Medicare Compliance & Reimbursement

If you’re curious about trends in nursing home enforcement activities, you have some new data to consider.

On June 3, the Centers for Medicare & Medicaid Services (CMS) issued a Survey & Certification (S&C) memo announcing the public release of data on nursing home enforcement actions between 2006 and 2014. The memo (S&C: 16-27-NH) includes enforcement reports on the distribution of federal enforcement remedies imposed during these years by CMS Region and State, by type of enforcement action, and by year imposed.

For surveys, continued increases in oversight cause a steady rise in the average number of deficiencies cited per survey from 2003 through 2007. But CMS blames the steady decrease in the number of average survey deficiencies that occurred from 2008 through 2014 on the recession.

The percent of surveys yielding citations for pressure ulcers has steadily decreased over the years, while citations for unnecessary medications has skyrocketed. The percent of surveys with zero health deficiencies cited has steadily risen from just under 8 percent in 2008 to just over 10 percent in 2014.

The percent of surveys with Substandard Quality of Care deficiencies has declined only slightly, from just over 4 percent in 2008 to about 3 percent in 2014. But those with Actual Harm/Immediate Jeopardy deficiencies are another story — surveys with citations of these types of deficiencies have dropped dramatically, from a peak of 18 percent in 2006 to under 11 percent in 2013 and 2014.

The percent of active providers with any enforcement remedies has also declined, from 18.1 percent in 2006 to 14.2 percent in 2014. But the number of active providers that faced civil money penalties (CMPs) soared, from 28 in 2006 to 145 in 2014.

Link: To read the S&C memo and for more information on nursing home enforcement activities, visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationEnforcement/Nursing-Home-Enforcement.html.