A new skilled nursing facility (SNF) validation program could be the tipping point in verifying provider quality measurements and could lead to a decrease in incentives. This program would change how nursing homes are evaluated and funded, directly impacting the quality of care provided in facilities. The Centers for Medicare & Medicaid Services (CMS) recently outlined details for its SNF Quality Measure Validation Program. This is an initiative set to ensure the accuracy of the data that nursing homes are reporting through the Minimum Data Set (MDS). The MDS-based measures circle into CMS’s Quality Reporting Program (QRP) and Value-Based Purchasing (VBP) system, which affect both public quality ratings and payment incentives, as McKnight’s Long-term Care News shares.
CMS will begin auditing 10% of nursing homes each year starting this fall. With that, chosen facilities will need to submit medical chart documents for 10 MDS assessments to prove their accuracy. Measures under review include rates of falls with major injury, pressure ulcer prevalence, drug regimen reviews, discharge outcomes, and transfer-of-information metrics, as shared in the statement. For residents, this creates a big change in their daily lives. At first, this sounds like more of an administrative issue rather than a resident. However, the consequences can directly impact the residents and the care provided in nursing homes nationwide. If the data from MDS is accurate, CMS and the public can better gauge a facility’s actual performance. This need for transparency is a positive change and can cause underperforming nursing homes to fill those gaps with improved care. This system is a great way to fix recurrent issues, but experts warn that if it’s found problematic by the CMS, facilities can face several issues. McKnight’s LTC News highlights the possible issues of inflated quality scores, mismatched documentation, or high error rates. If found, facilities can face the consequences of pay reductions, targeted enforcement, and stronger oversight.
This can lead to issues such as staffing and financial cuts that can directly impact the residents across facilities. It not only affects the residents’ daily routines in facilities, but also the quality of care provided. If facilities fail to send in their documents, the CMS will take 2% of that facility’s annual payment. If that 2% is to pile up, further harm can be inflicted on residents. These decisions are made to positively impact residents in facilities, but if not acted upon correctly, they can be detrimental.
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If you know of someone who has been neglected or injured while a resident of a nursing home or long-term care facility, have them contact the lawyers at DLP, who have been representing nursing home abuse victims for over forty years. We at DLP Law Firm can protect you against nursing home-related issues. If facilities stay truthful and timely in their reporting, resident health and safety across facilities will not be jeopardized.
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