INDIANAPOLIS – Families researching nursing homes for their loved ones will be left without a crucial evaluation tool until 2022.
The Centers for Medicare and Medicaid Services (CMS) has announced it won’t update nursing home ratings until April 2022, partially because of the suspension of annual surveys and facility reporting during the pandemic.
Facilities won’t resume their CMS reporting requirements, including resident care assessments and quality evaluations, until January 2022. CMS will use the new data to update ratings later that year.
The delay in updated ratings leaves millions of families in the dark, including those navigating the nursing home process in Indiana, where 90 of the state’s 535 facilities have a one-star rating — the lowest rating on a five-star scale — and another 100 have just two stars.
Families, already cut off from their loved ones, won’t know whether conditions have improved at Indiana’s nursing homes or whether patient care deteriorated during the course of the pandemic. Other families, having to choose a nursing facility for a critically ill relative, will have little current information to guide them.
While the state surveying agency, the Indiana State Department of Health, posts nursing home inspection reports online, it now has a huge backlog after suspending most inspections since March.
Even before the pandemic, as revealed in a CNHI News Indiana investigation, the Department of Health was behind in its rigorous yearly inspections of facilities, failing to review 44 within an 18-month span over the summer.
Those surveys serve as a basis for nursing home ratings on CMS’ Nursing Home Compare website.
The CMS announcement came as the state last week confirmed a “surge” in nursing home cases, which account for less than 6% of all state cases but more than 56% of deaths.
Woody Myers, the Democratic candidate challenging Gov. Eric Holcomb, has criticized the state’s efforts to contain the virus in long-term care facilities.
“I think we could have done a lot more, a lot earlier,” Myers said. “We know that it has to be brought in to them so if we can stop it at the door, we can do a lot more to help them.”
Lindsay Weaver, the chief medical officer of the Department of Health, said the state has a new, five-point plan to combat the virus in long-term care facilities.
“Our (plan) is a deliberate and target(ed) counter strike to the attack the virus is waging in these facilities,” Weaver said.
But the department also acknowledged that it cannot resume normal inspections because of the resurgence.
CMS ordered homes in mid-March to suspend federal inspections, as well as all complaint inspections except those where nursing home patients might be in immediate jeopardy of death or injury. Instead, the state agency was to focus on infection control issues.
Between March 23 and Aug. 17, the Indiana department of health conducted 1,008 COVID-focused surveys and 301 immediate jeopardy complaint investigations.
During that same period, the department received another 1,354 complaints it classified as non-emergencies, which meant they did not trigger an inspection.
The department briefly resumed investigations from Aug. 17 until Oct. 13, finishing 1,088 surveys at a rate of about 17 per day. Then the department suspended investigations again.
“We returned to doing only immediate jeopardy complaints again to enable surveyors to complete another infection control survey in every facility during the month of October,” the state health department said via email.
The 216 federal recertification surveys conducted this year concluded before the pandemic, the department said. In 2019, the state performed 553 standard surveys and another 1,944 complaint surveys, according to CMS’s Quality, Certification and Oversight Reports.
When most complaint inspections were again suspended, 266 non-emergency complaints were unresolved.