New methods in use for monitoring and regulating care facilities

WASHINGTON — A new set of standards for rating the quality of care at nursing homes will supplement the standard certification program for these facilities, according to a presentation here.

The Centers for Medicaid and Medicare Services has begun to focus on quality of care as a compliance issue, said Julie Melendez, BSN, RN, JD, here at the National Congress on Health Care Compliance.

“Quality of care is a top priority for the Office of the Inspector General,” she said, noting the previous method of surveying facilities and certifying them “is not enough.”

Nursing home facilities will be monitored for failure to care; billing for nonexistent or worthless services; and submitting false certifications, statements and documents. Regulatory violations can result in exclusion from Medicaid programs, Ms. Melendez said. Key standards of care monitoring include the number of patients with pressure ulcers, unexpected weight loss and number of falls at a facility, she added.