Q: CMS has a new policy of publishing citations against nursing homes during appeals. Why would they include non-final citations?
A: CMS has announced it would begin publishing citations against nursing homes even while those citations are appealed. Thus, it will immediately post deficiency citations under Informal Dispute Resolution and Independent Informal Dispute Resolution (IDR/IIDR).
This is a stark change from the traditional policy. The clear purpose behind not posting citations under IDR/IIDR until the dispute is complete was simple: Any family doing due diligence regarding a facility should not be unduly influenced by cited deficiencies when they have not been finally adjudicated. Though the deck is stacked against them, nursing home operators do actually win appeals.
Now, CMS will display disputed items on Care Compare with a note. If upheld, they will remain posted. If overturned, the citation will be removed. If the severity is reduced, the citation will be displayed at the reduced level. Still, citations will not be included in calculating a star rating until the dispute is resolved.
The above “safeguards” are insufficient to address the key drawback. Families will be making decisions about nursing homes based upon premature information. It is exceedingly unlikely that subsequent changes will be known by families in sufficient time to counter the earlier information.
CMS stated that “consumers should have as much information about nursing homes as possible to support their healthcare decisions.” Here’s my fix to the that: “Consumers should have as much [accurate] information about nursing homes as possible to support their healthcare decisions.”
Putting out premature information about a facility increases the likelihood of families relying on inaccurate information. That helps no one.
