On June 13 VHCA-VCAL staff Keith Hare, April Payne, and Matt Mansell traveled to Philadelphia to meet with the Centers for Medicare and Medicaid Services (CMS) Regional Office to discuss Virginia’s nursing centers’ improved performance in quality measures and how the trend of increases in scope and severity does not seem to match performance.

Virginia’s nursing centers have seen a marked increase in the scope and severity of tags in recent years.  Additionally, CMS recently instituted a policy via S&C 16-31-NH to require the imposition of a CMP any time Immediate Jeopardy is cited in a survey and that CMPs will be levied without permitting a facility to correct deficiencies.  CMS has also subsequently implemented inflationary increases to the penalty amounts.

CMPs assessed in Virginia from 2014-2016 ($5,530,291):

• 2016: $2,951,339
• 2015: $2,102,242
• 2014: $476,710

Analysis of quality measures (QMs) at Virginia’s nursing centers shows that the majority have improved or remained the same from October 2015-September 2016:

• Short Stay QMs– 4 out of 5 have improved or stayed the same
• Long Stay QMs – 11 out of 13 have improved or stayed the same

In recent months VHCA-VCAL has met with officials from the Office of Licensure and Certification (OLC) to discuss the penalties.  VHCA-VCAL members also wanted to approach CMS about our concerns, some of which fall to the Region 3 Office level and not OLC, which prompted the association to seek this meeting.

VHCA-VCAL has also had discussions with the Virginia Department of Medical Assistance Services (DMAS) about how that agency will use the funds from the CMPs.  CMS requires that the CMP monies be used to improve nursing facility quality of care or quality of life for residents.

We will keep you apprised of developments on this issue.