Skilled nursing facilities (SNF) often fail to meet care planning and discharge planning requirements, according to a recent Office of Inspector General (OIG) report. The OIG found that 37% of resident stays, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans. While 31% of resident stays, SNFs did not meet discharge planning requirements. SNFs received $5.1 billion in Medicare reimbursement for stays where quality-of-care requirements were not met. The OIG report also found examples of poor quality of care related to wound care, medication management, and therapy.
The OIG recommends that the Centers for Medicare & Medicaid Services (CMS):
- Strengthen the regulations on care planning and discharge planning
- Provide guidance to SNFs to improve care planning and discharge planning
- Increase surveyor efforts to identify SNFs that do not meet care planning and discharge planning requirements and hold these SNFs accountable
- Link payments to meeting quality-of-care requirements
- Follow up with the SNFs that failed to meet care planning and discharge planning requirements or that provided poor quality of care