The Centers for Medicare & Medicaid Services (CMS), which administers Medicare and partners with state governments to administer Medicaid, recently announced steps to strengthen its oversight of nursing homes in hope of improving quality of care and patient safety.
The steps were announced after the discovery that a number of nursing homes nationally have low unsafe staffing levels, particularly on weekends, and periods where no registered nurses are onsite. CMS Administrator Seema Verma said the agency discovered “potential risks” of staffing inflation after reviewing new payroll-based staffing data that is self-reported but not audited by the nursing homes.
“We’re deeply concerned about potential inadequacies in staffing, such as low weekend staffing levels, or times when registered nurses are not onsite, and the impact that this can have on patient care,” she said.
CMS said it aims to address the risks by using “frequently updated payroll-based data” to provide state survey agencies with a list of nursing homes that have a significant drop in staffing levels on weekends or that have several days in a quarter when a registered nurse isn’t onsite.
State survey agencies then will be required to conduct surveys on some weekends based on the list, CMS said. If surveyors identify insufficient staffing levels, the facility will be cited and required to implement a plan of correction.
Other initiatives announced by CMS include clarifying how facilities should report hours and deduct time for staff meal breaks, and providing facilities with tools to help ensure that their resident census is accurate.
CMS said the initiatives are part of broader efforts to strengthen safety and health outcomes for nursing home residents. Among them are the “Nursing Home Compare” website, and facility “star ratings” which CMS provides to increase transparency about nursing home quality and to help consumers and their caregivers make informed decisions.
Other CMS initiatives include the “National Partnership to Improve Dementia Care in Nursing Homes,” which strives to reduce the “inappropriate prescribing” of anti-psychotic drugs in nursing homes, and the recently-launched “Civil Money Penalty Reinvestment Program,” which is an initiative to improve residents’ quality of life by providing nursing home staff, management, and others with certain tools, education, and assistance to enhance care.