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⭒ New Developments

New Research: Nursing Homes Inflate CMS “Quality Measures”

It should surprise nobody to hear that new research finds nursing homes inaccurately report the conditions of their residents when submitting “quality measure” data to the Centers for Medicare and Medicaid Services. The self-reported data is used as one of three major components to a facility’s federal 5-star rating. For years, nursing home resident advocates have argued that any ratings system should not rely on unaudited, self-reported data from the nursing homes themselves because they have an incentive to report inflated data. In the new research, quality measure data was compared to Medicare claims data for nursing home residents who were hospitalized. The comparisons demonstrated that nursing homes substantially underreport the number of residents who develop pressure sores while in the facility. The data also showed inaccurate reporting regarding urinary tract infections (UTIs) and resident falls.