The system that rates nursing home facilities for their level of care has a flaw that promotes therapy beyond a patient’s need or ability. Since nursing homes are partially rated for their care per patient per minutes of care offered, patients sometimes receive therapy to add to those minutes of patient care. “The system really rewards high-intensity care,” said Harvard University expert on nursing-home spending. “There are patients being treated who aren’t appropriate.”
CMS responded to this concern with the following statement, “To help ensure that patient need rather than payment incentives are driving provision of therapy services, CMS is providing approval to the Medicare Fee-for-Service Recovery Auditor Contractors (RACs) to investigate this issue.” Patient records need to be audited to verify the therapy received matches the need and ability of the patient. For more, read the story.
