Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107201

Elaine L. Lew, BA, Survey & Certification Group, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, MS S2-12-25, Baltimore, MD 21244, 410-786-9353, elew@cms.hhs.gov

Compared to other providers of health care, nursing homes are held to a high level of public accountability by both Federal and State governments. As widely known, problems identified in facilities are characterized as “deficiencies” and are publicly reported on the Medicare Web-site Nursing Home Compare. However, the identification of a deficiency is only the beginning of a chain of actions that can result in enforcement remedies. These remedies, ranging from financial penalties to termination from participation in the Medicare/Medicaid programs, appear to be straightforward to use as enforcement tools. Procedures to effectuate them are dictated under Federal law, which has been further supported by Federal rules, operational manuals, and guidelines implemented by the Centers of Medicare & Medicaid Services (CMS) and the 51 state survey agencies. Overall, the enforcement of nursing home health and safety standards has evolved into a complex process with multiple players involved, as summarized in this presentation.

Evaluation of the complete Federal regulatory process is challenging, since, up until recently, there has been no system to support data analyses. In 2001, the CMS regional offices began to collect information about actions taken against facilities. Although CMS' new Enforcement Tracking System serves as an administrative and management tool, it may be used to characterize the full enforcement process, which is described further in the following presentations.

Learning Objectives:

• 3. Describe the nursing home regulatory process that ostensibly ensures public accountability for quality standards;
  7. Describe state differences and major trends in nursing home enforcement;
  11. Assess whether this system of enforcement is actually working as intended.

Keywords: Nursing Homes,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF I am an employee of the Centers for Medicare & Medicaid Services..