A nurse rolling a senior in a wheelchair
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A government watchdog is urging the Centers for Medicare & Medicaid Services to keep a more watchful eye on facility-initiated discharges after finding nursing homes rarely complied with federal requirements to notify ombudsmen of intended moves. 

An analysis issued Monday by the Health and Human Services’ Office of the Inspector General revealed that a majority of ombudsmen reported they struggled to get timely, complete and accurate facility-initiated discharge notices.

“Providers could look to their ombudsmen and again look to those requirements about the six allowable reasons for discharges, and properly filling out those notices and make sure they’re following those regulations,” Shanna Weitz, the report’s lead analyst, told McKnight’s Long-Term Cares News on Friday. 

Investigators called on CMS to provide more training to nursing homes on federal requirements for facility-initiated discharge notices and to implement deferred initiatives aimed at addressing inappropriate notices. 

The OIG also recommended that CMS assess the effectiveness of its enforcement actions in cases of non-compliant facility-initiated discharge. The agency agreed with the three recommendations but noted that its enforcement evaluation could take time due to the ongoing public health emergency.  

The report also criticized a lack of data on facility-initiated discharges by nursing homes. While nursing homes are required to send discharge notices to state ombudsmen, neither CMS nor the Administration for Community Living collect data on the number of discharges that take place. State ombudsmen also don’t count or track the number of notices they receive. Consumer advocates have criticized nursing home discharge policies during the pandemic as a way to get rid of unwanted patients, and experts had predicted reform on the matter could come under the Biden administration

“The best [way] to help keep nursing homes safe is we need to have information about the number and the nature of these facility-initiated discharges,” Weitz said.