CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.
Overall, nursing home operators are well-regulated and follow federal guidelines, said Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide. He added the report should have included context about other measures of quality care, such as the agency's rating system, which shows more homes are earning the top five-star rating than when the system began in 2009.
"We wish the OIG report had broadened its focus to look more at health outcomes, for when one uses CMS's own data on other quality measures, skilled nursing centers are trending toward better, not worse, health results," Crist said.
Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.
"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."
Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.
Investigators found the homes didn't always do what was needed to ensure a smooth transition.
In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.
The OIG report, http://1.usa.gov/VaztQm
The Medicare nursing home database, http://1.usa.gov/MSkcLt
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