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Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-07-19-03238
Report Description

The Medicare and Medicaid programs cover care in nursing homes for eligible beneficiaries. Sections 1819 and 1919 of the Social Security Act (the Act) establish requirements for CMS and States to perform surveys of nursing homes to determine whether they meet Federal participation requirements. For Medicare and Medicaid, these statutory participation and survey requirements are implemented in Federal regulations at 42 CFR part 483, subpart B, and 42 CFR part 488, subpart E, respectively.Nursing homes are required to comply with all Federal, State, and local laws, regulations, and codes, as well as accepted professional standards and principles (42 CFR § 483.70). Federal regulations on life safety (42 CFR § 483.90) require that nursing homes comply with standards set forth in the National Fire Protection Association (NFPA) Life Safety Code (NFPA 101) and Health Care Facilities Code (NFPA 99). CMS lists applicable requirements on Form CMS 2786R, Fire Safety Survey Report. Federal regulations on emergency preparedness (42 CFR § 483.73) include specific requirements for nursing homes’ emergency preparedness plans and reference the Standard for Emergency and Standby Power Systems (NFPA 110) as part of these requirements. CMS lists applicable requirements on its Emergency Preparedness Surveyor Checklist. The Fire Safety Survey Report and Emergency Preparedness Surveyor Checklist are used when CMS or a designated agency performs a nursing home survey. The results of each survey are reported and added to CMS’s Automated Survey Processing Environment (ASPEN) system.

Report Type
Audit
Location

IA,
United States

Number of Recommendations
4
Questioned Costs
$0
Funds for Better Use
$0

Open Recommendations

This report has 4 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
270107 No $0 $0

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise follow up with the 20 nursing homes to ensure that corrective actions have been taken regarding the life safety and emergency preparedness deficiencies identified in this report,

270108 No $0 $0

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise work with CMS to develop standardized life safety training for nursing home staff, conduct more frequent surveys at nursing homes that have a history of multiple high-risk deficiencies, (212-909-10-02) and require nursing homes and inspection contractors to (1) tag systems that are critical to the health and safety of nursing home residents when they have found that these systems may not work as required when needed and (2) notify the State agency. (074-348-10-02)

270109 No $0 $0

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise conduct more frequent surveys at nursing homes that have a history of multiple high-risk deficiencies,

270110 No $0 $0

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise require nursing homes and inspection contractors to (1) tag systems that are critical to the health and safety of nursing home residents when they have found that these systems may not work as required when needed and (2) notify the State agency.

Department of Health & Human Services OIG

United States