Conflicting Requirements for Reporting Abuse–Notes

On 12-2-19 CDPHE, Husch Blackwell, Law Enforcement representatives and CHCA presented a symposium “Conflicting Requirements for Reporting Abuse”.

Jo Tansey, shared some of the most recent CMS directives:

• Beginning in January CDPHE will be going to facilities that self-report (FRIs) suspected or alleged abuse to investigate the allegations. Depending on the severity of the FRI, CDPHE will prioritize the facility visits to 3, 5 and 15 day mandatory visits. Any substantiated abuse incidents will result in a citation, usually at the G severity level.
• Misappropriation of property guidance has been updated: Items of little or no monetary value, such as potato chips, that are reported as missing should be dealt with by the facility through their grievance process. Value however is to be largely determined by the resident and should be established early in the investigative process.
• The Nursing Home Compare website roll out of the “red hand” was discussed; it appears likely that many facilities will be impacted by the hand over time. If a facility had two “D” level deficiencies in a row related to abuse or one “G” level related to abuse the facility posting on Medicare.Gov will have a ”red hand” notification, warning the public that the facility has received a deficiency for abuse.
• CMS guidance about abuse reporting and Phase 3 implementation is expected sometime in the second quarter of 2020.

Law Enforcement expressed some of the difficulties and time consuming aspects of the CMS abuse reporting requirements. Some jurisdictions have made an online reporting system available to nursing homes which appears helpful to both nursing homes and law enforcement.

Providers shared frustrations with the CMS reporting requirements, and the possibility of these reporting requirements impacting their ability to provide quality care to their residents. AHCA is actively working with CMS to expose the pitfalls of the reporting requirements.