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Inspections also are conducted in response to complaints. Regular surveys are required more often (every nine to 15 months) for nursing homes, and less often (every three years) for hospices and home health agencies. State health and social services agencies are primarily responsible for conducting the inspections and other monitoring of LTSS quality (with Centers for Medicare & Medicaid (CMS) oversight where there are federal standards). How is long-term services and supports quality regulated?įederal quality standards exist for nursing homes, home health agencies and hospices, while states are responsible for regulating residential care, personal care, and other home and community-based services (Table 1). The Appendix Tables provide data about LTSS providers and consumers, summarize key federal laws and policies related to quality, and list selected federal quality measures. This issue brief discusses four key issues related to long-term services and supports (LTSS) including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years. The last several decades also have seen a shift to home care and other community-based services, with few quality measures for these settings available and little empirical evidence available. Recurring concerns include staffing levels, abuse and neglect, unmet resident needs, quality problems, worker training and competency, and lack of integration with medical care.

1 While progress has been made, care quality issues in nursing homes and residential care facilities 2 (also called assisted living) continue to be highlighted frequently in the press 3 and by numerous government reports 4 and research studies 5 (see Appendix Table 1). The Act also merged Medicare and Medicaid standards, required comprehensive assessments of residents, set minimal requirements for licensed nursing staff, and required inspections to focus on outcomes of care. 2017 marks the 30 th anniversary of the passage of the Nursing Home Reform Act as part of the Omnibus Budget Reconciliation Act of 1987, the federal legislation that substantially strengthened federal standards, inspections and enforcement of nursing home quality.

Cms nursing home compare 5 star ratings of nursing homes