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6103 - Nursing Home Compare Website

 
Implementation Status 
Statutory Text 

Summary

Stipulates a number of additions to the Nursing Home Compare website, including: staffing data; links to state Internet websites with information regarding state survey and certification programs; standardized complaint forms; summary information on the number, type, severity, and outcome of substantiated complaints; and the number of adjudicated instances of criminal violations by a facility or the employees of a facility.  With certain exceptions, provides that such information be included on the Nursing Home Compare website by March 23, 2011.  Calls for review and modification of the site as well as delineates the manner in which the information ought to be reported to the Secretary (with applicable deadlines).  Requires SNFs and NFs (under Medicare and Medicaid, respectively) to make available survey, certification, and complaint investigation reports over the preceding three years.  Stipulates requirements relative to guidance to states on Form 2567 state inspection reports and calls for the development (by March 23, 2012) of a consumer rights information page on the Nursing Home
Compare website.

Last updated: (November 1, 2016)  

Implementation Status

 
Summary 
Statutory Text 

Prior to January 2013, CMS in early 2011 rulemaking pertaining to section 6111 (re: civil monetary penalties and nursing homes) alluded in response to comments addressing public reporting of particular information related to enforcement actions that it intended to “publish relevant enforcement information.”  CMS has since issued a number of letters to state survey agencies providing guidance on the implementation of this provision – see here (re: upcoming Nursing Home Compare website changes) and here (re: state consumer oriented websites).  A 2012 CMS action plan highlights various enhancements to the Nursing Home Compare website in light of the ACA and otherwise.  More information may be obtained on CMS’ Nursing Home Compare website.

On August 21, 2014, Reps. Doris Matsui (D-CA) and Jan Schakowsky (D-IL), Co-Chairs of the Congressional Seniors Task Force, along with other House colleagues, wrote to CMS urging the agency to implement sections 6103 and 6106 of the ACA requiring that “nursing home staffing information be obtained through a payroll data collection system.”

In an October 6, announcement delineating recent initiatives aimed at improving the quality of post-acute care,  CMS provided new details regarding an upcoming expansion of the agency-wide Five Star Quality Rating System for Nursing Homes, which incorporates some improvements funded by the recently-enacted Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).

On Feb. 20, CMS implemented changes to its 5-star ratings on the Nursing Home Compare website to incorporate quality metrics for short and long-stay antipsychotic patients; address staffing level computations; and raise the scoring standard for the quality measure performance dimension.

On May 21, CMS updated the available data on its nursing home compare website.

On June 18, CMS updated the Nursing Home Compare database.

On July 16, CMS released a proposed rule that revises the requirements that long-term care facilities must meet to participate in the Medicare and Medicaid programs. The rule addressed this provision of the ACA. Comments are due Sept. 14.

On Dec. 17, 2015, CMS released updated nursing home compare data.

2016

On Feb. 24, 2016, CMS updated the data for its Nursing Home Compare Website.

On Apr. 27, CMS added six new quality measures to Nursing Home Compare. Three of these six new quality measures are based on Medicare-claims data submitted by hospitals. This is the first time CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These three quality measures measure the rate of re-hospitalization, emergency room use, and community discharge among nursing home residents.

On May 25, CMS updated the data on its Nursing Home Compare website.

On June 22, CMS updated the data on its Nursing Home Compare site.

On July 28, CMS released July quarterly reports for Skilled Nursing Facilities (SNFs) through the Nursing Home Compare reporting system, including information on the SNF Value-Based Purchasing (VBP) Program. The agency also released a fact sheet on reporting requirements for the Skilled Nursing Facility Quality Reporting Program (SNF QRP).

On Aug. 10, CMS updated Nursing Home Compare, incorporating new measures.  The new measures include successful discharges, emergency visits and re-hospitalizations, adding to measures previously announced in April.

On Sept. 29, CMS issued a final rule delineating major reforms to Medicare and Medicaid conditions of participation (CoPs) impacting long-term care (LTC) facilities. In particular, the rule stipulates new prohibitions on the use of pre-dispute binding arbitration agreements as a condition of admission to the facility, among other reforms. The rule addresses these provisions of the ACA.

On Oct. 26, CMS updated the Nursing Home Compare website.

November: On Nov. 28, CMS updated the Nursing Home Compare website.

Statutory Text

 
Implementation Status 
Summary 

SEC. 6103. NURSING HOME COMPARE MEDICARE WEBSITE. (a) SKILLED NURSING FACILITIES.— (1) IN GENERAL.—Section 1819 of the Social Security Act (42 U.S.C. 1395i–3) is amended— (A) by redesignating subsection (i) as subsection (j); and (B) by inserting after subsection (h) the following new subsection: ‘‘(i) NURSING HOME COMPARE WEBSITE.— ‘‘(1) INCLUSION OF ADDITIONAL INFORMATION.— ‘‘(A) IN GENERAL.—The Secretary shall ensure that the Department of Health and Human Services includes, as part of the information provided for comparison of nursing homes on the official Internet website of the Federal Government for Medicare beneficiaries (commonly referred to as the ‘Nursing Home Compare’ Medicare website) (or a successor website), the following information in a manner that is prominent, updated on a timely basis, easily accessible, readily understandable to consumers of long-term care services, and searchable: ‘‘(i) Staffing data for each facility (including resident census data and data on the hours of care provided per resident per day) based on data submitted under section 1128I(g), including information on staffing turnover and tenure, in a format that is clearly understandable to consumers of long-term care services and allows such consumers to compare differences in staffing between facilities and State and national averages for the facilities. Such format shall include— ‘‘(I) concise explanations of how to interpret the data (such as a plain English explanation of data reflecting ‘nursing home staff hours per resident day’); ‘‘(II) differences in types of staff (such as training associated with different categories of staff); ‘‘(III) the relationship between nurse staffing levels and quality of care; and ‘‘(IV) an explanation that appropriate staffing levels vary based on patient case mix. ‘‘(ii) Links to State Internet websites with information regarding State survey and certification programs, links to Form 2567 State inspection reports (or a successor form) on such websites, information to guide consumers in how to interpret and understand such reports, and the facility plan of correction or other response to such report. Any such links shall be posted on a timely basis. ‘‘(iii) The standardized complaint form developed under section 1128I(f), including explanatory material on what complaint forms are, how they are used, and how to file a complaint with the State survey and certification program and the State long-term care ombudsman program. ‘‘(iv) Summary information on the number, type, severity, and outcome of substantiated complaints. ‘‘(v) The number of adjudicated instances of criminal violations by a facility or the employees of a facility— ‘‘(I) that were committed inside the facility; ‘‘(II) with respect to such instances of violations or crimes committed inside of the facility that were the violations or crimes of abuse, neglect, and exploitation, criminal sexual abuse, or other violations or crimes that resulted in serious bodily injury; and ‘‘(III) the number of civil monetary penalties levied against the facility, employees, contractors, and other agents. ‘‘(B) DEADLINE FOR PROVISION OF INFORMATION.— ‘‘(i) IN GENERAL.—Except as provided in clause (ii), the Secretary shall ensure that the information described in subparagraph (A) is included on such website (or a successor website) not later than 1 year after the date of the enactment of this subsection. ‘‘(ii) EXCEPTION.—The Secretary shall ensure that the information described in subparagraph (A)(i) is included on such website (or a successor website) not later than the date on which the requirements under section 1128I(g) are implemented. ‘‘(2) REVIEW AND MODIFICATION OF WEBSITE.— ‘‘(A) IN GENERAL.—The Secretary shall establish a process— ‘‘(i) to review the accuracy, clarity of presentation, timeliness, and comprehensiveness of information reported on such website as of the day before the date of the enactment of this subsection; and ‘‘(ii) not later than 1 year after the date of the enactment of this subsection, to modify or revamp such website in accordance with the review conducted under clause (i). ‘‘(B) CONSULTATION.—In conducting the review under subparagraph (A)(i), the Secretary shall consult with— ‘‘(i) State long-term care ombudsman programs; ‘‘(ii) consumer advocacy groups; ‘‘(iii) provider stakeholder groups; and ‘‘(iv) any other representatives of programs or groups the Secretary determines appropriate.’’. (2) TIMELINESS OF SUBMISSION OF SURVEY AND CERTIFICATION INFORMATION.— (A) IN GENERAL.—Section 1819(g)(5) of the Social Security Act (42 U.S.C. 1395i–3(g)(5)) is amended by adding at the end the following new subparagraph: ‘‘(E) SUBMISSION OF SURVEY AND CERTIFICATION INFORMATION TO THE SECRETARY.—In order to improve the timeliness of information made available to the public under subparagraph (A) and provided on the Nursing Home Compare Medicare website under subsection (i), each State shall submit information respecting any survey or certification made respecting a skilled nursing facility (including any enforcement actions taken by the State) to the Secretary not later than the date on which the State sends such information to the facility. The Secretary shall use the information submitted under the preceding sentence to update the information provided on the Nursing Home Compare Medicare website as expeditiously as practicable but not less frequently than quarterly.’’. (B) EFFECTIVE DATE.—The amendment made by this paragraph shall take effect 1 year after the date of the enactment of this Act. (3) SPECIAL FOCUS FACILITY PROGRAM.—Section 1819(f) of the Social Security Act (42 U.S.C. 1395i–3(f)) is amended by adding at the end the following new paragraph: ‘‘(8) SPECIAL FOCUS FACILITY PROGRAM.— ‘‘(A) IN GENERAL.—The Secretary shall conduct a special focus facility program for enforcement of requirements for skilled nursing facilities that the Secretary has identified as having substantially failed to meet applicable requirement of this Act. ‘‘(B) PERIODIC SURVEYS.—Under such program the Secretary shall conduct surveys of each facility in the program not less than once every 6 months.’’. (b) NURSING FACILITIES.— (1) IN GENERAL.—Section 1919 of the Social Security Act (42 U.S.C. 1396r) is amended— (A) by redesignating subsection (i) as subsection (j); and (B) by inserting after subsection (h) the following new subsection: ‘‘(i) NURSING HOME COMPARE WEBSITE.— ‘‘(1) INCLUSION OF ADDITIONAL INFORMATION.— ‘‘(A) IN GENERAL.—The Secretary shall ensure that the Department of Health and Human Services includes, as part of the information provided for comparison of nursing homes on the official Internet website of the Federal Government for Medicare beneficiaries (commonly referred to as the ‘Nursing Home Compare’ Medicare website) (or a successor website), the following information in a manner that is prominent, updated on a timely basis, easily accessible, readily understandable to consumers of long-term care services, and searchable: ‘‘(i) Staffing data for each facility (including resident census data and data on the hours of care provided per resident per day) based on data submitted under section 1128I(g), including information on staffing turnover and tenure, in a format that is clearly understandable to consumers of long-term care services and allows such consumers to compare differences in staffing between facilities and State and national averages for the facilities. Such format shall include— ‘‘(I) concise explanations of how to interpret the data (such as plain English explanation of data reflecting ‘nursing home staff hours per resident day’); ‘‘(II) differences in types of staff (such as training associated with different categories of staff); ‘‘(III) the relationship between nurse staffing levels and quality of care; and ‘‘(IV) an explanation that appropriate staffing levels vary based on patient case mix. ‘‘(ii) Links to State Internet websites with information regarding State survey and certification programs, links to Form 2567 State inspection reports (or a successor form) on such websites, information to guide consumers in how to interpret and understand such reports, and the facility plan of correction or other response to such report. Any such links shall be posted on a timely basis.  ‘‘(iii) The standardized complaint form developed under section 1128I(f), including explanatory material on what complaint forms are, how they are used, and how to file a complaint with the State survey and certification program and the State long-term care ombudsman program. ‘‘(iv) Summary information on the number, type, severity, and outcome of substantiated complaints. ‘‘(v) The number of adjudicated instances of criminal violations by a facility or the employees of a facility— ‘‘(I) that were committed inside of the facility; and ‘‘(II) with respect to such instances of violations or crimes committed outside of the facility, that were violations or crimes that resulted in the serious bodily injury of an elder. ‘‘(B) DEADLINE FOR PROVISION OF INFORMATION.— ‘‘(i) IN GENERAL.—Except as provided in clause (ii), the Secretary shall ensure that the information described in subparagraph (A) is included on such website (or a successor website) not later than 1 year after the date of the enactment of this subsection. ‘‘(ii) EXCEPTION.—The Secretary shall ensure that the information described in subparagraph (A)(i) is included on such website (or a successor website) not later than the date on which the requirements under section 1128I(g) are implemented. ‘‘(2) REVIEW AND MODIFICATION OF WEBSITE.— ‘‘(A) IN GENERAL.—The Secretary shall establish a process— ‘‘(i) to review the accuracy, clarity of presentation, timeliness, and comprehensiveness of information reported on such website as of the day before the date of the enactment of this subsection; and ‘‘(ii) not later than 1 year after the date of the enactment of this subsection, to modify or revamp such website in accordance with the review conducted under clause (i). ‘‘(B) CONSULTATION.—In conducting the review under subparagraph (A)(i), the Secretary shall consult with— ‘‘(i) State long-term care ombudsman programs; ‘‘(ii) consumer advocacy groups; ‘‘(iii) provider stakeholder groups; ‘‘(iv) skilled nursing facility employees and their representatives; and ‘‘(v) any other representatives of programs or groups the Secretary determines appropriate.’’. (2) TIMELINESS OF SUBMISSION OF SURVEY AND CERTIFICATION INFORMATION.— (A) IN GENERAL.—Section 1919(g)(5) of the Social Security Act (42 U.S.C. 1396r(g)(5)) is amended by adding at the end the following new subparagraph: ‘‘(E) SUBMISSION OF SURVEY AND CERTIFICATION INFOR- MATION TO THE SECRETARY.—In order to improve the timeliness of information made available to the public under subparagraph (A) and provided on the Nursing Home Compare Medicare website under subsection (i), each State shall submit information respecting any survey or certification made respecting a nursing facility (including any enforcement actions taken by the State) to the Secretary not later than the date on which the State sends such information to the facility. The Secretary shall use the information submitted under the preceding sentence to update the information provided on the Nursing Home Compare Medicare website as expeditiously as practicable but not less frequently than quarterly.’’. (B) EFFECTIVE DATE.—The amendment made by this paragraph shall take effect 1 year after the date of the enactment of this Act. (3) SPECIAL FOCUS FACILITY PROGRAM.—Section 1919(f) of the Social Security Act (42 U.S.C. 1396r(f)) is amended by adding at the end of the following new paragraph: ‘‘(10) SPECIAL FOCUS FACILITY PROGRAM.— ‘‘(A) IN GENERAL.—The Secretary shall conduct a special focus facility program for enforcement of requirements for nursing facilities that the Secretary has identified as having substantially failed to meet applicable requirements of this Act. ‘‘(B) PERIODIC SURVEYS.—Under such program the Secretary shall conduct surveys of each facility in the program not less often than once every 6 months.’’. (c) AVAILABILITY OF REPORTS ON SURVEYS, CERTIFICATIONS, AND COMPLAINT INVESTIGATIONS.— (1) SKILLED NURSING FACILITIES.—Section 1819(d)(1) of the Social Security Act (42 U.S.C. 1395i–3(d)(1)), as amended by section 6101, is amended by adding at the end the following new subparagraph: ‘‘(C) AVAILABILITY OF SURVEY, CERTIFICATION, AND COMPLAINT INVESTIGATION REPORTS.—A skilled nursing facility must— ‘‘(i) have reports with respect to any surveys, certifications, and complaint investigations made respecting the facility during the 3 preceding years available for any individual to review upon request; and ‘‘(ii) post notice of the availability of such reports in areas of the facility that are prominent and accessible to the public. The facility shall not make available under clause (i) identifying information about complainants or residents.’’. (2) NURSING FACILITIES.—Section 1919(d)(1) of the Social Security Act (42 U.S.C. 1396r(d)(1)), as amended by section 6101, is amended by adding at the end the following new subparagraph: ‘‘(V) AVAILABILITY OF SURVEY, CERTIFICATION, AND COMPLAINT INVESTIGATION REPORTS.—A nursing facility must—‘‘(i) have reports with respect to any surveys, certifications, and complaint investigations made respecting the facility during the 3 preceding years available for any individual to review upon request; and ‘‘(ii) post notice of the availability of such reports in areas of the facility that are prominent and accessible to the public. The facility shall not make available under clause (i) identifying information about complainants or residents.’’. (3) EFFECTIVE DATE.—The amendments made by this subsection shall take effect 1 year after the date of the enactment of this Act. (d) GUIDANCE TO STATES ON FORM 2567 STATE INSPECTION RE- PORTS AND COMPLAINT INVESTIGATION REPORTS.— (1) GUIDANCE.—The Secretary of Health and Human Services (in this subtitle referred to as the ‘‘Secretary’’) shall provide guidance to States on how States can establish electronic links to Form 2567 State inspection reports (or a successor form), complaint investigation reports, and a facility’s plan of correction or other response to such Form 2567 State inspection reports (or a successor form) on the Internet website of the State that provides information on skilled nursing facilities and nursing facilities and the Secretary shall, if possible, include such information on Nursing Home Compare. (2) REQUIREMENT.—Section 1902(a)(9) of the Social Security Act (42 U.S.C. 1396a(a)(9)) is amended— (A) by striking ‘‘and’’ at the end of subparagraph (B); (B) by striking the semicolon at the end of subparagraph (C) and inserting ‘‘, and’’; and (C) by adding at the end the following new subparagraph: ‘‘(D) that the State maintain a consumer-oriented website providing useful information to consumers regarding all skilled nursing facilities and all nursing facilities in the State, including for each facility, Form 2567 State inspection reports (or a successor form), complaint investigation reports, the facility’s plan of correction, and such other information that the State or the Secretary considers useful in assisting the public to assess the quality of long term care options and the quality of care provided by individual facilities;’’. (3) DEFINITIONS.—In this subsection: (A) NURSING FACILITY.—The term ‘‘nursing facility’’ has the meaning given such term in section 1919(a) of the Social Security Act (42 U.S.C. 1396r(a)). (B) SECRETARY.—The term ‘‘Secretary’’ means the Secretary of Health and Human Services. (C) SKILLED NURSING FACILITY.—The term ‘‘skilled nursing facility’’ has the meaning given such term in section 1819(a) of the Social Security Act (42 U.S.C. 1395i– 3(a)). (e) DEVELOPMENT OF CONSUMER RIGHTS INFORMATION PAGE ON NURSING HOME COMPARE WEBSITE.—Not later than 1 year after the date of enactment of this Act, the Secretary shall ensure that the Department of Health and Human Services, as part of the information provided for comparison of nursing facilities on the Nursing Home Compare Medicare website develops and includes a consumer rights information page that contains links to descriptions of, and information with respect to, the following: (1) The documentation on nursing facilities that is available to the public. (2) General information and tips on choosing a nursing facility that meets the needs of the individual. (3) General information on consumer rights with respect to nursing facilities. (4) The nursing facility survey process (on a national and State-specific basis). (5) On a State-specific basis, the services available through the State long-term care ombudsman for such State.

Browse ACA Titles

  • I-Quality, Affordable Health Care for all Americans
  • II-Role of Public Programs
  • III-Improving the Quality and Efficiency of Health Care
  • IV-Prevention of Chronic Disease and Improving Public Health
  • V-Health Care Workforce
  • VI-Transparency and Program Integrity
  • VII-Improving Access to Innovative Medical Therapies
  • VIII-Community Living Assistance Services and Supports (CLASS ACT)
  • IX-Revenue Provisions

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