Numbers, numbers, numbers! We collect them, report them, document them, and use them to make decisions every day. But what happens when the information doesn’t add up? Whether we are talking about staffing, assessments, medications, or discharge planning, accurate information in senior living matters. Recent reports and studies give us several reasons to take a closer look at the information we collect and how we use it.

Let’s start with staffing. Nursing homes must electronically submit direct care staffing information to the Centers for Medicare & Medicaid Services (CMS) through the Payroll-Based Journal (PBJ). However, a recent Office of Inspector General audit of staffing information reported through PBJ identified concerns with the accuracy of some of that information.

According to the audit, 45 of 100 sampled items included a net total of 748.5 registered nurse hours without adequate support. For another two sampled items, nursing homes did not provide documentation to verify 336 hours. Based on its sample, OIG estimated that nursing homes reported approximately 938,000 RN hours without the support required under federal requirements.

As reported by McKnight’s Long-Term Care News, OIG recommended that CMS use audit errors to help select nursing homes for follow-up audits. In addition, OIG recommended that CMS verify corrective actions, educate providers about PBJ guidance, and communicate trends that audits identify.

Staffing numbers aren’t the only information that deserves our attention. Discharge documentation is another area where getting it right matters. CMS recently provided an OBRA Discharge Assessment Determination fact sheet to help providers determine when they need to complete an OBRA Discharge assessment. This is another good opportunity to review your current processes and ask whether staff understand what they need to do and when.

Then there are medications. Transitions between the hospital and skilled nursing setting can create opportunities for medication discrepancies. A study reported by McKnight’s Long-Term Care News found that about one in six medications deprescribed at hospital discharge started again following admission to a skilled nursing community. That should make us stop and think. Was restarting the medication intentional? Did the hospital communicate the reason for deprescribing it? And did everyone have the same information?

Discharge planning itself can also affect what happens next. Another study highlighted by McKnight’s examined discharge planning services and transition-of-care outcomes for patients with hip fractures. The findings provide another reminder that discharge planning involves much more than completing paperwork. Information that follows a resident from one care setting to another can influence what happens after that transition.

So, what does all of this mean for you? Maybe it is time to take a closer look at the information moving through your community. Start with your PBJ numbers. Do they match your supporting documentation? Next, look at your OBRA Discharge assessments and whether staff complete them when required. Consider medication changes during transitions as well. Is everyone communicating those changes clearly? Finally, review your discharge planning process. Does the next care provider receive the information needed to understand the resident’s needs?

There are lots of rocks to unturn. Accurate information in senior living involves much more than checking a box or submitting another report. Take some time to look at your processes, talk about them at your next QAPI committee meeting, and identify where information may get lost, misunderstood, or reported incorrectly. You might be surprised by what you find!

Stay well and stay informed!