House Committee Seeks Answers Concerning CMS Oversight of Nursing Homes

Abstract

Four members of the House Committee on Energy and Commerce have written to the Centers for Medicare & Medicaid Services requesting more information on CMS’s role as overseer of nursing homes. The letter, addressed to CMS Administrator Seema Verma, comes in the wake of recent reports of abuse, neglect, and patient harm that have allegedly occurred at skilled nursing facilities and nursing facilities nationwide. “These reports raise serious questions about the degree to which [CMS] is fulfilling its responsibility to ensure federal quality of care standards are being met, as well as its duty to protect vulnerable seniors from elder abuse and harm in facilities participating in the Medicare and Medicaid programs,” wrote authors Greg Walden (R-OR), chairman of the Committee on Energy and Commerce; Gregg Harper (R-MS), chairman of the Subcommittee on Oversight and Investigations; Michael C. Burgess, MD (R-TX), chairman of the Subcommittee on Health; and Gus M. Bilirakis (R-FL). Of particular importance in the letter were the events involving the Rehabilitation Center at Hollywood Hills in Hollywood, FL, where the authors said 14 residents died in the immediate aftermath of Hurricane Irma. According to the Florida Agency for Health Care Administration, during the storm the rehabilitation center failed to follow their emergency management protocol after the facility’s air conditioning system lost power. The letter also detailed the history of allegations against Jack Michel, MD, managing member of the limited liability company that owns the rehabilitation center, such as an alleged scheme involving Dr. Michel and his associates engaging in seven different types of kickback arrangements. The committee members highlighted news reports concerning nursing home residents being abused and neglected, which in some cases the nursing homes failed to adequately detect and investigate. Additionally, the committee members highlighted news reports concerning nursing home residents being abused and neglected, which in some cases the nursing homes failed to adequately detect and investigate. Specifically, they mentioned a 2017 analysis published by CNN indicating that between 2013 and 2016 “the federal government cited more than 1,000 nursing homes for either mishandling cases related to, or failing to protect residents against, rape, sexual abuse, or sexual assault, with nearly 100 facilities incurring multiple citations.” The letter also stated that the Office of Inspector General at the Department of Health and Human Services (HHS OIG) found that CMS had not enforced Section 1150B of the Social Security Act, a law that imposes various penalties for failure to report possible crimes against SNF and nursing facility residents, despite the law being in effect since March 23, 2011. In its defense, CMS claimed that the HHS Office of the Secretary had not delegated the enforcement of Section 1150B to CMS, according to an HHS OIG report. As a result of these and other developments, the congressmen have asked CMS to provide a briefing on the issues raised in the letter by no later than April 16, 2018. Furthermore, they requested all documents and information on several specific issues by April 23, including: •Dr. Michel and the Medicare- and Medicaid-participating facilities owned, operated, or controlled by Dr. Michel.•Incident complaints at long-term care facilities that resulted from hurricanes Harvey, Irma, and Maria.•Nursing home complaint investigations undertaken since 2010.•How CMS ensures nursing home staff are appropriately licensed.•Whether HHS has finished delegating enforcement of Section 1150B to CMS, and, if so, whether CMS has enforced the law. To read the complete letter, visit https://energycommerce.house.gov/wp-content/uploads/2018/04/20180402CMS.pdf. Brian Ellis is a freelance writer and editor based in NJ.