OIG to Investigate CMS Oversight of Skilled Nursing Staffing Measures

In the wake of controversy over nationwide skilled nursing staffing levels, the health care industry’s top government watchdog has stepped in to investigate.

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) announced that it will launch a probe into the way skilled nursing facilities maintain their staffing records — with a focus on the Centers for Medicare and Medicaid Services’ (CMS) oversight of those requirements.

Kaiser Health News first reported the story on Thursday.

“We will examine nursing staffing levels reported by facilities to the Payroll-Based Journal (PBJ) and CMS’s efforts to ensure data accuracy and improve resident quality of care, by both enforcing minimum requirements and incentivizing high-quality staffing above minimum requirements,” the OIG wrote in its notice.

Kaiser and the New York Times first raised the issue earlier this summer, reporting that the new PBJ requirements revealed that nursing home staffing levels had been overreported for years. For instance, the payroll data revealed that even SNFs that had received positive staffing scores under the Five-Star Quality Rating System had deficiencies; in response, CMS handed out nearly 1,400 one-star staffing ratings to facilities across the country in late July.

OIG plans to release its report on the issue sometime in fiscal year 2020, which begins October 1, 2019.

PBJ took some providers by surprise when CMS rolled it out in April, and providers may still be grappling with how to accurately record agency staffing levels and hours for registered nurses who may come in on days when they were not initially scheduled to work.

“People are like, ‘Wait, what happened? What did I do to go down? What did I do to go up?’” Don Feige, founder of software firm ezPBJ, told Skilled Nursing News earlier this month. “I think that’s triggered a lot of people now to start to analyze and figure out what’s in their data … I think we’re in the first few months of that awareness and that seeking to understand what’s really going on with their staffing data.”

Written by Alex Spanko

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