CMS Launches New Initiative
The Centers for Medicare and Medicaid Services (CMS) has launched a new initiative aimed at examining the issue of facility-initiated discharges that violate federal regulations. According to CMS, facility-initiated discharges continue to be one of the most frequent complaints made to State Long Term Care Ombudsman Programs. In FY 2015, "discharge/eviction" was the most frequent nursing facility complaint category processed by the Long Term Care Ombudsman Programs nationally.
CMS notes that discharges that violate federal regulations are of great concern, because in some cases they can be unsafe and/or traumatic for residents and their families. These discharges may result in residents being uprooted from familiar settings, termination of relationships with staff and other residents, and residents even being relocated long distances away, resulting in fewer visits from family and friends and isolation. In some cases, residents have become homeless or remain in hospitals for months.
As part of the initiative, CMS is evaluating facility-initiated discharge issues in nursing homes and considering a variety of interventions, including surveyor and provider training; intake and triage training; civil money penalty (CMP)-funded projects that may help prevent facility-initiated discharges that violate federal regulations; and enforcement. CMS is encouraging states to consider CMP reinvestment proposals that utilize funds to prevent improper facility-initiated discharges.
As part of the effort to fully address facility-initiated discharges that violate federal regulations, CMS will review deficiencies precipitated by facility-initiated discharges. Unless directed otherwise by the CMS Regional Office (CMS RO), state survey agencies must transfer any case involving facility-initiated discharge violations to the CMS RO for review where there is placement in a questionable or unsafe setting, where residents remain hospitalized, where there is a facility pattern, or other circumstances that the RO may identify of cases they would like transferred. This does not change any other enforcement policies that identify cases that must be transferred to the RO. Following review, the ROs may take enforcement action if they deem it proper.
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