![]() This statement summarizes GAO's October 2015 report, GAO-16-33. To monitor compliance with these standards, CMS enters into agreements with state survey agencies to conduct on-site surveys of the state's homes and also collects other data on nursing home quality.Īlthough CMS and others have reported some potential improvements in nursing home quality, questions have been raised about nursing home quality and weaknesses in CMS oversight. To help ensure nursing home residents receive quality care, CMS defines quality standards that homes must meet to participate in the Medicare and Medicaid programs. Such monitoring is important for CMS to better understand how its oversight modifications affect nursing home quality and to improve its oversight given limited resources.Īpproximately 15,600 nursing homes participating in the Medicare and Medicaid programs provide care to 1.4 million residents-a population of elderly and disabled individuals. CMS concurred with this recommendation and told us it has begun to take steps to address it. To help ensure modifications do not adversely affect CMS's ability to assess nursing home quality, GAO recommended that CMS monitor modifications of essential oversight activities to better understand the effects on nursing home quality oversight. CMS officials told GAO that some of the reductions to oversight activities were in response to an increase in oversight responsibilities and a limited number of staff and financial resources. For example, CMS reduced the number of nursing homes participating in the Special Focus Facility program-which provides additional oversight of certain homes with a history of poor performance-by over half from 2013 to 2014. GAO found that some modifications expanded or added new activities-such as creating new training for state surveyors on unnecessary medication usage-while others reduced existing activities. However, CMS had not monitored how the modifications might affect its ability to assess nursing home quality. GAO's October 2015 report found that CMS had made numerous modifications to its nursing home oversight activities. GAO continues to believe that regular audits are needed to ensure the accuracy and comparability of nursing home quality data. The agency concurred with this recommendation and has been conducting regular audits of nurse staffing data but does not have a plan to audit other quality data on a continuing basis. GAO recommended CMS implement a plan for ongoing auditing of quality data. GAO recommended that CMS implement a standardized survey methodology across states, and in November 2017 CMS completed national implementation.ĬMS did not regularly audit selected quality data including nurse staffing and clinical data (for example, on residents with pressure ulcers) to ensure their accuracy. For example:ĬMS allowed states to use different survey methodologies to measure deficiencies in nursing home care, which complicates the ability to make comparisons nationwide. GAO also found that data issues complicated CMS's ability to assess nursing home quality trends. In contrast, trends in care deficiencies, nurse staffing levels, and clinical quality measures indicated potential improvement in nursing home quality. 2 June 2014.GAO's October 2015 report found mixed results in nursing home quality based on its analysis of trends reflected in key sources of quality data that the Centers for Medicare & Medicaid Services (CMS) collects.Īn increase in reported consumer complaints suggested that consumers' concerns about nursing home quality increased. "What are the five-star quality ratings?." What are the Five-Star Quality Ratings?. Cabrini of Westchester is proud to be rated a FIVE STAR RATING in Quality Measures in long term and short term resident care. Use the Five-Star ratings together with other sources of information. This system can give you important information, help you compare nursing homes by topics you consider most important, and help you think of questions to ask when you visit the nursing home. The Five Star Quality Rating System is not a substitute for visiting the nursing home. Use the Five-Star together with other information This information gives you a "snap shot" of the care individual nursing homes give. Reviewing health inspection results, staffing data, and quality measure data are three important ways to measure nursing home quality. Nursing homes vary in the quality of care and services they provide to their residents. Then, these three ratings are combined to calculate an overall rating. What are the five-star quality ratings? Five-Star Quality RatingĪ star rating is provided for each of these three sources, in case some areas are more important to you than others. ![]()
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