Special surveys to determine Minimum Data Set coding accuracy and nursing home staffing levels will occur nationwide in 2015, the Centers for Medicare & Medicaid Services announced in an Oct. 31 memorandum.
A five-state pilot of the focused surveys concluded in August, and there were deficiencies reported on 24 out of 25, according to CMS. The problems included inaccurate staging and documentation of pressure ulcers, plus how antipsychotic medications were classified. The surveys are being implemented in all states because they improved the ability to “identify errors and deficiencies related to MDS coding and resident care,” the memo to survey agency directors stated.
In at least some of these surveys, the surveyors will conduct interviews and review records to gather information about staffing levels, and to get a clearer picture of turnover throughout the year. The surveyors should be able to corroborate self-reported staffing information provided by facilities, the memo explained. A recent New York Times article asserted that some nursing homes “game the system” and the self-reported staffing data needs to be verified, setting off Congressional calls for action.
The special surveys were started in response to Office of Inspector General findings that skilled nursing facilities widely supply MDS information that is not “supported or consistent with the medical record.”
Coding inaccuracies or staffing problems brought to light by these surveys could result in citations and could be subject to further review, the memo states. The surveys are expected to take two days. CMS will work with state agencies to determine how many of these surveys will occur and which facilities will be involved. They are expected to begin early in fiscal year 2015.
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