WASHINGTON – Long-term care groups are concerned about the conflicting pressures of increasing calls for quality and declining reimbursements.
Nursing home organizations were hoping for legislative action in December to reverse expected cuts in Medicare reimbursement to skilled nursing facilities.
At press time, the status of the reimbursement reductions was unchanged.
Groups have proposed quality initiatives to boost the level of care, but are also making the point that quality can’t be improved outside of adequate reimbursement for care.
There is an “unbreakable link between stable funding and quality,” said Steve Biondi, vice president for clinical services at Extendicare Health Services, in testimony on behalf of the American Health Care Association before the Senate Special Committee on Aging.
AHCA’s testimony noted improvements in clinical quality goals that aligned with data tracked by the Online Survey, Certification and Reporting system of the Centers for Medicare & Medicaid Services. Publicly reported data points to improvements in patient outcomes, increases in overall direct care staffing levels and significant declines in quality-of-care deficiencies.
The organization, which represents many of the nation’s 16,000 nursing homes, believes making the survey and enforcement process more transparent is a key to sustaining quality improvements.
As part of the transparency effort, the CMS published a ranking of poor performing nursing homes last November. About 128 nursing homes were singled out as “special focus facilities” because they scored poorly on quality measures. Of those, 54 were identified as having chronic underperformance issues and were to be listed on CMS’ Web site.
“Release of the list was prompted by the number of facilities that were consistently providing poor quality of care, yet were periodically instituting enough improvement that they would pass one survey only to fail the next,” CMS officials said.
“Such facilities with a ‘yo-yo’ compliance history rarely addressed underlying systemic problems.”
The SFFs will be more aggressively surveyed and face more aggressive enforcement, with the last step being removal from participation in the Medicare and Medicaid programs.