As fellow healthcare providers, hospital and nursing home interests are frequently intertwined. 

Often, they are at odds with another, such as when it comes down to things like splitting a funding pie. Usually, those head-to-head confrontations don’t end well for nursing homes, with their relatively smaller war chests.

But whether they’re teammates or rivals, neither should ever pass up a chance to learn from the other. After all, rare is the athletics coach who doesn’t study his successful counterparts to get a little better himself or herself. 

You listening, nursing homes? 

You ought to be, because right now it’s looking like your hospital buddies could be getting a present that you can only dream of.

It seems the Centers for Medicare & Medicaid Services is going to “let hospitals off the hook for COVID-era lapses,” as the headline of a recent Kaiser Health News article put it. 

Hmmm. Ever get any pressure from CMS or come under fire for anything you did regarding the deadly virus that has gripped much of the world, and the elderly population in particular?

The envious details include the waiving of about $350 million in financial penalties for some hospitals because certain safety measures were not designed to account for pandemic conditions, such as COVID surges and, ahem, worsened workforce shortages.

CMS’s top medical officer fretted about the potential effects of “skewed or inaccurate data.”

Wonder if nursing home interests might have ever complained about data and outcomes that were affected by the biggest national health emergency in more than 100 years? Wait, that’s one of the main planks of their argument for why costs have been so high and reimbursements under the PDPM system would naturally be more than expected. 

No ‘Compare’

CMS’s forgiving attitude toward hospitals, however, is not universal: Patient advocates are up in arms about what they see as a whitewashing. But it’s yet to be seen if they can stop or even slow CMS from suppressing some of  the hospital data from its own Medicare Care Compare website. Yes, that’s the same website that is hosting more revealing nursing home information than ever before, including staffing levels and other data soon to start appearing.

Actually, some of the hospital data will continue to appear. But not all of it when it comes to things such as falls and sepsis, according to the KHN report.

CMS says that penalizing hospitals under a certain program created by the Affordable Care Act would be unreasonable, given the impact of the pandemic on certain metrics.

A year’s pause of enforcing the hospital penalties is reasonable, adds a university professor who is an expert on hospital quality. The financial penalties are based on metrics that can easily be swayed by triggers that include COVID-19 surges and other abnormal dramatic effects, he pointed out.

One can envision nursing home “students” squirming at their desks, yearning to ask “teacher,” CMS, if it can get some of that justification attention, too.

It seems there are plenty of other differences between hospitals and nursing homes, if that weren’t already painfully obvious. While nursing homes have state surveyors to worry about, the majority of hospitals deal with private, non-governmental inspectors and accrediting agencies. A federal watchdog has noted how CMS hasn’t had, or used, the authority to “make the accrediting agencies execute a special, covid-spurred infection control survey for hospitals to ensure patient safety,” as Kaiser described it.

It’s not as if nursing homes would be subject to special COVID-spurred infection control surveys. Oops. Scratch that thought.

CMS actually agreed with the Office of Inspector General’s findings last year about the agency’s failings in overseeing hospital accreditors. (No, we’re not making this up. Though to be fair, the OIG also has taken issue with some aspects of CMS’s oversight of nursing homes in the past.)

But if there’s anything that we learn from this latest episode of hospitals vs. nursing homes, it’s … oh, you know the rest already.

James M. Berklan is McKnight’s Executive Editor.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.