Medicare Compliance & Reimbursement

Industry Note:

CMS Clamps Down on Nursing Home Fraud and Abuse

Nursing homes care for some of the most vulnerable patients in the U.S., and new policies from the feds aim to ensure they aren’t taken advantage of.

Details: The Centers for Medicare & Medicaid Services (CMS) announced that it would ramp up its oversight of the State Performance Standards System (SPSS) and double down on inspectors who ignore fraud and abuse.

“Nursing home patient and resident safety is a top priority for the Trump Administration. Abuse and neglect are never acceptable,” stresses Seema Verma, CMS administrator in a release. “After careful study of State inspector performance, CMS is taking action to increase oversight of inspectors and ensure States are conducting thorough and appropriate inspections.”

Highlights from the new measures to “strengthen oversight” include:

  • Increased monitoring of inspectors
  • New enhanced State Performance Indicators
  • More accountability on the part of the State Survey Agencies
  • Flexibility for CMS to add more agency measures at will
  • Administrative burden cuts to streamline paperwork and cut duplicity

Reminder: This update is the first step in a five-part plan that CMS initiated in April to improve the safety and efficiency of nursing homes while circumventing fraudulent behavior.

Read the CMS release at www.cms.gov/newsroom/press-releases/trump-administration-strengthens-oversight-nursing-home-inspections-keep-patients-and-residents-safe.