Medicare Improves Nursing Home Quality and Safety
Medicare improves nursing home quality and safety by implementing meaningful measures to ensure patient satisfaction. The Centers of Medicare and Medicaid Services (CMS) officials said they’ll release and publish a list of over 400 underperforming nursing home facilities.
Also, including facilities with repeat offenses for persistent health and safety violations. However, these nursing homes saw no increase in federal investigations even after multiple offenses.
The CMS agency had backlash due to the lack of clarity and failing to report the inadequate facilities to consumers. This list includes the possible eligible enrollees for the CMS’ Special Focus Facility initiative. Giving those with consistent poor care ratings some incentive to improve their performance and quality of care.
Habitual offending nursing facilities may have additional site inspections. Participants constantly receiving violations may result in complete exclusion from the Medicare and Medicaid programs.
About 10% of program participants wind up getting banned from receiving Medicare and Medicaid due to a lack of compliance. However, more than 90% “graduate” from the program by expressing substantial improvements for about 12 consecutive months.
Medicare Improves Nursing Home Quality and Safety
“Oversight of America’s poorest quality nursing homes falls short of what taxpayers should expect”. A recent report that publishes the names of candidates for Special Focus.
According to this report, patients and families want transparency about the real quality of care.
“Improving safety and quality in America’s nursing homes is one of CMS’ top priorities,” said Dr. Kate Goodrich – the CMS Chief Medical Officer. CMS is seeking new and better ways to publish the information of the candidates; as it should have an update each month.
Seema Verma is the Administrator for CMS. In April, she mentions one of her top priorities is to increase transparency as part of her five-part plan to ensure long-term care (LTC) facility system of high-quality.
The goal is to increase the safety and care patients are receiving in nursing homes. LTCs are the personal homes for many beneficiaries under Medicare and Medicaid health insurance coverage.
As CMS finalizes the new rulings, this allows nursing home providers to focus on the patient’s needs rather than paperwork.
Likewise, the proposed rule is part of CMS’agency-wide efforts in reducing the burden to providers, the Patients Over Paperwork initiative and it responds to President Trump’s Executive Order. Under the President’s order, federal agencies are directed to “cut the red tape.”
Seema Verma made a statement about the importance of the patient’s needs and focus on updating rules and systems to implement great health care services.
The statement Seema Verma made was this; “We know our regulations work best when they are smart, targeted and patient-focused, so we have taken a close look at our rules with patients and burden in mind. We’ve identified opportunities for reducing provider burden while maintaining high-quality resident care.”
Requirements for Long-Term Care Facilities
On Tuesday, July 16, 2019, the Centers for Medicare & Medicaid Services announced a new proposed rule. “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P).
As one part of CMS’s five-part plan to ensure patients receive a high-quality LTC facility system. The plan is to direct attention to building stronger requirements for such facilities. Transparency of a facilities’ performance rating increase and the rule promotes the improvement of health outcomes for LTC residents.
Once this rule is finalized, CMS predicts the changes in the rule will grant about $616 million in savings each year for long-term care settings. In turn, the ability to dedicate resources for improving the quality of resident care would increase greatly.
Under this rule, there’s fewer hours and resources spent on unnecessary and repetitive requirements that are counterproductive to high-quality resident care. For example, excessive paperwork.
The proposed ruling makes it easier to provide better care to residents by simplifying the facilities requirements to administer it.
CMS may be able to maintain resident safety standards and health by identifying situations for reducing burden. Including increasing flexibility allowing facilities to meet specific patient needs by eliminating the prescriptive requirements.
Among others, CMS believes these changes will preserve time and resources for LTC facilities; allowing them to focus more on the needs of the facility’s residents.
Medicare Improves Skilled Nursing Home Facility Quality and Safety Reporting Program
Recent developments made by CMS focuses on the methods used for transferring health information between healthcare providers alike and/or the patient. Specifically, including the “hand-off” transfer of a patients’ list of regulated medications during a critical care transition.
Measures should meet the requirements of the IMPACT (Improving Medicare Post-Acute Care Transformation Act of 2014). CMS believes the system IMPACT uses, shows the importance of improving the method of how providers hand-off medication information during transitions.
The patient’s well-being, safety, and quality of care must be the main priorities for healthcare providers. Continuous review of patient safety and improving quality help CMS determine what areas need the most redesigning and updating.
The expectation of receiving care from a safe facility is reasonable. Seniors in SNFs likely have health conditions requiring the assistance of a healthcare provider.
Facilities shouldn’t be part of the reason a condition develops or worsens. CMS agrees that calling out SNFs for poor performance ratings drives the bus for improving their system on providing quality healthcare.
CMS highlights performance ratings on safety measures don’t stop with skilled-nursing facilities. Dialysis treatment centers and hospital ratings are equally as important.
Giving relevant information to consumers, clear and true performance ratings on critical priority areas (such as patient safety) pushes facilities to offer better service.
Meaningful Measures: Medicare Improves Nursing Home Quality and Safety
Connecting CMS strategies and individual measures/initiatives are called Meaningful Measure areas. These connections show how to achieve high-quality outcomes for patients receiving healthcare.
Measures should meet the needs of the patient. As well as, developing ways to increase the quality of all healthcare services.
At the top of the list is reducing the number of infections found in patients associated with receiving healthcare services. CMS states that roughly 1 in 25 hospital patients suffers from (at minimum) one healthcare-related infection.
This measurement area works on the prevention of infections in all healthcare settings by making care safer.
Reducing the harm caused in the delivery of care is preventable healthcare harm. 2.8 million individuals seek emergency treatment for fall injuries, with relatable costs of $31 billion each year.
This area aims to help patients avoid non-infectious injuries like falls; other complications like bedsores are also avoidable with proper care. Any harm that happens during a patients’ healthcare service is the main cause of significant morbidity and mortality.
Harm Reduction During Healthcare Services
Although, ample improvements have already been made – health and safety surveys still show many reports of substantial harm in some nursing homes. Harm reduction in nursing facilities results in a higher quality care rating and happier residents.
Because of this issue, CMS has several specific initiatives that zoom in on the topic and inform people how important patient safety is. New regulatory requirements are put in place to help with infection control.
New requirements such as, providing efficient care which prevents harms such as bed sores.
The continuous progression of the National Partnership to Improve Dementia Care in Nursing Homes is another priority for CMS. Seeking to reduce the inappropriate use of antipsychotics in dementia patients.
The process for health inspections also recently got a make-over. Particularly, the change adds emphasis for inspectors on facilities where patient fall rates and pressure ulcers are high.
CMS Quality Improvement Networks are seeking additional ways to reduce healthcare-acquired conditions.
Working to swiftly share the best practices of high performing nursing homes with facilities that have poor performance. Although it’s one of many; other quality improvement developments are in the works.
Consumers should know how a facility operates before becoming a patient. Underperforming facilities should utilize this information. By using the practices of nursing homes with a high performing rating as a model for improving their quality of care.
CMS Implements Quality Assessment and Performance Improvement Plan
A Quality Assessment and Performance Improvement plan is a new requirement of recent CMS regulations. All nursing homes must develop a plan that identifies events that may be harmful to a person.
Additionally, this plan must include a system and an evaluation process of safety events for patients.
Finally, relating to the efforts of protecting nursing home residents’ right to make their own educated decisions – CMS issued a final rule. This updates the nursing home requirements to use binding arbitration agreements.
The proposal supports caregivers and patients by lifting the ban on binding arbitration agreements. CMS states these agreements (should the patient choose) may not include language that prevents residents or others from communicating with federal, state or local authorities.
The Centers for Medicare & Medicaid Services proposal and final rules are the most recent updates in the extensive plan CMS is taking to give the focus back to patients.
If you’d like to read more about the final or proposing rules, you may visit the federal register.
CMS wants your feedback!
The CMS agency wants to hear from the consumer! The proposed rule is open for commentary until September 16, 2019. Since the point is to focus more on the patient, your opinion is of most importance.
CMS understands that quality of care is vital to a person’s overall health condition. Visit https://www.regulations.gov/ to submit your suggestions, comments, and feedback.