Category: Regulatory Oversight

Financial Audits

Everyone thinks there is too much waste, fraud, and abuse in Medicare and Medicaid programs. Skilled Nursing News had an article on Ned Lamont’s bill to solve the problem. The Governor of Connecticut proposed a bill that will authorize forensic audits to review operator annual financial reports conducted by the state Department of Social Justice. This proposal

Surveyors Needed

A May Report from the U.S. Senate Special Committee on Aging “confirmed that nursing home inspection agencies are severely understaffed, noting that 32 state survey agencies report job vacancy rates of 20 percent or more.” The U.S. Department of Health and Human Services Office of Inspector General (OIG) will search deeper into the surveys conducted

Long-Term Care Ombudsman

The General Accountability Office (GAO) released a new report on the Long-Term Care Ombudsman Program (LTCOP), sharing findings from interviews with five selected state LTC Ombudsman Programs, the Administration for Community Living (ACL), and various stakeholders. The GAO reviewers also looked at ombudsman data from the National Ombudsman Reporting System for fiscal years 2019 – 2022.

CMS Star Rating Now

A 14 News article by Caroline Klapp examined the Center for Medicare and Medicaid Services (CMS) scores for nursing homes, and how well they really assess the quality of a facility. Overall, it appears the CMS ratings are a useful tool to evaluate nursing homes, but their scores should not be taken to be infallible.

OIG to Study Fall Reporting

The Office of Inspector General has concerns about nursing homes reporting falls and other traumatic events. If a nursing home accepts Medicare or Medicaid (which the vast majority do), the operator is required to report resident falls in patient assessments. However, often this does not happen because preventable falls affects the Star rating for the

Mariner Settlement

Mercury News reported California operator Mariner Health Care agreed to pay up to $15.5 million in penalties, plus $2.25 million in costs, if the chain continues to fail to abide by terms related to patient safety and staffing levels. In 2021, all 19 of Mariner’s facilities and the company’s corporate management were sued for unsafely discharging

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