LTC Business Office Survey Prep Refresher

LTC Business Office Survey Prep Refresher

The Business Office Manager (BOM) in a long-term care (LTC) facility plays a pivotal role in ensuring the seamless financial and administrative operations of the facility. While their day-to-day duties primarily revolve around billing, payroll, and accounts receivable, their role in preparing for the annual state survey cannot be overstated. Below, we explore the essential duties of a BOM and provide actionable steps to help them navigate the survey process with confidence.

Core Responsibilities of a Business Office Manager in LTC

1. Billing and Revenue Cycle Management:

• • Overseeing Medicare, Medicaid, Managed Care, and private pay billing.
  • Ensuring timely submission of claims and monitoring accounts receivable for outstanding balances.
  • Maintaining accurate resident financial records.

2. Accounts Payable and Payroll Management:

• • Processing vendor payments and ensuring proper documentation.
  • Managing employee payroll to ensure accurate and timely disbursement.

3. Resident Trust Fund Oversight:

• • Safeguarding and maintaining accurate records of resident trust funds.
  • Providing regular statements to residents or their legal representatives as required by state regulations.

4. Regulatory Compliance:

• • Keeping up-to-date with state and federal regulations related to billing, financial reporting, and resident trust funds.
  • Collaborating with other departments to ensure documentation aligns with compliance standards.

5. Collaboration with Interdisciplinary Teams:

• • Partnering with the Administrator, Director of Nursing, and MDS Coordinator to align operational goals.
  • Supporting staff with financial or administrative queries.

Preparing for the Annual State Survey

The state survey is a critical event for any LTC facility, as it assesses the facility’s compliance with regulations and overall quality of care. As a BOM, your preparation can significantly impact the outcome of the survey. Here are key strategies to ensure you’re ready:

1. Resident Trust Fund Audit:

• • Ensure all resident trust accounts are up-to-date and reconciled.
  • Verify that disbursements align with resident authorizations and are properly documented.
  • Prepare detailed records for surveyors, including individual resident statements and account summaries.

2. Compliance Documentation:

• • Review policies and procedures related to financial management, ensuring they align with state and federal regulations.
  • Confirm that required postings (e.g., Resident Rights, Medicaid Fraud Hotline) are visible and accessible.

3. Billing and Claims Records:

• • Verify that all billing records are accurate and well-organized.
  • Be prepared to provide documentation related to Medicare, Medicaid, and Managed Care claims if requested by surveyors.

4. Resident Admission and Discharge Files:

• • Ensure financial documentation for resident admissions and discharges is complete and easily accessible.
  • Confirm that agreements, consents, and payment plans are signed and filed correctly.

5. Mock Surveys and Team Collaboration:

• • Participate in a mock survey to identify potential areas of concern.
  • Collaborate with department heads to address deficiencies in administrative or financial records.

6. Staff Training and Communication:

• • Educate front-line staff on the role of the BOM in the survey process.
  • Communicate the importance of accurate documentation and timely responses to surveyor inquiries.

7. Vendor and Contractor Files:

• • Review contracts and payment records for vendors and contractors to ensure compliance with financial policies.
  • Ensure that all invoices and receipts are filed and accessible.

During the Survey

When surveyors arrive, your role as BOM may involve providing specific documentation and answering financial questions. Here are some tips for handling this process smoothly:

• • Stay Calm and Organized: Keep all necessary files and documentation in a designated location for quick access.
  • Be Transparent: Provide clear and honest answers to surveyor questions and avoid withholding information.
  • Highlight Strengths: If applicable, showcase proactive measures your facility has implemented to enhance financial operations and resident satisfaction.

Post-Survey Follow-Up

After the survey, review any feedback or citations related to the business office. Collaborate with the Administrator and other department heads to develop and implement a plan of correction, if needed. Use the survey as an opportunity to refine processes and reinforce compliance efforts.

Final Thoughts

The Business Office Manager’s role in a long-term care facility is integral to its success, both operationally and during regulatory surveys. By staying proactive, organized, and informed, you can ensure your facility is well-prepared for the annual state survey and continues to deliver excellent care to residents. The BOM’s attention to detail and commitment to compliance not only protect the facility from financial risks but also contribute to a culture of accountability and excellence. Gain more helpful survey preparedness strategies for your team when you join Proactive for the Survey Smart webinar series in 2025.