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June 5, 2019

Sens. release list of about 400 'troubled' nursing homes

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    Sens. Bob Casey (D-Pa.) and Pat Toomey (R-Pa.) on Monday released a previously undisclosed list from CMS of nearly 400 U.S. nursing facilities that inspectors determined have a "persistent record of poor care," including health, safety, and sanitary issues, the Associated Press reports.

    What do consumers want from post-acute care?


    The list includes nursing facilities that were candidates for CMS' Special Focus Facilities (SFF) program, which is intended for facilities that have demonstrated serious and ongoing health and safety violations, according to the AP. In 2019, 88 facilities were designated to the SFF program, and 435 were considered candidates. SFF program participants are inspected by federal investigators two times as often as other facilities and are subject to monetary penalties or expulsion from Medicare and Medicaid eligibility if inspections show that quality has not improved, the AP reports.

    All SFF designated nursing homes are assigned a special icon on CMS' Nursing Home Compare website to alert patients and families of the designation. However, SFF facilities' star quality ratings are hidden until they move out of the program, according to Skilled Nursing News.

    CMS publicly discloses the names of nursing facilities that eventually are selected for the SFF program, as well as information about the facilities with quality issues. But the agency in the past has not disclosed the names of SFF candidates or assigned such facilities a designation on Nursing Home Compare, Skilled Nursing News reports.

    Sens. release 'secret document' of underperforming nursing homes

    Casey and Toomey on Monday released CMS' list of the approximately 400 nursing facilities that were listed as 2019 candidates for the SFF program as of April due to a "persistent record of poor care," the senators said in a statement. Casey and Toomey previously had asked CMS to disclose the list, but the agency declined, Politico's "Pulse" reports. The senators then decided to release the list on their own, along with a report that "examines federal oversight of … consistently poor-performing nursing homes," the senators said.

    The senators in the statement said publishing the list ensures transparency for patients and families who are looking for high-quality nursing homes. "[T]here are some [nursing homes] that are consistently failing to meet objective standards of adequacy," Toomey said. He added, "To date, CMS has arbitrarily excluded from public disclosure a subset of these underperforming nursing homes."

    "We've got to make sure any family member or any potential resident of a nursing home can get this information, not only ahead of time but on an ongoing basis," Casey said.

    Verma says CMS resources for SFF program are limited

    CMS Administrator Seema Verma in a letter sent last month to Casey said federal budget cuts in 2014 limited the number of nursing homes the agency can put in SFF.

    Verma wrote that the number of spots for nursing homes in the SFF program decreased from 167 in 2010 to 88 in 2019. The number of candidate slots also decreased from 835 in 2010 to 440 in 2019, according to Verma.

    Verma added that "candidates for the SFF program typically will have a very low star rating," so "consumers and other stakeholders are alerted to the quality of care issues in these facilities by viewing their star rating and survey results on the Nursing Home Compare website" (Alonso-Zaldivar, Associated Press, 6/4; Diamond, "Pulse," Politico, 6/4; Spanko, Skilled Nursing News, 6/3; Lam, USA Today, 6/4).

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