HHS, CMS Promoting Quality and Safety in NHs

The Centers for Medicare & Medicaid Services (CMS) issued its fiscal year (FY) 2023 Skilled Nursing Facilities Prospective Payment System (SNF PPS) proposed rule on Monday, April 11, which asks for public feedback on how health equity improvements and staffing in nursing homes (NHs) can impact improved health outcomes.

“Everyone deserves to receive safe, dignified, and high-quality care, no matter where they live,” said Health and Human Services (HHS) Secretary Xavier Becerra. 

Medicare payments are provided to more than 15,000 NHs under the SNF PPS, which serves more than 1.5 million individuals. HHS wrote in a press release that approximately $35 billion in FY 2022 is the projected estimate of Medicare spending to NHs.

“Through the SNF PPS proposed rule, CMS is continuing its work to transform the SNF payment system to a more patient-centered model by making payments based on the needs of the whole patient, rather than focusing on the volume of certain services the patient receives,” stated HHS.

Staffing levels in NHs was reported as an integral part of reaching the goal to improve the quality of NHs for its residents.

“The COVID-19 pandemic has highlighted serious problems at some of the nation’s nursing homes that have persisted for too long. And we have seen the tragic impact that inadequate staff resources can have on residents and staff,” said CMS Administrator Chiquita Brooks-LaSure.

To ensure all NH residents receive high quality and safe care and that staff has the support they need, CMS is asking for insight to help establish minimum staffing requirements in NHs. In addition to the provided input, CMS will be conducting a new research study to establish the type and optimal level of NH staffing needs.

According to HHS, proposed rules on NH minimum staffing level requirements are slated to be issued within a year.

“Looking at the relationship between staff turnover and quality of care, preliminary analysis by CMS has shown that as the average staff turnover decreases, a facility’s overall rating on CMS’ Nursing Home Five Star Quality Rating System increases, which suggests that lower turnover is associated with higher overall quality,” reported HHS.

In an effort to identify and reduce disparities in NHs, CMS is asking for comments on ways to arrange or classify measures in NH quality reporting programs.

“CMS is proposing a 3.9%, or $1.4 billion, update to the payment rates for nursing homes, which is based on a 2.8% SNF market basket update plus a 1.5 percentage point market basket forecast error adjustment and less a 0.4 percentage point productivity adjustment,” wrote HHS.

To achieve budget neutrality in FY 2023 with the prior payment system, CMS proposes to adjust SNF payment rates downward by 4.6% or $1.7 billion.

Reference:
Health and Human Services. HHS takes actions to promote safety and quality in nursing homes. Published April 11, 2022. Accessed April 12, 2022. https://www.hhs.gov/about/news/2022/04/11/hhs-takes-actions-to-promote-safety-and-quality-in-nursing-homes.html