A report by the US Department of Health and Human Services Office of the Inspector General (OIG) has criticized Centers for Medicare & Medicaid Services (CMS) for inaccurately reporting on nursing home issues on its Care Compare sites. The report found that 67% of sampled nursing homes did not have a flag for one or more of their issues with health, fire safety, and emergency preparedness. This lack of reporting impedes consumers’ ability to make informed decisions about healthcare access. The OIG urged CMS to retroactively correct misreporting and improve the review process.
The US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has criticized the Centers for Medicare & Medicaid Services (CMS) for inaccurately reporting on nursing home issues on its Care Compare sites. The OIG report indicated that 67 of the 100 sampled nursing homes did not have a flag for one or more of its issues with health, fire safety, and emergency preparedness. The report also found that the lack of reporting impedes consumers’ ability to make informed decisions about healthcare access.
CMS hosts its Care Compare websites, which are tailored for a consumer audience to help them assess their options for healthcare encounters they can schedule. The Nursing Home Care Compare websites help consumers understand the cost and quality of a nursing home before admission. CMS populations that quality information in part using assessments from state survey agencies. State survey agencies visit the nursing homes and complete a survey assessment about the healthcare quality, fire safety, and emergency preparedness of each nursing home. From there, CMS uploads that quality data onto Care Compare.
However, according to the OIG report, CMS does not always include negative reports from the state survey agencies on the Nursing Home Care Compare website. In fact, this happens around 67 percent of the time, the report estimated using its 100-nursing home sample size. OIG looked at a nationally representative cross-section of 100 nursing homes in the United States and collected information about health, fire safety, and emergency preparedness both from the Care Compare website and the raw data from the state survey agencies.
The Office said that under-reporting is a prevalent problem. For 67 of the 100 nursing homes included in the analysis, CMS failed to report on one or more of their deficiencies on Care Compare. CMS most commonly failed to report on fire safety problems, with 52 sampled nursing homes having a flag on the state survey report but not on Care Compare. For 34 nursing homes, CMS did not report on health deficiencies. It was significantly less common for CMS to fail to report on emergency preparedness issues; this was only an issue for two nursing homes. This could be because emergency preparedness problems are less common than fire safety or health deficiencies. That said, OIG did report that CMS did not report on the results of the yearly fire safety and emergency preparedness inspections for 42 of the sampled nursing homes.
It should be noted that 100 is a somewhat small sample size, considering there are around 15,000 nursing homes on the Care Compare website. But if those 100 nursing homes are truly representative of the entire nation, the OIG researchers said the analysis is indicative of a negative situation. If its sample results hold true, OIG said that means 10,303 nursing homes had one or more deficiencies during inspections left off Care Compare.
OIG urged CMS to retroactively correct this misreporting for the sampled nursing homes. And to prevent future issues, the Office suggested that CMS improve the review process for the results it reports on Care Compare. Specifically, OIG recommended that CMS require state survey agencies to verify any reported deficiencies and provide technical assistance and training to state agencies.
OIG said CMS agreed with its recommendations for offering more technical assistance and training but did not comment on other recommendations.
Pitfalls in quality reporting on Care Compare can have consequences for individuals looking for a good healthcare experience. Without accurate quality information, consumers are unable to make informed decisions. This latest report has come after some less-than-stellar government reports about Nursing Home Care Compare. In February 2023, the Government Accountability Office (GAO) said Nursing Home Care Compare obscures some nursing home ownership information, which would be pertinent information for individuals making care access decisions.
