OIG Issues Trends in Nursing Home Deficiencies Report

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The Office of Inspector General (OIG) just posted a data brief for its analysis of “nursing home deficiencies that were identified by State survey agencies (State agencies) across the Nation for calendar years 2013 through 2017 (review period). This data brief offers the Centers for Medicare & Medicaid Services (CMS) and other stakeholders (e.g., State agencies and nursing home management) insight into deficiency trends at nursing homes nation-wide. It also complements our previous report on State agencies’ verification of correction of nursing home deficiencies.”

“Our (OIG) objective was to analyze trends in the deficiencies that State agencies identified in nursing home surveys across the Nation. Our (OIG) data analysis showed the following:

  • The number of nursing home surveys and deficiencies slightly increased each year from 2013 through 2016, then slightly decreased in 2017.
  • Ninety-four percent of deficiencies had “less serious” ratings, and 6 percent of deficiencies had “more serious” ratings.
  • About 31 percent of nursing homes had a deficiency type that was cited at least five times during our review period.
  • Ten States accounted for half of the deficiencies identified.
  • The top 10 of 340 deficiency types accounted for more than 40 percent of deficiencies.”

At this point, you’re likely rubbing your eyes and asking yourself if you read the above bullets correctly, particularly the last 3 bullets. Read them again – you did see correctly. The last 2 bullets were stunners for me.

OIG goes on to say:

“The results of our analysis do not clearly indicate whether the quality of care and the safety of nursing home residents improved during our review period.

We made several recommendations to CMS in our previous report to help ensure the health and safety of nursing home residents. Implementing those recommendations and considering the information in this data brief may help CMS and other stakeholders to identify areas for improvement in the nursing home survey and certification process, ensure that deficiencies recur less frequently at nursing homes, and improve the quality of care and the safety of residents at nursing homes across the Nation.”

Trends in Deficiencies at Nursing Homes Show That Improvements_A-09-18-02010 is a 23-page data brief that provides background on the LTC survey process. The source of data for this brief was nursing home survey and deficiency data obtained from CMS’s Certification and Survey Provider Enhanced Reporting (CASPER) system for CYs 2013 through 2017. Records for one nursing homes in all 50 States and the District of Columbia were reviewed including 2 surveys related to resident care and services and 3 deficiencies related to resident care and services with ratings of D or higher, indicating that a facility was not in substantial compliance with Federal participation requirements. OIG also used data from Minimum Data Set (MDS) reports obtained from the publicly available CMS website to determine the average number of nursing home residents nation-wide and in each State. For the review period of 2013 through 2017, these data showed that the average number of nursing home residents nation-wide was 1.4 million per year. Appendix A contains details of the OIG audit scope and methodology.

This OIG report is a must-read, to be sure. There’s a significant amount of information within this brief and the Appendices; graphics also enhance this report. The Interactive Map-Nursing Home Deficiencies in Each State, Calendar Years 2013-2017 is well worth reviewing as well. When I click on my home state of Iowa, this is what I see – check out your state:

figA

Share the report with your facility’s management team. Lots of entities are reviewing MDS and survey reports!

Fig3

Fig4

Fig1

Fig2