Capitol Correspondence - 04.22.19

GAO Weighing in on Nursing Home Oversight Puts CMS under Even Higher Scrutiny

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ANCOR is sharing this article by Politico Pro because some people with disabilities who are on waiting lists for community supports live in nursing homes. The report mentioned in the article comes at a time when the Senate is closely scrutinizing nursing homes through its oversight work on the Senate Finance Committee.

As shared by Politico Pro:

“A new GAO report concludes that CMS must address reporting ‘gaps’ after failing to fully track nursing home abuse allegations in Oregon for at least 15 years.

— What the watchdog uncovered: CMS had incomplete data on nursing home abuses in Oregon, which means the agency may have missed identifying patterns of abuse it could have stamped out. And because some abuses weren’t reported to CMS, the agency’s flagship Nursing Home Compare tool, which allows patients to review quality of care, provided ‘incomplete information,’ GAO concluded — potentially putting Oregon patients at risk.

GAO called on CMS to evaluate how it collects data from its state surveys, among several recommendations. It wasn’t clear from the GAO report if other states had similar gaps in nursing home oversight.

— SEEMA VERMA’S response: In a blog post, the CMS administrator didn’t directly acknowledge the GAO report but stressed that the agency is working to strengthen oversight and improve data collection from the states.

When asked for comment, a CMS spokesperson referred POLITICO to a section of Verma’s blog post noting the ‘wide variation’ in how state survey agencies (SSAs) identify and penalize abuse.

‘Residents deserve consistent nursing home quality, regardless of location, so CMS is revising our oversight of SSA performance,’ Verma wrote.”


Ripple effect at the state level: According to another Politico Pro article, “Texas lawmakers are considering reforms aimed at improving the state’s worst-in-the-nation nursing home quality, seeking to build on laws passed in recent years that have yet to demonstrate an effect.

The proposals — to limit antipsychotics and improve hiring practices — come against a backdrop of decreased federal oversight and few new initiatives to lift quality in other states.


Now, lawmakers have filed several bills: TX HB3533 (19R) and TX HB3400 (19R) would mandate more stringent criminal background checks when hiring nurses’ aides, who provide most direct care; TX SB1212 (19R) and TX HB2050 (19R) would require signed consent for antipsychotics. Research shows the medications are over-prescribed in an effort to maintain control over patients, especially in poorly staffed facilities.”