Skilled Nursing Facilities: Expect Additional Inspections As Result of OIG Report

In August 2014, the OIG completed a study based on nursing facilities’ records of reporting abuse and neglect. Federal regulations require all nursing facilities to keep detailed records regarding any instances of alleged abuse or neglect. The report was published after having reviewed a sample of 250 nursing facilities and their compliance regarding abuse and neglect reporting. Based on that sample, the OIG determined that:

  • 85% of nursing facilities reported at least one allegation of abuse or neglect to OIG in 2012, whether it was substantiated or not.
  • Only 76% of nursing facilities have policies that abide by federal regulations for reporting allegations of abuse or neglect and subsequent investigation results.
  • Only 53% of abuse and neglect allegations and investigation results were reported as required by federal law.
  • Only 61% of nursing facilities had documentation for regulatory compliance under Section 1150B of the Social Security Act, which requires all nursing facilities to:
    •  Inform covered individuals annually (i.e., owners, operators, employees, managers, agents, or contractors of nursing facilities) of their responsibility to report to the proper entities any reasonable suspicion of crime, and
    • Post a clear conspicuous notice stipulating employees’ rights to file a complaint under Section 1150B.

Due to the disappointing results from OIG’s reports, nursing facilities can expect to see added inspections in the coming years. OIG has recommended that CMS confirm that all nursing facilities:

  1. Maintain compliance policies regarding the reporting of alleged abuse or neglect;
  2. Inform all covered individuals of their responsibility to report any reasonable suspicion of crime; and
  3. Report any and all allegations of abuse or neglect, as well as subsequent investigation results, in a timely manner and to the appropriate entities.

Click here for the full OIG report.