The federal government and state survey agencies will likely place a heightened emphasis on high-priority complaints in nursing facilities and how soon they’re investigated based on newly released data from the Office of the Inspector General, according to one industry expert.
The OIG published an interactive map and data Tuesday on trends in nursing home complaints between 2016 and 2018. The data revealed that the number of high-priority complaints and complaints not investigated within 10 days have been increasing over the last three years.
High-priority nursing home complaints increased from 32,774 in 2016 to 33,974 in 2018, a nearly 4% rise. The number of those complaints that weren’t investigated by state surveyors within 10 days increased from 5,061 in 2016 to 6,540 in 2018 (a 29% rise).
“Providers need to be aware that an increase in high-priority complaints that are not investigated within the 10-day time period are a priority for CMS and state survey agencies,” warned Lisa Thomson, chief marketing and strategy officer for Pathway Health.
The number of complaints per 1,000 nursing home residents is trending similarly. There were about 47 complaints made nationally per 1,000 residents in 2016, the findings revealed. That number increased to about 50 complaints made in 2017, and jumped again to about 52 in 2018 — an 11% rise over the two-year span.
Thomson noted that during this time period providers had to deal with a new survey process and new regulations (Phase 2 of the Requirements of Participation) that went into effect. She said that despite the trends, providers must remain focused and should “continue to provide good quality care with positive outcomes.”
“I think it’s important for us as providers to continue to stay on top of that data and to realize that while the number of complaints are increasing as the public becomes more aware of first, how to make a complaint, and secondly, how to review organization data through public sites, the scope and severity of the potential citations correlated to complaints has decreased,” she said.
The number of Immediate Jeopardy complaints in nursing homes, however, are trending downwards. There were 6,039 Immediate Jeopardy complaints made nationally in 2016, according to the findings. That number dropped to 5,451 in 2017, and 5,245 in 2018.
State survey agencies’ response times to Immediate Jeopardy complaints are also improving. Findings showed that the number of those types of complaints that weren’t investigated within two days was 1,452 in 2016. That number dropped to 964 in 2017, and declined to 670 in 2018.
“While these are trends we’re seeing here, we just have to continue to put our focus on providing the best outcomes and monitoring our data,” Thomson said.
The OIG is also planning to release additional insights on the timeliness of state survey investigations into serious nursing home complaints. A 2017 report found that nursing home complaints rose by 33% between 2011 and 2015.