The federal government’s top health care watchdog last week announced a plan to investigate whether nursing homes are following rules around discharges, specifically citing media reports about improper evictions from facilities.
The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) added a probe of facility-initiated discharges to its formal work plan, with the goal of releasing a final report by fiscal 2022.
“A facility-initiated transfer or discharge of a resident from a nursing home can be an unsafe and traumatic experience for the resident and his or her family,” the OIG observed.
Discharges and evictions were the most common complaint received through the Long-Term Care Ombudsman Program from 2011 to 2016, the OIG observed, citing data from the National Ombudsman Reporting System.
The OIG has already looked into problems with facility-initiated discharges at both the state and federal Centers for Medicare & Medicaid Services (CMS) levels, though the work plan addition makes it a formal priority.
“We have ongoing work determining the extent to which state long-term care ombudsmen, state survey agencies, and CMS address facility-initiated discharges from nursing homes,” the OIG noted. “To complement this ongoing work, we will examine the extent to which nursing homes meet CMS requirements for facility-initiated discharges.”
CMS targeted improper discharges, commonly known as “patient dumping,” in a December 2017 memo to operators proposing a variety of potential solutions to the problem.
“Discharges which violate federal regulations are of great concern because in some cases they can be unsafe and/or traumatic for residents and their families,” David R. Wright, director of CMS’s Survey and Certification Group, wrote in the memo. “These discharges may result in residents being uprooted from familiar settings; termination of relationships with staff and other residents; and residents may even be relocated long distances away, resulting in fewer visits from family and friends and isolation of the resident.”
The New York Times this past summer published a piece exploring an apparent rise in improper discharges — potentially driven by new incentives to take on higher-acuity residents — during the COVID-19 pandemic, renewing public interest in the topic.
“The media has highlighted the rise in nursing home evictions,” the OIG observed.