Government orders more weekend nursing home inspections

Measures to assure the safety of nursing home residents may have had the weekend off. In order to lower the hospitalization of residents, the Centers for Medicare and Medicaid Services announced that it will increase weekend inspections of nursing homes by state survey agencies reviewing the quality of care and resident safety. The CMS undertook this action after Congressional concerns were expressed over nursing home neglect and abuse.

The CMS notified states that it will use payroll-based staffing information to identify nursing homes with reduced staffing on weekends. It will require agencies to raise their off-hour surveys of staffing levels from 10 to 50 percent.

Nursing homes with higher nursing staffing levels usually have lower resident hospitalizations. While most facilities lower staffing somewhat during weekends, CMS pointed out that some nursing homes have substantially reduced staffing. There were even no registered nurses on weekend duty at some facilities.

Reports from Kaiser Health News and other news organizations of nursing home abuse, neglect, and inferior care stoked Congressional interest and increased pressure on the CMS to improve its oversight of nursing homes across the country. In addition to increased weekend inspections, CMS is revising Medicare payments to skilled nursing homes based upon the frequency of hospitalizations within 30 days of discharge. Poor performers will be penalized while bonuses will be awarded for better performance.

In November, the CMS also announced the development of new training materials for nursing home professionals to reduce adverse health care events, improve dementia care, and strengthen the quality of staffing. There will be a new rule allowing the levying of civil penalties of up to $200,000 upon nursing home staff who do not report resident abuse or other unlawful activities.

These improvements, however, should be balanced with reduced CMS oversight policies initiated late last year. CMS imposed an 18-month moratorium on important parts of a federal regulation that would have imposed monetary penalties, payment denials, or termination from the Medicare program on nursing homes that did not comply with regulations calling for adequate on-site staff, which staff could provide behavioral health and other services.

Despite these new measures, vulnerable nursing home residents will continue to be abused and neglected. Families who suspect abuse and neglect should seek legal assistance. An attorney can assure that nursing home residents are treated in a dignified and professional manner and take legal action for failing to comply with a reasonable standard of care.

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