CMS Plans To Update Nursing Home Compare System With E-Filing

On Monday, CMS announced that it will overhaul the Nursing Home Compare rating program that has long been criticized for its dependence on unverified data, the New York Times' "Business Day" reports.

Background

The reporting system assigns a certain number of stars to nursing home facilities, similar to systems used to rate hotels. The best possible rating Medicare can give to a nursing home is five stars (Thomas, "Business Day," New York Times, 10/6). The ratings are used by providers to help decide where to refer patients when they are discharged from hospitals. In addition, the ratings are usually the first metric investors and lenders use to help decide whether to fund a nursing home. However, an analysis by "Business Day" found that the system could mislead consumers, investors and others about the facilities' conditions because it is based on incomplete information (California Healthline, 8/25).

Nursing Home Compare Updates

The revamped nursing home reporting system will no longer rely on self-reported data that were rarely audited, according to "Business Day." Instead, officials will implement an electronic filing system through which nursing homes will report their staffing levels on a quarterly basis. The data will be verified with payroll information.

In addition, CMS will start an auditing program to ensure all of the reported data are accurate ("Business Day," New York Times, 10/6).

According to the AP/Sacramento Bee, the updates will take at least one year to implement. Until then, nursing home ratings will be based on updated quality measures (AP/Sacramento Bee, 10/6).

For example, starting in January 2015, ratings also will be based on the percentage of a nursing home's residents who are receiving antipsychotic drugs, as well as staffing levels and quality statistics. CMS plans to add other measures, including:

• The percentage of residents readmitted to hospitals; and
• The percentage of residents released from nursing home care.

Officials also said the new reporting system eventually will allow consumers to view statistics like staff turnover and other quality measures.

While the electronic reporting system will begin in 2015, the data will not be reflected in nursing home ratings until 2016, according to officials.

CMS Administrator Marilyn Tavenner, said, "We are focused on using as many tools as are available to promote quality improvement and better outcomes for Medicare beneficiaries" ("Business Day," New York Times, 10/6).

Obama Signs Hospice Bill

In related news, President Obama on Monday signed a bill (HR 4994) that increases hospice inspections, The Hill reports (Viebeck, The Hill, 10/6).

The bill -- called the Improving Medicare Post-Acute Care Transformation Act, or IMPACT Act -- provides $11 million in funding to establish an electronic collection system and requires hospices to be inspected every three years ("Business Day," New York Times, 10/6).

CMS Issues Home Health Agency Proposed Rule

On Monday, CMS also issued a proposed rule that changes the conditions of participation for home health agencies that treat Medicare and Medicaid beneficiaries, Modern Healthcare reports (Demko, Modern Healthcare, 10/6).

The proposed rule aims to enhance quality assessments and communications systems. According to CQ HealthBeat, it is the first time CMS has changed the conditions since 1989 (Adams, CQ HealthBeat, 10/6).

The proposed rule includes:

• A provision that would require HHAs to explain patients' rights in way they will understand;
• A provision that would require HHAs to establish programs to control and prevent infections; and
• An update to patient privacy protections that would account for modern technology.

The rule will be open to comments for 60 days (Modern Healthcare, 10/6).