Officials in the state of Kansas frequently took skilled nursing facilities at their word when following up on plans to fix certain deficiencies — a violation of federal requirements for SNFs that participate in Medicare and Medicaid.

The Kansas Department for Aging and Disability Services only verified SNFs’ strategies to correct deficiencies 52% of the time in 2014, according to a new report from the Department of Health and Human Services’ (HHS) Officer of the Inspector General (OIG).

In addition, the state couldn’t provide concrete evidence that SNFs had actually implemented correction plans in 13% of the cases from that year, with the OIG finding that supporting documentation had been deleted from the Kansas database.

In 2014, the OIG counted 2,127 health-related deficiencies at Kansas SNFs that required follow-ups under federal regulations. Once a facility submits a correction plan, states must then check back in to determine whether the new strategies have been implemented, either through SNF-provided evidence or an on-site visit.

The OIG used a representative sample of 100 deficiencies at 78 facilities in Kansas to extrapolate data for the full set; based on this analysis, the OIG found that only 1,114 of the total issues were investigated to their conclusions.

“The state agency’s practice was to accept the nursing homes’ correction plans as confirmation of substantial compliance without obtaining the required evidence of correction for less serious deficiencies,” the OIG reported.

For instance, a SNF that failed to collect complete data about a patient’s dental care came up with a plan to finish the task and also take steps to avoid such problems in the future. Kansas was required in this situation to review evidence that those changes had taken place, but instead sent a letter to the SNF confirming its compliance based solely on the proposal, the OIG found.

The Kansas Department for Aging and Disability Services also failed to conduct required surveys of nursing home care within the mandated 15-month timeframe a little less than half of the time, the OIG said.

Kansas officials have already altered their policies, making “immediate systemic changes” to the way the state follows up on deficiencies and correcting the loss of data, according to the OIG. Additionally, the state has taken steps to improve the frequency of its required surveys, and reevaluated surveyor wages to help with a shortage of workers at those positions.

Written by Alex Spanko