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 AHCA Pushes Back Against OIG Report

The American Health Care Association (AHCA) on Thursday pushed back against a report from the Department of Health and Human Services’ Office of Inspector General that accused long term care professionals of sloppy care planning.

OIG reported Thursday that skilled nursing facilities routinely ignore, or miss, care plan requirements in Medicare-backed services worth billions of public dollars. But AHCA Senior Vice President Greg Crist the report fails to “acknowledge broader, more universal quality indicators that are trending upwards, not backwards, that a lack of viable care plans would result in if folks were indeed suffering.”

“Every one of our members is required to implement a care plan on the first day an individual enters the building,” he added. “Care plans change daily because a patients’ health needs change daily. If the care plan didn't match 100 percent every day, OIG sees that as a violation. We see that as practicing medicine. Circumstances change, and our caregivers are adapting to meet new medical conditions. We're more focused on health outcomes and have seen them improve for our patients.”

OIG said it used a random sample of 245 nursing home stays during calendar year 2009. It claimed in Thursday’s report that in:

  • 37 percent of stays, homes “did not meet care plan or service requirements;”
  • 26 percent of stays, homes “did not develop care plans that met requirements,” including “measurable objectives and detailed timeframes [sic];”
  • 19 percent of stays, homes “developed care plans that did not address one or more problem areas identified in the beneficiaries’ assessments;”
  • 15 percent of stays, homes “did not provide services in accordance with care plans;”
  • 31 percent of stays, homes “did not meet discharge planning requirements;”
  • 16 percent of stays, homes “did not have summaries of the beneficiaries’ stays or statuses at discharge;” and
  • In 23 percent of stays, homes “did not have post-discharge plans of care.”

The report can be found here.

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