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  1. Opinion

Ensuring safety and quality in nursing homes | Seema Verma

Seema Verma, administrator, Centers for Medicare and Medicaid Services
Published Jul. 16

BY SEEMA VERMA

Special to the Tampa Bay Times

Few health care decisions are as difficult as choosing a nursing home. Some are simply seeking short-term care before returning home. For others, a nursing home may eventually become their new home.

In any case, patients and their families and caregivers should have all the support they need to navigate this complex and delicate decision. Most importantly, they should have the security and peace of mind that they will be kept safe from abuse and neglect. Through the Centers for Medicare and Medicaid Services — or CMS — the Trump administration is empowering residents and their caregivers with information about nursing home safety and quality, and we're doubling down on our efforts to keep residents safe.

Every nursing home resident deserves be treated with respect at all times. Abuse and neglect are never acceptable. CMS is charged with developing and enforcing quality and safety standards that keep patients safe throughout the health care delivery system, including nursing homes. This responsibility lies at the core of government's role in the health care system and, with approximately 1.5 million Americans living in nursing homes, we consider it nothing short of a sacred trust.

We're constantly working to fulfill that responsibility. But a recent inspector general analysis of 2016 nursing home data showed the challenges this administration faced when we arrived. The inspector general said more could have been done to address abuse. We agree and have already taken swift action to chart a path toward improved safety and quality in nursing homes. I recently announced a five-part strategy detailing the Trump administration's work to date, and what we're planning.

CMS is strengthening oversight, enhancing enforcement, increasing transparency, improving quality and putting patients over paperwork. This means stronger oversight of our state partners, who visit each nursing home in the nation annually to ensure consistency and compliance in the nursing home inspection process. It also means holding nursing homes accountable for the care they provide. The Trump administration is also investing in identifying problems and improving quality — like our recent efforts to reduce antipsychotic drug use in nursing homes residents with dementia. And we're putting patients over paperwork by eliminating burdensome or duplicative rules that keep providers from focusing on caring for residents, not bureaucracy. Just today, CMS published a rule that streamlines and simplifies many prescriptive regulations that have consumed nursing homes' precious time and resources. Those resources — we estimate savings of over $600 million in administrative costs — can now be prioritized toward caring for residents.

President Trump is holding nursing homes accountable and reducing unnecessary regulatory burdens, and also empowering residents and caregivers by giving them the information they need to make informed decisions. Today, we released a rule that protects patients' right to transparent information about how to settle disputes with nursing home providers.

We also offer transparent quality of care information. CMS offers prospective residents and caregivers a comprehensive resource on our Nursing Home Compare website. Nursing Home Compare displays performance on annual inspections, staffing levels, and performance on federal quality measures in a simple rating, from one to five stars.

We're always improving the information on Nursing Home Compare. Just recently, we made significant updates to the website, which included new staffing information and new quality measures. We're also working to provide more information related to past cases of abuse and neglect. We urge all potential residents and caregivers to consult Nursing Home Compare as an important source of information before choosing a nursing home.

We're also increasing transparency about other programs, like our Special Focus Facility program, which targets poor performers for more frequent inspections. Today, we are publishing a list of nursing homes that are candidates for this program to alert consumers to serious quality issues before selecting a nursing home.

We're not in this alone. Our federal partners, like the Government Accountability Office and inspector general, help us find areas for improvement. We value their input and always take their recommendations seriously. We're also asking Congress for its support. We investigate every complaint about nursing home quality. These complaints have increased approximately 20 percent since 2013, yet Congress hasn't increased our funding for inspections since 2015. By passing President Trump's 2020 budget, members of Congress can help nursing home residents in their own communities by increasing funding for inspections and allowing us to focus our resources on nursing homes that need increased scrutiny. We know Congress shares our desire for high-quality, safe nursing homes, so we hope it will give us the tools we need.

We are personally committed to making sure Americans have access to the highest-quality nursing home care. We also encourage residents and loved ones to speak out. If you know of abuse or neglect in a nursing home, you should immediately alert a supervisor, social worker, administrator, doctor, or long-term care ombudsman. If you need help, you can use our website to find contact information for your state's survey agency and long-term care ombudsman, who provides free and trusted help. With our nationwide improvement initiatives and your vigilance, we will continue to ensure the safety of our nation's care system.

Seema Verma is administrator, Centers for Medicare and Medicaid Services.

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