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This page provides basic information about being certified as a Medicare and/or Medicaid nursing home provider and includes links to applicable laws, regulations, and compliance information. Since March 4, CMS and its network of state-based inspectors have conducted over 8,300 surveys with the results of a total of 5,700 available today. The results of the completed surveys and the reports are available on Nursing Home Compare. CMS plans to post the results of the inspections monthly on an ongoing basis as they are completed. The data released today shows that as of May 31, 2020, about 13,600 nursing homes – approximately 88 percent of the 15,400 Medicare and Medicaid nursing homes – had reported the required data to the . These facilities reported over 95,000 confirmed COVID-19 cases and almost 32,000 deaths.
The Centers for Medicare & Medicaid Services has the authority to impose civil money penalties in nursing homes participating in the Medicare and Medicaid programs. The fines for these facilities can be obtained through a freedom of information request at Freedom of Information Act Request Service Center. The nursing home inspection information can be accessed at Centers for Medicare & Medicaid Services at Nursing Home Compare. Information is also available on the Nursing Home Quality Initiative.
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There are necessary regulatory delays between when a nursing home is inspected and when fines or findings from the inspection will appear on this web site. Therefore, when visiting a nursing home, we encourage you to request copies of more recent inspection results. An Initial is a survey for initial Medicare/Medicaid certification survey of Skilled Nursing Facilities or Nursing Facilities in order to participate in the Medicare/Medicaid programs.
Points are assigned based on the scope and severity of the deficiency. In order to calculate the Nursing Home Survey Star Rating, the points from the past 3 survey cycles are totaled, weighted, and compared against all the other homes in a given state. Skilled nursing facilities and nursing facilities are required to be in compliance with the requirements in 42 CFR Part 483, Subpart B, to receive payment under the Medicare or Medicaid programs. To certify a SNF or NF, a state surveyor completes at least a Life Safety Code survey, and a Standard Survey. You can use this to learn more about the quality of care provided by Massachusetts nursing homes. The survey protocols and interpretive guidelines serve to clarify and/or explain the intent of the regulations.
for About the Surveys
All surveyors are required to use them in assessing compliance with Federal requirements. Deficiencies are based on violations of the regulations, which are to be based on observations of the nursing home’s performance or practices. Below in the downloads section, we also provide you related nursing home reports, compendia, and the list of special focus facilities (i.e., nursing homes with a record of poor survey performance on which CMS focuses extra attention). Medication in an adult care home may be administered by designated, trained staff. Smaller adult care homes that provide care to two to six unrelated residents are commonly called family care homes. The CMS regional office determines a facility’s eligibility to participate in the Medicare program based on the State’s certification of compliance and a facility’s compliance with civil rights requirements.
CMS has recently added new guidelines for facilities with a history of severe Abuse deficiencies. Facilities with this designation are capped at 2 Stars for the Survey Rating, no matter how much higher they may have been. The weighted scores are then added together to create the Weighted Survey Score.
Other Nursing Home related data and reports can be found in the downloads section below.
When choosing a nursing home, review the survey findings to help you make an informed choice when considering a nursing home. However, it is important to use more than one piece of information to make the decision of which nursing home is right for the care of a family member or friend. Consumers should use this survey findings information as an aid to - not a substitute for - an in person visit to the nursing home under consideration. Visits to nursing facilities being considered and discussion with friends, family and staff members prior to deciding which facility will best meet your needs are essential.
The Division inspects nursing homes at least every 9-15 months to assess compliance with federal standards of care. This includes adequacy of staffing, quality of care, and cleanliness of facilities. Also, as necessary, we investigate complaints and serious incidents occurring within nursing homes.
Abuse
The goal of inspections is to assess how well the nursing home complies with applicable laws and regulations affecting the quality of care provided. Inspections are typically conducted on an annual basis and when the State receives complaints. Inspections conducted on an annual basis typically last four days. Complaint inspections may last one or more days depending upon the number of allegations and what surveyors find during the course of the inspection. CMS has posted publicly available training for nursing home surveyors and providers in theQuality, Safety, and Education Portal that explains the updates and changes of the regulations and guidance. Search the Training Catalog for "Long Term Care Regulatory and Interpretive Guidance and Psychosocial Severity Guide Updates – June 2022." This portal is free to use, but registration is required.
This plan of correction must include information on how and when the problem was corrected, as well as how it will be prevented in the future. Facilities have the right to informally appeal any deficiencies found during a survey through an informal dispute resolution process. For nursing homes, months will typically pass between inspections and much could change for the better or worse in a facility between inspections. Therefore, it is advised that you inspect the facility yourself before making such an important decision. Nursing homes are for people who need chronic or rehabilitative care, who, on admission are not acutely ill and who do not usually require special facilities such as an operating room, X ray facilities, laboratory facilities, and obstetrical facilities.
A nursing home provides care for people who have remedial ailments or other ailments, for which medical and nursing care are indicated; who, however, are not sick enough to require general hospital care. Nursing care is their primary need, but they will require continuing medical supervision. A Recertification/Complaint is when the annual Recertification survey and one or more Complaint surveys are conducted at the same time.
In addition to this, nursing homes are required to report COVID-19 cases and deaths directly to the Centers for Disease Control and Prevention and today CMS is making this data publicly available. As part of today’s announcement CMS is also posting the results from the targeted inspections announced on March 4, 2020, to allow inspectors to focus on the most serious health and safety threats like infectious diseases and abuse during the pandemic. This is part of the Trump Administration’s historic transparency efforts to ensure residents, families and the general public have information about COVID-19 in nursing homes.
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