State survey agencies will be stepping up their long-term care enforcement efforts, the Centers for Medicare & Medicaid Services administrator suggested Tuesday.
Enhanced enforcement is the agency’s next step in the previously announced five-part initiative to improve nursing home quality and safety standards. The effort also focuses on strengthening oversight, increasing transparency, improving quality and putting “Patients Over Paperwork,” CMS Administrator Seema Verma noted in a blog post.
The agency has done a comprehensive review of its enforcement mechanisms and is making “significant [and] creative enhancements” to its enforcement efforts, according to Verma.
Targeted improvement areas included oversight of state survey agencies (SSAs) and better communication with SSAs and providers on expectations. The agency also is focusing on collaborating directly with corporate leaders of nursing home chains and staffing levels at facilities.
“Federal regulations are clear with respect to RN staffing, and that’s because we know patients and residents are safer when sufficient staffing levels are maintained. Unfortunately, all too often, we found that nursing homes weren’t complying with federal rules,” Verma wrote. “That’s unacceptable, so we’ve implemented a few strategies to bring nursing homes into compliance.”
CMS also plans to “take a hard look” at its civil money penalties that it imposes on nursing homes for noncompliance. The agency plans to announce new policies regarding penalties that promote equity and reduce variation.
The agency has also requested $442 million for survey and certification work — a $45 million increase from last year — for the FY 2021 budget.
“The increased funding would enable CMS to continue to meet the statutory survey requirements while dealing with the increase in volume and severity of complaints, and rising survey costs,” Verma wrote.
Also as part of its work on the five-part initiative, on Friday, CMS released a memo to surveyors announcing the release of two additional toolkits as part of the five-part initiative.
The first toolkit — the Developing a Restful Environment Action Manual (DREAM) Toolkit — offers educational resources and practical interventions for residents with dementia that can be implemented by nursing home administrators, directors of nursing and staff to promote high-quality sleep.
The second — the Head-to-Toe Infection Prevention (H2T) Toolkit — includes resources for staff to help prevent common infections by improving activities of daily living care.
