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New Medicare Icons Show Nursing Homes with Past Abuse and Neglect Issues

Part of choosing the right nursing home for your loved ones is to find a location that doesn’t have a bad history of abuse and neglect issues. These issues come up with surprising regularity, which makes it hard for family members to conduct their research. However, the Centers for Medicare and Medicaid Services (CMS) have introduced icons that will make these issues easier for everyone to see. CMS and elder rights groups tout the plan, but it remains unpopular with nursing home providers. 

Instead of listing all of the past issues at a nursing home, the new system uses icons. When they look up the nursing home on the Medicare website, they’ll see an image with a red circle surrounding a hand, palm forward and fingers up, in the “stop” position. The system had its official launch at the end of October. These icons are the brainchild of the Centers for Medicare and Medicaid Services (CMS), the government agency that maintains the Nursing Home Compare website. The icon will appear for one year on the information page of nursing homes where a patient was harmed because of neglect or was physically, mentally, or sexually abused. 

The CMS, which is part of the U.S. Department of Health and Human Services, called the move a “critical move toward improved transparency” and “empowering consumers to make the right decisions for themselves and their loved ones.” If nothing else, these changes will make it easier for everyone to check into the history of a nursing home.

“CMS’ top priority is patient safety, and that starts with empowering patients with transparency – especially regarding abuse. Our new abuse icon helps patients make the best choices for their care, incentivizing nursing homes to compete on quality,” CMS Administrator Semma Verma wrote in an email that was quoted in an article for News-Press.com

Many nursing home operators fear these icons and wealth of information will provoke unwarranted fear in potential patients, current residents, and their families.  The result is making them avoid an otherwise good nursing home because of a single, unintentional error of an employee or the unpredictable actions of a resident.

“It’s not about transparency, it’s about the misuse of data, bordering on the abuse of data,” said Martin Goetz, chief executive officer of River Garden Senior Services in Jacksonville. Goetz, whose nursing home has the government’s 5-star rating, the highest available, believes CMS is reacting to government reports and Senate hearings documenting abuse and neglect in skilled nursing facilities and accusing the agency of lax oversight.

Nursing home operator groups, such as LeadingAge, an association of nonprofit nursing homes and other senior health and wellness service organizations, also oppose the use of these icons. “The icon is misleading,” Katie Smith Sloan wrote recently in an opinion piece in “McKnight’s Long-Term Care News.” “There is a significant difference between one levied for harm resulting from intentional mistreatment and one for harm that is the unintended consequence of misguided action. But that distinction will be lost on most consumers.”

Regardless of these objections from operators, there’s no denying that there have been many examples of elder abuse in the news. In June, the Department of Health and Human Services Office of Inspector General released a report based on a review of 37,607 hospital emergency room Medicare claims for nursing home residents from eight randomly selected states. The admitting diagnosis code was used to determine if the claims indicated a “high risk for potential abuse or neglect.” It included things such as a broken nose, bedsores, sepsis, or pneumonia from inhaling food or vomit. 

Similarly, another report on abuse, this one in June from the U.S. Government Accountability Office, found that although rare, citations for violation doubled from 2013 to 2017. There were 430 reports in 2013 and 875 in 2017.

Family members who are looking for an appropriate nursing home for their loved ones should look at The Caregiver’s Guide from Steve Watrel, P.A.