CMS often does not penalize nursing homes that place the safety of patients at risk or that have long-term problems, according to a report released on Wednesday by the HHS Office of Inspector General, the AP/Long Island Newsday reports. According to the report, CMS should have terminated the contracts of 55 nursing homes between 2000 and 2002 but failed to terminate contracts in 30 of those cases. In some cases, states did not refer problems with the nursing homes to CMS before the required termination date, the report finds. In other cases, CMS regional staff reported that they did not want to displace patients when they believed the facilities would return to compliance with federal rules, according to the report. "Contrary to our recommendation regarding facility termination, ... (CMS) will continue to apply the remedy in a manner that it believes best protects the well-being of residents," the report states.
The report also finds that in 28% of 706 cases between 2000 and 2002, CMS failed to deny Medicare reimbursements for new patients when nursing homes take more than three months to return to "substantial compliance" with federal rules. CMS Administrator Mark McClellan said that the period reviewed in the report preceded significant improvements in agency enforcement against problems in nursing homes and that the agency has worked with facilities to improve their performance. He added that without that effort, "thousands of nursing home residents would have been forced to relocate even though the problems were abated within a few weeks." Senate Finance Committee Chair Chuck Grassley (R-Iowa) said that the report indicated a lack of CMS enforcement against problems in nursing homes. "I'm sympathetic to the argument that termination would displace residents. But residents in immediate jeopardy at a nursing home need to be somewhere safer," Grassley said, adding, "They're the most vulnerable to abuse and neglect. Termination has to be real and enforced, or troubled nursing homes may have no other incentive to clean up their act" (Freking, AP/Long Island Newsday, 5/17).