Nursing Homes that Neglected Patients Got $5.1B From Medicare: Report

The country’s Medicare program paid more than $5.1 billion to nursing homes that were not providing the proper standard of care for residents, according to a new government report. 

A study (PDF) published last month by the Department of Health and Human Services Office of Inspector General (DHHS-OIG) reports that out of $32.2 billion paid to skilled nursing facilities in 2012, $5.1 billion, or nearly 16%, went to facilities that failed to provide adequate care to patients.

Investigators indicate that nursing home neglect occurred in about 15% of all nursing home stays.

The report found that 74% of nursing facilities surveyed in 2007 had at least one quality of care deficiency, and found that many failed to provide appropriate care plans and failed to meet one or more Medicare requirements for beneficiary assessments or care plans.

Inspectors found incidents of lack of staffing, failure to treat nursing home bedsores, malnutrition and dehydration at the nursing home, and cases of improper medications given the residents.

“Additionally, reviewers found examples of poor quality care related to wound care, medication management, and therapy,” the report states. “These findings raise concerns about what Medicare is paying for.”

The reviewers suggest that their findings demonstrate a need for more stringent oversight of nursing homes and other nursing care facilities in order to ensure that they perform appropriate care planning and discharge planning.

The report lays out a number of recommendations for the Centers for Medicare & Medicaid Services (CMS). The recommendations include calls to:

• Strengthen nursing home regulations on care planning and discharge planning.
• Provide guidance to nursing homes on improving care
• Increase efforts to identify and hold accountable facilities engaged in nursing home neglect
• Link Medicare payments to nursing homes to quality of care requirements
• Follow up on nursing homes that fail to meet quality of care standards.

The reports says that CMS agrees with all of its recommendations.