CMS Administrator Seema Verma recently vowed to “push beyond the status quo” in its oversight of nursing homes. Read the full blog entry. She has directed “a comprehensive review of our regulations, guidelines, internal structure, and processes related to safety and quality in nursing homes” to focus on these five areas:
- Strengthening and revising oversight of state survey agencies to address inconsistency across the country. CMS is “examining the way surveyors identify issues such as abuse, facility staffing levels, and dementia care,” and “clarifying expectations regarding when abuse must be reported to the State and law enforcement. This means setting clear timelines for SSAs to review allegations of abuse and neglect.”
- Enhancing enforcement polices, including focused attention on facilities that fail to provide required nurse staffing, and targeted oversight of nursing homes that have not improved their antipsychotic medication utilization rates for long-stay residents. Looking ahead, CMS has “asked Congress to provide us the authority to adjust the frequency of mandatory nursing home surveys so we can focus more of our time and resources on nursing homes that are poor performers while continuing efforts to respond to complaints.”
- Increasing transparency (public access to information), such as by incorporating PBJ data into Nursing Home Compare and the Five-Star Quality Rating System, and “continuing to explore other ways to improve Nursing Home Compare, including highlighting specific quality issues like abuse or the inappropriate use of antipsychotic medication.”
- Improving quality, including investment of civil money penalty dollars to reduce adverse events (see the Civil Money Penalty Reinvestment Program website for more information), value based payment mechanisms, and development of quantifiable goals relating to infections and other issues.
- Putting patients over paperwork, by removing unnecessary burdens on providers that create staffing challenges and increase cost without increasing quality.
