The OIG has issued a report, “Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements,” assessing SNF compliance with federal requirements to develop a care plan for each Medicare beneficiary, provide services in accordance with the individual’s care plan, and establish a discharge plan for each beneficiary. Based on an extremely small sample of only 190 SNF stays in 2009 – which OIG projects to more than 1.1 million stays – the OIG estimates that 37% of SNFs did not develop care plans that met federal requirements or did not provide services in accordance with care plans. In addition, the OIG estimates that SNFs did not meet discharge planning requirements in 31% of stays. The report also reviews examples of what it considers poor quality of care in the SNF setting, including a few cases involving wound care, medication management, and therapy. In response to these findings, the OIG recommends that CMS, among other things: strengthen care planning and discharge planning regulations; provide more detailed guidance to SNFs; improve surveyor efforts to identify and hold accountable SNFs that do not meet care and discharge planning requirements; and link payments to meeting quality-of-care requirements (such as by incorporating quality measures for care planning and discharge planning in its SNF Value-Based Purchasing program). CMS concurred with the OIG’s recommendations and discussed the status of its efforts in this area. Related OIG information is posted here