CMS Offers New Details on Approach to Safety and Quality in Nursing Homes

August 30, 2019
Policy Snapshot

As a way of providing more details on the five-part strategy the Centers for Medicare & Medicaid Services (CMS) is taking to ensure safety and quality in nursing homes, CMS Administrator Seema Verma has begun a blog series offering more details for each step. This topic was also the subject of CMS’ Beyond the Policy podcast with the administrator and CMS Medical Director and Director of Clinical Standards and Quality Dr. Kate Goodrich, who has worked with the Society on various issues. View the podcast here.

CMS’ approach includes:

  1. Strengthening Oversight
  2. Enhancing Enforcement
  3. Increasing Transparency
  4. Improving Quality
  5. Putting Patients over Paperwork

In the administrator’s recent post she focused on strengthening oversight. CMS is moving toward improving State Survey Agencies (SSAs) consistency by issuing updated, streamlined guidance specifically on how they determine an imminent patient safety risk, known as “Immediate Jeopardy.” The new Immediate Jeopardy guidelines will provide SSAs with clear and consistent procedures when evaluating noncompliance that constitute Immediate Jeopardy situations, which require immediate action to address. CMS hopes to improve safety standards and ensure fairness for providers by holding them to uniform standards and processes.

CMS has moved to a single computer-based system for the survey process. This has allowed a more streamlined direction for SSAs as they evaluate nursing homes. It also provides CMS with standardized data on SSA performance. CMS analyzes the data, including focusing on outliers such as states reporting a significantly lower than average number of citations per survey.

Moving forward CMS is going to focus on how to best utilize its regional offices and how to best leverage those relationships to improve survey work. CMS also is considering new ways to address SSA performance problems beyond financial penalties.

In addition, CMS said it has asked Congress for authority to transition to a risk-based survey model for nursing homes. The goal is to target low-performing nursing homes with more frequent surveys. CMS is proposing to survey top performing facilities every 30 months, with no more than 36 months between surveys.

Click here to read the entire blog post.