HHS Watchdog To Probe Enforcement Of Elderly care Staffing Standards


The inspector general in the Department of Health and Human Services this month launched an examination into federal oversight of skilled assisted living facilities amid signs some homes aren't meeting Medicare's minimum staffing requirements.

The review comes on the heels of the Kaiser Health News and Ny Times investigation that found nearly 1,400 nursing facilities report having fewer rns working than the Centers for Medicare & Medicaid Services (CMS) requires or failed to provide reliable staffing information towards the government.

The Office of Inspector General said it would examine the staffing data nursing facilities submit to the government through CMS' new system that utilizes payroll records. That system gives a better view of staffing than the self-reported numbers facilities had provided for nearly a decade.

The IG said it would also consider how CMS ensured accuracy from the records, enforced minimum staffing requirements and rewarded facilities that exceeded those standards.

Donald White, a spokesman for the inspector general, said the project was “part in our ongoing overview of programs in the department.” The report is likely to be issued in the federal fiscal year that begins in October 2021.

KHN's research into the payroll records found thousands of nursing homes had one or more days in which the facilities didn't report a registered nurse on duty not less than eight hours, as required by Medicare.

KHN also found great volatility in the staffing of cnas daily, with particularly low numbers on weekends. Those aides are crucial to daily care, helping residents eat, bathe and complete other basic activities.

In July, Medicare assigned its lowest staffing rating of one star to nursing homes that didn't satisfy the registered nurse standard, as published around the Elderly care Compare website. Still, only about half of those homes saw their overall star rating – the most crucial consumer guide – drop.

CMS declined to comment about the new examination.

Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy, said she hoped the probe would spur CMS to take action against facilities where payroll records show they're leaving residents with insufficient nursing coverage.

“We know registered nurses are critical, and they're finding that they are not there on weekends,” Edelman said.

Earlier this month, Sen. Ron Wyden (D-Ore.), citing the KHN reporting, asked CMS to explain how it's addressing the issue of nursing homes' inadequate staffing data or understaffing.

LeadingAge, an association of nonprofit providers of getting older services including nearly 2,000 nursing facilities, said in response to Wyden's letter that facilities have complained their data is not turning up correctly on the website which “kinks” in the new system have to be exercised.

“Even if the report results from an error that is immediately corrected, the star isn't restored before the next quarterly reporting period,” the group wrote.