Posts tagged #Compliance Healthcare ACA OIG California Medicare Skilled Nursing Long Term Care

Some States Fell Short in Timely Investigation of the Most Serious Nursing Home Complaints between 2011-2015


On September 29, 2017, the Office of Inspector General (OIG) released a report finding that some states fell short in timely investigation of the most serious nursing home complaints between 2011-2015. Under federal and state regulations, CMS relies on individual states’ respective state survey agencies to address various types of concerns raised by residents, family members, and nursing home staff. Such concerns include residents admitted to the hospital because of preventable infections, residents left sitting in their urine and feces for hours, and inappropriate social media posts by employees.

State agencies must conduct onsite investigations within a certain period of time for the most serious level of complaints. Previous reports by the OIG found that state agencies often did not conduct onsite investigations within the required time frame, which requires that immediate jeopardy cases be investigated within two working days and that non-immediate jeopardy-high priority cases be investigated within 10 working days.

OIG Results

The OIG found that during 2011-2015, while the number of nursing home residents decreased overall, the number of nursing home complaints state agencies received increased 33 percent (47,279 to 62,790). The report also found that, in 2015, both Tennessee and Georgia received a total of 912 immediate jeopardy complaints, which accounts for 17% of all immediate jeopardy complaints. Out of 912 complaints, 654 (71%) were investigated late. Additionally, across all five years, Arizona, Maryland, New York, and Tennessee accounted for almost half of the high priority complaints not investigated onsite within 10 workings days. Furthermore, almost one-quarter of states did not meet CMS’s annual performance threshold for timely investigations of high priority complaints in all four years and all states substantiated almost on third of the most serious nursing home complaints.

Overall, the OIG data report offers Centers for Medicare and Medicaid Services some insights into the states that have room for improvement in prioritizing and responding within the required time frame to nursing home complaints. The OIG will continue to monitor the oversight of nursing homes and will initiate additional reviews as necessary.

National Partnership to Improve Dementia Care Achieves Goals to Reduce Unnecessary Antipsychotic Medications in Nursing Homes

On October 2, the National Partnership to Improve Dementia Care announced that it met its goal of reducing the national prevalence of antipsychotic use in long-stay nursing home residents by 30 percent by the end of 2016. It also announced a new goal of a 15 percent reduction by the end of 2019 for long-stay residents in those homes with currently limited reduction rates. Nursing homes with low rates of antipsychotic medication use are encouraged to continue their efforts and maintain their success.

For More Information:

·         Fact Sheet

·         National Partnership to Improve Dementia Care in Nursing Homes webpage

Preparing Long-Term Care Providers for 2017

Compliagent has teamed up with Healthicity to bring you an informative webinar entitled "Preparing Long-Term Care Providers for 2017".  This webinar covers recent enforcement data, a regulatory overview, enforcement case studies and best practice recommendations. Presented by Compliagent's COO, Paige Pennington, this webinar is a helpful resource for all Long Term Care providers looking to stay compliant in 2017. 

SAMHSA Reporting Requirements to Reduce Risk of Diversion for Controlled Medications

With an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin,[1] medication-assisted treatment (MAT) is at the vanguard of America’s fight back against increasingly pervasive opioid and opiate misuse