CMS to Post Citations Under Dispute on Care Compare

The Centers for Medicare & Medicaid Services (CMS) just announced via a news release and associated QSO Memo that it will be increasing transparency by adding additional information to Care Compare. Per the January 18, 2023 press release:

CMS is planning to publicly display survey citations that are under dispute by providers on Care Compare. The current process is to keep those deficiencies out of public view until the process is completed. Going forward, in order to ensure consumers have current information, these citations will be displayed with a note that they are under dispute by the nursing home. They will not be factored in to the Five-Star Quality Rating system until the dispute is completed.

In the associated QSO Memo, “Updates to the Nursing Home Care Compare Website and Five Star Quality Rating System: Adjusting Quality Measures Ratings based on Erroneous Schizophrenia Coding, and Posting Citations Under Dispute,” CMS provides some examples about the volume of survey citations that are in the IDR/IIDR process. State Agencies are expected to have less than half of their disputed deficiencies overturned, so this could be another way to deter providers from attempting an Informal Dispute Resolution in order to delay posting. Here are some interesting figures provided by CMS:

  • In the past two years, there have been 67 surveys with 80 deficiencies cited at a Scope/ Severity of Immediate Jeopardy that went through the IDR/IIDR process.
  • In the past two years, there are more than 300 citations that have been in the IDR process for more than 6 months.

CMS provided these examples as grounds for why this information needs to be posted publicly – the delay would prevent consumers from seeing the whole picture of a facility’s survey history. It also indicates that there is a significant backlog in getting the IDR process completed in a timely manner.

Unfortunately, here’s one more statistic from CMS that’s not good news for providers:

  • Approximately 75% of citations that go through the IDR/IIDR process are not changed.

We note that on average, the majority of citations (approximately 75%) do not change after completion of the IDR/IIDR process.

Statement from CMS QSO Memo (Ref: QSO-23-05-NH)

For full details, read the CMS Media Release here and QSO-23-05-NH here. We will be posting about the other significant part of this announcement in a separate post on the CMSCG Blog shortly.

About CMS Compliance Group, Inc.

CMS Compliance Group, Inc. is an interdisciplinary team of regulatory compliance and quality improvement consultants. We work with post-acute providers to improve their quality of care and services while achieving and maintaining compliance. CMSCG has an established reputation for its survey consulting services, including regulatory response related to survey outcomes. To learn more, visit our nursing home services overview or contact us to discuss how we can work together.

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