Feds
Pull Reimbursement Payments for Ohio Nursing Home for Pattern
of Providing Poor Resident Care
An Ohio nursing home will be closing due to the loss of eligibility to receive Medicare and Medicaid reimbursement payments for their residents. The Centers for Medicare & Medicaid Services (CMS) initially warned the nursing home last December that if the residents’ care issues were not brought into compliance with federal requirements, their eligibility for reimbursement payments was in jeopardy.
The nursing home has been cited multiple times over a period of years due to poor resident care that included such things as residents’ losing weight and complaints of inadequate personal care, such as residents not being bathed for weeks.
The facility was purchased by a new company in December. Several residents expressed their feeling that the government had acted too quickly, and that conditions had greatly improved since the new owners began managing the nursing home.
The chief operating officer for the new owner reported that the nursing home had been working to return to federal compliance, but just could not do it in this short amount of time.
State officials indicated that residents will be relocated to other available facilities throughout the state.
Compliance Perspective
The failure of a facility to restore care delivery to an acceptable federal compliance level in a timely manner after being notified of the potential for loss of federal reimbursement payments can result in exclusion as a Medicare and Medicaid healthcare provider.
Discussion Points:
- Review policies and procedures regarding the facility’s response to deficiencies cited by state and federal inspectors, and ensure that protocols are followed to keep the facility in federal/state compliance status.
- Train staff about the need to provide high quality of care for residents that meets or exceeds state/federal compliance regulations.
- Periodically audit reported complaints and incidents to determine if the issues have been resolved and/or corrected. Oversee the quality of care provided by staff through the monitoring efforts of the QAPI/QAA Committee.
