Report: OIG to tackle adverse events, therapy payments in nursing homes

OIG's recommendations for how SNFs receive Medicare payments for therapy services were included in the new report
OIG's recommendations for how SNFs receive Medicare payments for therapy services were included in the new report

Federal regulators' investigative arm has set its sight on adverse events in nursing homes, and how Medicare pays for skilled nursing therapy, according to a report released Tuesday.

The Office of Inspector General's 2016 Compendium of Unimplemented Recommendations outlines 25 unimplemented recommendations the office says would help cut costs and improve quality among Department of Health & Human Services programs. Many of the office's recommendations have seen some progress, but as of the publishing date, OIG believed “more should be achieved,” report authors stated.

Included in the report is OIG's recommendation that the Centers for Medicare & Medicaid Services increase its efforts to identify and prevent adverse events, including substandard treatment, inadequate resident monitoring, or failure to provide necessary care. CMS, along with the Agency for Healthcare Research and Quality, concurred with OIG's recommendation.

CMS released draft guidance in July to nursing homes regarding medication-related events, and is currently in the process of creating guidance for events related to resident care and infections. Those guidances are slated for final released in 2017.

The compendium also covers OIG's call for CMS to re-evaluate and reform how skilled nursing facilities receive Medicare payments for therapy services. CMS agreed with OIG's recommendations to evaluate how much Medicare payment rates for therapy should be reduced, as well as the office's recommendation to change the method of therapy payment.

CMS is currently conducting a study to evaluate therapy payment options and will use the results to inform any changes to payment methods it proposes.

OIG's compendium also includes recommendations on Medicare, Medicaid, human services programs, and food and drug safety.