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October 06, 2014 12:00 AM

CMS expands nursing home reporting requirements, updates rules for home health agencies

Paul Demko
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    The CMS will implement a quarterly electronic filing system for nursing homes, subject to audits, to report staffing levels. The enhanced reporting will include data on what types of workers are on duty and the rate of personnel turnover.

    The effort to provide more information on nursing home staffing is among a number of changes designed to bolster the Nursing Home Five Star Quality Rating System, CMS announced Monday.

    The rating system came in for criticism this summer in the New York Times, which reported that ratings often were based on incomplete information and so could mislead consumers.

    The CMS will expand an inspection program aimed at verifying staffing and quality data and increase the number of quality metrics it utilizes to asses nursing homes.

    Starting next year, for example, the CMS will rate facilities on the extent to which antipsychotic medications are utilized in patient care. Critics have said CMS is not doing enough to curb the use of antipsychotic drugs in nursing homes.

    In the future, the agency will add re-hospitalizations to the quality metrics considered in calculating a facility's rating.

    “Nursing homes are working to improve their quality, and we are improving how we measure that quality,” said Dr. Patrick Conway, deputy administrator for innovation and quality at the CMS, in a statement. “We believe the improvements we are making to the five star system will add confidence that the reported improvements are genuine, are sustained, and are benefiting residents.”

    The CMS also released a proposed rule (PDF) Monday addressing conditions of participation for home health agencies with Medicare or Medicaid patients. The agency last updated those requirements in 1989. A proposed rule was issued in 1997, but never finalized. The conditions apply to roughly 12,500 agencies nationwide that provide care to 5 million Medicare and Medicaid beneficiaries in their homes.

    Among the proposals is a requirement that patients have their rights explained to them in a language that they understand. The CMS also is updating patient privacy protections to reflect current technology. In addition, the agency proposes to require home health agencies to develop programs to control and prevent infections and communicable diseases.

    The CMS is seeking input on how to better incorporate feedback from the physician most responsible for a patient's care into the home healthcare treatment plan.

    “We believe that the continual involvement of physicians may facilitate better transitions of care, improve patient outcomes, and reduce acute care admissions by clearly establishing (and updating) treatment goals and plans, and effectively delivering care that meets those goals,” it states.

    The proposed rule will be open for comments for 60 days.

    Follow Paul Demko on Twitter: @MHpdemko

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