This blog post was written by our guest blogger Michele Treinin, Healthcare Analyst on the RMS Healthcare team.
Along with hospitals, home health agencies and in-center hemodialysis providers, skilled nursing facilities may be the next type of organization to have reimbursement tied to patient satisfaction scores and quality measures.
A report issued by the HHS Inspector General said that Medicare paid an estimated $5.1 billion for patients in skilled nursing facilities even though the nursing home failed to meet federal quality of care rules, which in some cases led to neglected patients and dangerous conditions. By law, nursing homes are responsible for writing care plans for individual patients for all care givers including doctors, nurses and other staff to keep everyone on the same page about overall well-being. The report exposed that patients often aren’t getting the care and help they need and that taxpayer money may be going to facilities that actually endanger the lives of the patients. These findings are concerning because it questions what Medicare is actually paying for and it comes at a time when healthcare quality and costs are receiving a lot of attention due to healthcare overhaul from the Obama administration.
The report estimates that in 20 percent of patient stays, health problems were not addressed in care plans. At the same time, patients received therapy that they didn’t need, which would result in a higher reimbursement from Medicare. The report was based on medical records from 190 patient visits in nursing facilities in 42 states that lasted three weeks.
The report raises questions on why homes are getting reimbursed for poor quality and performing unneeded services to get additional funding. Investigators recommended that payment be tied to the homes’ ability to meet basic care requirements, which would be undertaken by the Centers for Medicare & Medicaid Services (CMS).
Currently, there is a version of a CAHPS® survey for Skilled Nursing Facilities, but it is in no way tied to reimbursement. It is anticipated that within a short time, it will become a mandatory activity, which will result in reimbursement being tied to the scores received. If the facility is non-compliant, they may lose funds associated with it.
If you’re a nursing home looking to engage your patients and see where you rate with satisfaction before CMS ties it to reimbursement, contact Research & Marketing Strategies (RMS). RMS Healthcare is a full service healthcare research division that has been conducting CAHPS® surveys since 2006 with the inception of the HCAHPS® for hospitals. We are also a vendor for the ICH CAHPS® survey for in-center hemodialysis centers across the country along with HH-CAHPS® and CG-CAHPS®. For more information on the Nursing Home CAHPS® survey or any other CAHPS® survey, contact Sandy Baker, CAHPS® Director of Business Development at 1-866-567-5422 or email her at SandyB@RMSresults.com.
Credits to the following news article from the Washington Post – click here.