CMS clarifies long-term care quality review in managed care models

Providers fear they could be subject to harsher surveys following the Centers for Medicare & Medicaid Services pledge to make revisions to the system used to monitor the performance of state survey agencies. 

CMS announced several changes to enhance the State Performance Standards System (SPSS) as it seeks to “protect and improve” nursing home resident safety. 

LeadingAge is currently reviewing the changes and allowed “some aspects of it appear to ensure greater accuracy and timeliness,” according to Ruth Katz, the organization’s senior vice president of policy. 

Katz added, however, the organization has concerns about the effort and hopes the initiative doesn’t result in “an even more punitive approach to surveys.” 

“Timely and accurate surveys are in everyone’s best interest,” she said. “For instance, earlier this month, CMS announced plans to flag providers with an icon on Nursing Home Compare if they have been cited for abuse. This memo, though, seems to suggest that CMS and survey agencies aren’t sure of their ability to accurately assess abuse. So, we want to be sure that the terms of this memo will lead to the quality of care we all want.”

Changes to the system include: increased monitoring and system flexibility; additional state performance indicators, which will be reviewed quarterly; additional oversight on the handling of “immediate jeopardy” situations; and increased SSA access to CMS data. 

CMS’ move is part of its ongoing five-part plan to strengthen oversight in nursing homes. 

“By holding inspectors accountable for conducting timely and consistent inspections, we’re holding nursing homes accountable for providing safe, high-quality care — helping ensure safe nursing home environments,” Administrator Seema Verma said.