CMS Plans to Expand MDS Focused Survey and Staffing Reviews

A CMS pilot survey that had started in early 2014 is to be expanded nationwide. The pilot was completed in August 2014 and enabled surveyors (who received specialized training for these surveys) to review the nursing home resident assessment processes in more depth than the annual surveys. Findings from the surveys conducted included inaccurate staging and documentation of pressure ulcers, lack of knowledge regarding the classification of antipsychotic drugs, and poor coding regarding the use of restraints. Deficiencies were identified and cited on all but one survey (i.e., 24 of 25 surveys).  CMS felt these surveys enhanced surveyors’ ability to identify errors and deficiencies related to MDS coding and resident care, and has decided that the surveys will be expanded nationwide in 2015.

In addition, similar to the need to verify the accuracy of MDS information, assessing the accuracy of information on the staffing of nursing homes is critical, according to CMS, to assure that there is sufficient nursing staff to meet the needs of the residents.  Currently staffing information is only collected on the annual survey, and there is no information on how staffing levels may fluctuate throughout the year. Therefore, CMS has decided to expand the MDS focused surveys to review staffing information, as well. 

Concerns about care planning and assessment issues in nursing homes have been highlighted in several Office of the Inspector General (OIG) reports in 2012 and 2013.  More recently, concerns over the accuracy of the MDS and staffing, both self-reported measures on the CMS Five-Star Rating System, were raised in a New York Times article.

Contact: Elliott Frost, efrost@leadingageny.org, 518-867-8832