An April 2, 2018 letter written by several members of the House of Representatives queried the Centers for Medicare & Medicaid Services (CMS) about the oversight it is providing to nursing homes, as well as how the Agency is ensuring that standards of quality are met. The letter, which cites the death of nursing home residents in Florida post-Irma, also references the amount of recent negative press related to abuse and neglect in nursing facilities and cites OIG and other Agency studies related to the care of vulnerable populations, including an “early alert” from OIG about its review in this area.
The letter requests a hefty list of documentation from CMS by April 23, 2018, including the following:
- Hurricane Complaints – All documents and information that the Agency has received by State Agencies (SAs) regarding/relating to incidents at participating LTC facilities resulting from Hurricane Harvey, Hurricane Irma and Hurricane Maria, including the actions that CMS or the SAs took in response to complaints. The Office of the Inspector General has been reviewing emergency preparedness since Hurricane Katrina, and this continues to be an area of focus.
- Survey Deficiency Correction – All documents and information referring to/relating to any actions taken to ensure that survey deficiencies were corrected for surveys since January 1, 2010. CMS released a report on nursing home enforcement in June 2016 that showed the wide disparity in the way that facilities are surveyed as well as in the way that they are penalized.
- Nursing Home Complaint Investigations – All documents and information for nursing home complaint investigations undertaken since January 1, 2010, including information related to any actions taken in response to substantiated complaints.
- Special Focus Facilities – All documentation and information that the Agency has regarding complaints received by SAs regarding/relating to incidents at LTC facilities that have been selected as part of the Special Focus Facility (SFF) program, including actions CMS and/or the SAs took in response to complaints.
- Staff Licensure Requirements – Information regarding how the Agency ensures that nursing home staff satisfy relevant licensure requirements and what has been done to improve compliance with these requirements
- Section 1150B Enforcement Actions – Information about whether CMS has received enforcement delegation from HHS under Section 1150 of the Social Security Act, and if CMS has taken any enforcement actions. A key finding from the August 2017 OIG memo regarding its ongoing review of potential abuse or neglect of Medicare beneficiaries in SNFs is that CMS has not taken any enforcement actions under Section 1150B, which requires that SNF employees report incidents of abuse or neglect.