The Office of the Inspector General is conducting audits of nursing home Medicaid spending seeking to determine how much of Medicaid nursing home payments are spent on direct patient care. We do not know yet which states they will be looking at, but they have indicated they will select one for-profit, one non-profit and one government run nursing home in each state collected. It is suspected that the Administration may be looking at establishing national standard on how much of Medicaid payments should be spent on direct care. If this is the case, how “direct care” is defined will be critical in not only meeting the standard but also ensuring nursing homes can meet all their regulatory obligations within such a standard. The report is expected to be issued in 2023 according to the OIG work plan information. Please let us know if any members are contacted to be part of this audit.
