OIG: Nursing Home Complaints Increase Nationwide — Along with Delays in Investigations

The federal government’s top health care watchdog logged an increase in nursing home complaints last year, according to the most recent set of data from the Department of Health and Human Services, in tandem with a 23% rise in high-priority incidents that were not investigated within the proper timeframe.

The HHS Office of the Inspector General (OIG) rolled out its 2016-2018 trends in nursing home complaints on individual state surveys — with the most recent 2018 complaint average reaching its highest level in two years at 52.3 out of 1,000 residents, versus the previous year’s 49.9 per 1,000.

In addition, the number of high-priority grievances that failed to be investigated within the mandatory 10-day period peaked at 6,540 in 2018, as compared to 5,305 the year before.

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The highest-priority “immediate jeopardy” complaints, meanwhile, dipped from 5,451 in 2017 to 5,245 last year, with the number of IJ incidents not investigated within the required two days dropped from 964 to 670 over that span.

On a state-by-state basis, Hawaii received a mere 8.7 complaints per 1,000 for 2018, with only four high-priority incidents. Texas, at the other end of the spectrum, saw 102.3 complaints per 1,000, with 3,043 high-priority complaints — 1,304 of which were not investigated in 10 days — and 10 immediate jeopardy complaints not probed in two days.

Source: HHS OIG

As part of its recent focus on nursing home safety, the Centers for Medicare & Medicaid Services has begun tightening the reins on State Survey Agencies to ensure that rules and procedures are more uniform from state to state. This past week, CMS rolled out a number of new assessment tools — including a rubric and grading scale — for the State Performance Standards System (SPSS), which took effect for the 2020 fiscal year beginning October 1.

Despite the push for uniformity, the government is also currently debating enforcing varying metrics on a state-by-state case based on the ubiquity of certain safety issues in specific regions.

The latest regulatory guidelines form one part of CMS’s recent push toward transparency and boosting safety measures in nursing homes, which CMS administrator Seema Verma laid out in a five-point plan in July. That effort also includes the contentious addition of a warning icon on Nursing Home Compare for sites with episodes of abuse, and more rigorous standards for SNF quality ratings throughout the country.


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