Daily Editors' Notes

Federal regulators say they will back off nursing homes — at least for now

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John O'Connor
John O'Connor

If you've been involved in the long-term care field for any length of time, you should be quite familiar with how the government typically deals with bad news about nursing home care.

The classic pattern is this: 1) Damning report comes out, 2) the feds promise tougher inspections, and 3) tougher inspections commence. At least, that's how the dance played out until Thursday, apparently.

For those of you returning from a place that prevents access to news, the Inspector General's Office released a fairly damaging report a week ago. OIG inspectors essentially claimed that nursing homes too often deliver reckless care. How reckless? About 22% of residents experience injuries that the authors considered preventable. This includes things like avoidable falls, infections, medication errors and boomeranging back to hospitals too soon.

But this time, CMS appears to be departing from the usual storyboard. Rather than promising a crackdown featuring tougher inspections, the agency is saying that the in-waiting Quality Assessment and Performance Improvement program will take care of the mess.

As my colleague Tim Mullaney reported Friday, for now this means inspectors will focus on assisting providers in implementing QAPI-based quality improvement initiatives (as opposed to, say, finding more f-tags).

Not that QAPI just fell out of a tree. CMS has actually been providing QAPI-inspired “technical assistance” to nursing homes for more than two years.

But it's still uncertain when the much-delayed QAPI regulations will actually be put in place. And until that happens, we won't really know whether CMS has embraced a new approach, or merely found a new name for the old one.


John O'Connor is McKnight's Editorial Director.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.


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