![]() ![]() Federal rules do not prescribe how nursing facilities should be paid or how much they should be paid, but require that Medicaid payment policies should promote efficiency, economy, quality, access, and safeguard against unnecessary utilization. States have broad flexibility to determine payments to nursing facilities. Although states are increasing access to home- and community-based services (HCBS) as an alternative to institutional care, nursing facilities still accounted for 34 percent of Medicaid spending on long-term services and supports (LTSS) and 10 percent of total Medicaid spending in 2016 ( Eiken et al. ![]() In 2016, Medicaid spent $56.7 billion on nursing facility care and was the primary source of coverage for 62 percent of nursing facility residents ( Eiken et al. Nursing facility services are the second-largest category of Medicaid spending (after hospital services), and Medicaid is the primary payer for nursing facility care in the country. Nursing facility services are mandatory benefits that must be covered by all state Medicaid programs. These actions would improve transparency with the goal of diminishing this practice in nursing homes.Nursing facilities are institutions certified by a state to offer 24-hour medical and skilled nursing care, rehabilitation, or health-related services to individuals who do not require hospital care. CMS has announced that if a facility has been inaccurately diagnosing residents and wrongly administering antipsychotic medications, the facility’s Five-Star Quality Measure Rating on the Care Compare site could be negatively impacted. Antipsychotic medications can be dangerous when wrongly administered, and can lead to dire side effects, including death. In 2011, Senator Casey brought up concerns that many older Americans in nursing homes are being “chemically restrained with antipsychotic drugs even if they do not have a history of mental illness” and that “ome doctors are writing prescriptions for off label drugs that have nothing to do with the conditions that the older citizens have been diagnosed with.”Įvidence has shown that some nursing homes have wrongly coded residents as having schizophrenia in order to administer antipsychotic medications, overmedicating patients in the process. ![]() In 2021, after multiple requests from Senator Casey to make COVID-19 vaccination rates among residents and workers in nursing homes public, CMS began publishing user-friendly data on Care Compare. Senator Casey has long pushed for transparency in nursing homes. “It is crucial that nursing home residents and their families have access to timely information about allegations of serious health and safety violations at a nursing home.” “ These new measures from the Centers for Medicare & Medicaid Services are another important step the Biden Administration is taking to improve transparency and care quality in our Nation’s nursing homes ,” said Senator Casey. After Senator Casey wrote to CMS in May and called on them to improve transparency when nursing homes appeal their citations, the agency is announcing new steps to ensure that these citations will be publicly displayed on Care Compare. Currently, when nursing homes dispute violations or citations, that information is not displayed on CMS’ Care Compare website until after the dispute process is complete, often leaving residents and their families in the dark for months about potentially serious health and safety violations. Senator Bob Casey (D-PA) is applauding new measures from the Centers for Medicare & Medicaid Services (CMS) to improve nursing home transparency and address the overuse of anti-psychotic drugs in nursing homes. Senate Special Committee on Aging, Casey has long championed greater transparency and oversight of the Nation’s nursing homes Casey called on CMS in May 2022 to improve transparency for residents and families when nursing homes appeal citationsĪs Chairman of the U.S. ![]()
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