• Transition to Payroll-Based Journal (PBJ) Data – Starting in April, 2018, CMS will use PBJ data to determine each facility’s staffing measure on the Nursing Home Compare tool on Medicare.gov website, and calculate the staffing rating used in the Nursing Home Five Star Quality Rating System.

• Staffing data audits - We are providing lessons-learned from audits conducted, and guidance to facilities for improving their accuracy. Nursing homes whose audit identifies significant inaccuracies between the hours reported and the hours verified, or facilities who fail to submit any data by the required deadline will be presumed to have low levels of staff. This will result in a one-star rating in the staffing domain, which will drop their overall (composite) star rating by one star for a quarter.

• Requirement for registered nurse (RN) staffing – We are reminding nursing homes of the importance of RN staffing and the requirement to have an RN onsite 8 hours a day, 7 days a week. Nursing homes reporting 7 or more days in a quarter with no RN hours will receive a one-star rating in the staffing domain, which will drop their overall (composite) star rating by one star for a quarter. This action will be implemented in July 2018, after the May 15, 2018 submission deadline for data for 2018 Calendar Quarter 1, 2018 (January – March, 2018) data.

2018 Data Submission Dates for AHRQ’s Surveys on Patient Safety Culture™ (SOPS™) Databases:

The following AHRQ Survey on Patient Safety Culture™ (SOPS™) Database will open in 2018 for voluntary data submission:

·  Nursing Home Survey on Patient Safety Culture Database: June 1 – 21

The Surveys on Patient Safety Culture Databases contain data from those facilities choosing to submit their SOPS survey data. Participating facilities will receive a customized feedback report displaying their results as well as aggregated results from all participants.

Nursing homes across the United States routinely give antipsychotic drugs to residents with dementia to control their behavior, despite rules against the misuse of drugs as “chemical restraints,” Human Rights Watch said in a report and video released today. This abusive practice remains widespread, even though the use of antipsychotic drugs on older people with dementia is associated with a nearly doubled risk of death.

The 157-page report, “‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia,” estimates that every week in US nursing facilities, more than 179,000 people, mostly older and living with dementia, are given antipsychotic drugs without an appropriate diagnosis. Facilities administer these drugs in many cases without obtaining informed consent from residents or their families.

The report is based on visits by Human Rights Watch researchers to more than 100 nursing facilities in six states and more than 300 interviews with people living in facilities, their families, staff, long-term care and disability experts, government officials, and advocates.

Medicare beneficiaries, including elders and disabled persons, are being treated at inpatient and outpatient medical facilities for conditions that may be the result of abuse or neglect. The Elder Justice Act recognizes an older person's rights, including the right to be free of abuse, neglect, and exploitation. In addition, all 50 States have mandated reporter laws for the reporting of the potential abuse or neglect of elders and vulnerable persons. Prior OIG reviews have shown that there are problems with the quality of care and the reporting and investigation of potential abuse or neglect at group homes, nursing homes, and skilled nursing facilities. By analyzing the treating medical facilities' diagnoses, we will determine the prevalence of the potential abuse or neglect of Medicare beneficiaries. We will also determine whether the potential abuse or neglect occurred at a medical facility or at another location, such as the Medicare beneficiary's home.

• Federal regulations allow facilities to initiate discharges of residents only in specific instances.Despite these protections, discharges which violate Federal regulations continue to be one of the most frequent complaints made to State Long Term Care Ombudsman Programs.
• The Centers for Medicare & Medicaid Services (CMS) has begun an initiative to examine and mitigate facility-initiated discharges that violate federal regulations. CMS is examining State survey agency’s intake and triage practices for these type of discharge complaints, developing examples of inappropriate and appropriate discharges for surveyors, identifying best practices for nursing homes, developing training and evaluating enforcement options for these types violations.

CMS has established a Cyber Emergencies resource page.