National standardized surveys in the works

James M. Berklan, Editor
James M. Berklan, Editor

The General Accountability Office typically features excellent researchers and writers. But it seems they might have “buried the lead,” as we say in the journalism business, with their latest study concerning nursing homes.

The most important thing mentioned in the 48-page report — at least as far as operators are concerned — is something that emerged only as a recommendation on page 27. 

The GAO recommended creation of a standardized survey methodology “across all states.”

Not only that, but the Department of Health and Human Services said “it would set timeframes and milestones for the development and implementation of a standardized survey methodology.”

No reason to uncork the champagne yet, but it's a start.

It was an overshadowed development in “Nursing Home Quality: CMS Should Continue to Improve Data and Oversight.” This GAO production is recommended reading if you plan on staying in the business.

The overall good news for providers is, the numbers improved in four of the five areas studied. The not-so-good news: That fifth category (consumer complaints).

Consumer complaints is the sore-thumb category: They've risen 21% over the decade ending 2014.

At the same time, the number of serious deficiencies cited per facility dropped 41%. However, shame on the Centers for Medicare & Medicaid Services, report authors implied, because the agency does not have sufficient systems in place to check whether this is truly the case.

As for quality measures, nursing homes' scores showed improvement in all eight areas spot-checked from 2011 to 2014.

It seems, however, that when it comes to providers' self-reported information for staffing and quality measures, regulators believe in the “Trust but verify” theme — minus the trust part.

So they're not prepared to say with any certainty that nursing home quality has improved in recent years. The numbers might tend to point that way, they admit, but they want better oversight and analysis of data.

That's where things like payroll-based journaling of staffing levels is going to come in handy, they figure. No more “just take our word for it” numbers come July 1. 

The data noose is slowly but surely tightening for lesser performers.