Good morning, ProviderNation.
Just when you thought it was safe to go back in the water. The Department of Health and Human Services’ Office of Inspector General is taking a new bite out of industry. A new report out this morning claims that skilled nursing facilities routinely flout rules on care plan and service requirements.
Based on a random sample of 245 nursing home stays during calendar year 2009, OIG claims that in:
- 37 percent of stays, homes “did not meet care plan or service requirements;”
- 26 percent of stays, homes “did not develop care plans that met requirements,” including “measurable objectives and detailed timeframes [sic];”
- 19 percent of stays, homes “developed care plans that did not address one or more problem areas identified in the beneficiaries’ assessments;”
- 15 percent of stays, homes “did not provide services in accordance with care plans;”
- 31 percent of stays, homes “did not meet discharge planning requirements;”
- 16 percent of stays, homes “did not have summaries of the beneficiaries’ stays or statuses at discharge;” and that in
- 23 percent of stays, homes “did not have post-discharge plans of care.”
AHCA Senior Vice President Greg Crist says that OIG’s report is missing the Big Picture.
“The report fails to acknowledge broader, more universal quality indicators that are trending upwards, not backwards, that a lack of viable care plans would result in if folks were indeed suffering. Every one of our members is required to implement a care plan on the first day an individual enters the building,” he says. “Care plans change daily because a patients’ health needs change daily. If the care plan didn’t match 100 percent every day, OIG sees that as a violation. We see that as practicing medicine. Circumstances change, and our caregivers are adapting to meet new medical conditions. We’re more focused on health outcomes and have seen them improve for our patients.”