of product options may use unsafe or inappropriate equipment. 🏘️ Assisted Living: Facilities often don’t supply equipment; families buy retail options that lack medical-grade support — increases fall/injury risk. 🧓 Senior Day Care: Participants may use transport chairs or cushions not designed for prolonged sitting, creating pressure risks auditors notice.

Common Issue: Lack of maintenance or cleaning logs. How It Applies: 🏥 Skilled Nursing / Acute: Required by CMS to document sanitation between residents; missing logs = infection control citation. 🧑‍⚕️ Home Health: Portable equipment (e.g., Hoyer lifts, shower chairs) often reused between clients — without documentation of cleaning. 🏘️ Assisted Living / Congregate Homes: Must verify vendors sanitize and service equipment before assigning to new residents.

Common Issue: Staff and caregivers are not trained in safe transfer or equipment use — or training isn’t logged. How It Applies: 🏥 Skilled Nursing / Acute: In-service logs must be current for surveyors; training documentation is part of fall-prevention compliance. 🧑‍⚕️ Home Health: Caregivers (like Visiting Angels) must be educated by the DME supplier or nurse supervisor — otherwise the agency risks liability. 🏘️ Assisted Living / Congregate Homes: Facility staff should receive periodic training in safe use of wheelchairs, beds, and lifts even if they don’t supply them.

Common Issue: Equipment in use can’t be traced to a serial number or patient record. How It Applies: 🏥 Skilled Nursing / Acute: Auditors check serials against invoices; missing logs = billing discrepancies. 🧑‍⚕️ Home Health: If the same lift or commode circulates between homes, lack of asset tags creates liability exposure. 🏘️ Assisted Living: When families bring equipment, staff should document serial numbers in resident care plans for safety and incident reporting.

Common Issue: Facilities or agencies unknowingly source from unaccredited vendors. How It Applies: 🧑‍⚕️ Home Health Agencies: Must verify supplier accreditation (ACHC, BOC, etc.) to maintain compliance. 🏥 Skilled Nursing / Acute: Federal payors can recoup funds if products came from non-approved sources. 🏘️ Assisted Living / Congregate Homes: Family-purchased equipment from non-medical vendors (Amazon, retail) may void warranty or pose risk; facility can still be cited for unsafe usage.

Common Issue: Re-issuing or reusing equipment without proper sanitation and documentation. How It Applies: 🏥 Skilled Nursing / Acute: Must document cleaning, inspection, and re-assignment between residents. 🧑‍⚕️ Home Health: Shared-use items (e.g., lifts) require written sanitation protocol per patient. 🏘️ Assisted Living / Congregate Homes: When residents pass away or move, families may donate equipment — the facility must verify cleaning and inspection before reuse.