OIG Report Prompts New Nursing Home Rules, Inspection Techniques
CMS is developing new rules under the Affordable Care Act to improve nursing home care and working with HHS' Office of Inspector General to bolster the agency's investigative techniques in order to improve nursing home supervision, the Washington Post reports.
The efforts come after an OIG report released earlier this month found that about one-third of nursing home residents suffer harm because of substandard care (Jaffe, Washington Post, 3/6). Overall, the report estimated that about 60% of patients -- or more than 19,000 individuals -- had to stay at a hospital because of preventable injuries at least one time, and that these preventable injuries and hospital stays could have cost Medicare about $2.8 billion in 2011 (California Healthline, 3/6).
CMS Administrator Marilyn Tavenner said CMS, when it issues the new nursing home guidance later this year, will simultaneously direct inspectors to "review facility practices for identifying and reducing adverse advents."
In the meantime, a CMS spokesperson said the agency last summer created a website with several resources and training materials that over 5,000 nursing facilities have used to help reduce residents' pressure ulcers and medication errors.
In addition, Medicare officials started working with OIG to learn the agency's investigative techniques, which differ from current nursing home quality measures, according to the Post.
For example, CMS and OIG currently are condensing a list of 261 specific instances of nursing home resident harm in order to help nursing home operators and government inspectors quickly identify health problems that stem from poor treatment. In addition, CMS plans to adopt OIG's "trigger tool," which OIG developed to help identify potential harm. The tool is a list of 49 medical conditions -- such as hospital visits or low glucose levels -- that act as warning signs of potential harm (Washington Post, 3/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.