Medicare Guideline Changes Aimed At Curbing Nursing Home Abuse

We have long been writing about the issue of <"http://www.yourlawyer.com/practice_areas/nursing_home_negligence">nursing home abuse and, now, Medicare is working to stop the abuse and look into how to improve the guidance around nursing home care. eMaxHealth described the steps as creative and reported that the Centers for Medicare & Medicaid Services (CMS) issued new guidance—targeted for nursing home surveyors—late last week. The guidance provides more definition and clarity around care to help improve the quality of residents’ lives, said eMaxHealth.

Effective earlier this month, nursing home surveys were and will be conducted, reported eMaxHealth. The surveys will be focused on a variety of areas such as ensuring residents live with dignity; care and service options are provided; environments meet residents “needs and preferences”; a more “home-like” environment is provided, such as enhanced visitor access; and environments are de-institutionalized, for instance, doing away with meals distributed on “institutional trays … noise from overhead paging systems, alarms, and large nursing stations, said eMaxHealth.

Earlier this month we wrote that CMS is initiating a pilot program this summer to track how cash incentives to nursing homes improve care, specifically in nurse staffing and preventable hospitalizations, citing a prior Wall Street Journal article. The agency also flags those listed as the worst, which has increased to about 135, on the Web site. The most problematic facilities are labeled as “Special Focus Facilities,” noted the Journal. Late last year the CMS began ranking nursing homes “based on government inspection results, staffing data, and quality measures” via the “Nursing Home Compare” system, which is available at medicare.gov/NHCompare, said the Journal.

According to eMaxHealth, about 1.5 million people live in about 15,800 nursing homes on any given day; it is estimated that three million people will spend some time in such facilities every year, reported both eMaxHealth and the Journal. Earlier this month, the Journal estimated that there are roughly 16,400 nursing homes nationwide and taxpayers spend about $72.5 billion annually to subsidize nursing home care.

Speaking of the newest planned changes, CMS Acting Administrator Charlene Frizzera said, “These groundbreaking revisions matter in the daily lives of people who live in the nation’s long-term care facilities…. The improvements in the guidance are intended to support efforts underway to transform nursing homes into environments that are more like their homes through both environmental changes and resident-centered caregiving,” quoted eMaxHealth.

The new guidance stresses that the changes are not all about physical enhancements, but require more “person-centered care” that focuses on “individualization, relationships, and a psychological environment that welcomes each resident and offers comfort,” explained eMaxHealth. Also, the guidance explains that choices must be in keeping with resident “schedules,” “interests,” “assessments,” and care plans, noted eMaxHealth, and should take into account what is important and relevant to the resident, such as bedtime, bathing, and exercise schedules, to name a few.

The guidance, which can be found online here, notes that while some nursing homes already or are on the way to adopting these practices, “many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them,” quoted eMaxHealth.

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