Federal report targets Florida agency over nursing home verifications

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The state Agency for Health Care Administration failed to verify that nursing homes properly corrected deficiencies cited by agency staff in 2015, according to a report issued Friday by the U.S. Department of Health and Human Services inspector general’s office.

Federal officials are recommending that the state improve practices for verifying that deficiencies have been corrected. The Agency for Health Care Administration did not agree with the Office of Inspector General’s findings and asked that federal officials change the name of the audit titled, “Florida Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid.”

The inspector general reviewed 100 deficiencies at nursing homes across Florida that were flagged by regulators in 2015 and found that the agency verified the correction of 82 deficiencies. According to the report, the state agency did not obtain evidence of correction —- or sufficient evidence of correction —- for the remaining 18 deficiencies.



Based on those findings, the Office of Inspector General estimated that the state agency failed to obtain evidence of corrections for 455 of 2,381 deficiencies cited at facilities that participated in Medicare and Medicaid. Moreover, the report estimated that the state didn’t provide sufficient evidence that corrections had been properly made for another 130 deficiencies.

Agency for Health Care Administration spokeswoman Mallory McManus downplayed the findings, saying the report involves a small number of “isolated incidents in 2015 at nursing facilities that did not involve patient harm” and said the agency has since changed its operations.

Federal regulations require nursing homes that participate in Medicare and Medicaid to submit correction plans to the federal Centers for Medicare & Medicaid Services or to the proper state agency. State agencies must verify the correction of deficiencies by obtaining evidence or through onsite reviews.

But according to the report released Friday, a state official told a federal auditor that AHCA’s practice for less-serious deficiencies was to accept the nursing homes’ correction plans as confirmation of substantial compliance.

The report noted that an AHCA official cited a section of a federal manual that allowed for the practice. But the inspector-general report said the cited section of the manual “is not applicable to nursing homes. … Without verification of evidence of correction, the state agency cannot ensure CMS that nursing homes have complied with federal participation requirements and that residents are adequately protected.”

AHCA Secretary Justin Senior wrote a three-page letter in February on the findings and recommendations. In it, Senior said the “18 deficiencies in question were isolated incidents (not patterns or widespread), and none of them involved patient harm or immediate jeopardy. We are therefore concerned that the title significantly misrepresents the findings for Florida.”

A copy of the report is here.