Establishes requirements for sanctions and other actions involving low-performing nursing homes.
Impact
The bill will allow the Division to impose a range of sanctions based on the number of consecutive one-star ratings. For example, after receiving a one-star rating in two consecutive quarters, a nursing home may face restrictions on admitting new Medicaid enrollees, and after three quarters, the penalties could escalate to prohibiting new resident admissions altogether and even terminating their Medicaid participation. This aims to drive improvements in care but also places increased pressure on facilities, particularly those that are already struggling.
Summary
Senate Bill S1951 establishes a framework for assessing and responding to nursing homes that receive low-performance ratings as defined by the federal Centers for Medicare and Medicaid Services (CMS). Specifically, the bill outlines procedures to be followed by the Division of Medical Assistance and Health Services within the Department of Human Services (DHS) when nursing homes are rated one star— the lowest possible rating. If a nursing home receives a one-star rating, the DHS is mandated to issue warnings and ensure that the facility takes measures to enhance quality of care. Failure to improve could lead to significant sanctions.
Contention
Discussions around S1951 indicate potential points of contention related to the balance between ensuring high care standards and the operational burdens placed on nursing homes. Critics may raise concerns regarding how the stringent sanctioning could impact access to care for residents, particularly in areas with fewer alternatives for elderly care. The concerns also extend to ensuring that nursing homes maintain the ability to appeal decisions and that their rights are protected amidst these regulatory changes. Furthermore, the implications of implementing these changes while adhering to state and federal law have been noted as a complicating factor.
Establishes additional requirements for DOH to assess sanctions and impose penalties on nursing homes; revises reporting requirements for nursing homes.