New Feature On “Nursing Home Compare” Medicare Website Shows When Nursing Homes Are Cited For Patient Abuse

By Jason Bloome

The Center for Medicare and Medicaid Services has made changes to its Medicare Compare website (https://www.medicare.gov/nursinghomecompare) to make it easier for consumers to see if a nursing home has violated rules regarding abuse, neglect or exploitation of a resident.

The website will add a new red alert icon next to nursing homes that have these violations starting on October 23, 2019.  Nursing Home Compare provides detailed information about Medicare and Medicaid certified nursing homes in the United States.

According to CMS, consumers find it difficult to determine abuse violations when navigating the Nursing Home Compare website.   The red alert icon will simplify this task.

The red alert icon will tell consumers if over the past year there was a harmful abuse of a resident and if there was a potentially harmful abuse of a resident over the past two years.  CMS said the data would be updated monthly and that the icon would supplement their five star rating system.

The categories of harmful abuse and potential harmful abuse are:

1) A harm-level (scope and severity level G or higher) abuse citation on the most recent standard survey cycle or complaint survey within the past 12 months.

2) An abuse citation where residents where found to be potential harmed (scope and severity level D or higher) on the most recent standard survey cycle or complaint cuvey within the past 12 months and on the previous standard survey cycle or complaint survey in the prior 12 months.

According to CMS, facilities meeting either of these criteria will have their health inspection rating capped at a maximum of two stars and the best overall quality rating a facility that has received the abuse icon can have is four stars.

CMS noted in a statement:

“This means consumers will not be forced to wait for CMS’s quarterly updates to see the latest-related information — and nursing homes will not be flagged for longer than necessary if their most recent inspections indicate they have remedied the issues that caused the citations for abuse or potential for abuse and no longer meet the criteria for the icon.”

The red alert icon is part of an initiative begun by CMS in April 2019 to improve the tracking of nursing home quality and safety; a growing concern in a healthcare industry struggling to deal with an aging population, rising costs, and staffing shortages.  When it originally announced its initiative, CMS said it would focus on strengthening oversight, boost enforcement, increase transparency, develop better quality measures and streamline reporting requirements. 

The CMS announcement comes a few months after a Senate report revealed the government had identified several more troubled nursing homes than it initially disclosed to the public. In June 2019 CMS released a list of nearly 400 poorly performing nursing homes that qualified for but didn’t receive higher federal scrutiny.

The red alert icon reflects other changes begun by CMS to increase health care reporting transparency for consumers, including health care costs charged by hospitals.  In January 2020 CMS required hospitals to post their list price for services rendered to consumers and, in January 2020, it wants to force hospitals to post their payer-negotiated rates. 

CMS and Congress are also examining measures that will compel drug companies to inform consumers about the real cost of drugs in order to create a more competitive marketplace. 

Jason Bloome is owner of Connections – Care Home Consultants, an information and referral agency in Southern California.  More information at www.carehomefinders.com.