The Centers for Medicare & Medicaid Services said Wednesday it would release a list of nearly 400 poorly performing nursing homes that qualified for but have not received heightened federal scrutiny through what the agency calls the Special Focus Facility program.
The move comes after a Senate report this week revealed the federal government had identified far more troubled nursing homes that qualified for the program than it previously disclosed to the public, the Associated Press reported.
During a call with reporters, Kate Goodrich, M.D., director of CMS Center for Clinical Standards and Quality and chief medical officer, said the agency will be posting the Special Focus Facility candidate list after receiving numerous calls to release it.
“The recent heightened attention to and dialogue around the agency’s Special Focus Facilities program is welcome because it has amplified a very important national dialogue on national nursing home quality,” Goodrich said.
She declined to confirm when it would be posted, saying the agency was working to ensure it was in a format that was “understandable,” but she said it would be updated monthly once it is posted. She said the agency previously did not release the list because it already made a more comprehensive quality reporting tool available to the public, including star ratings, through its website Nursing Home Compare.
CMS contracts with state agencies, known as survey agencies, to investigate abuse allegations. That information is used for its oversight and is made available on the Nursing Home Compare website. Out of the 16,000 nursing homes around the country, about 3,000 have a one-star rating on their health inspection, Goodrich said.
There are 88 Special Focus Facility program slots for about 400 candidates for that program, Goodrich said. States help CMS narrow down which nursing homes are most in need of the available slots, she said.
Of those nursing homes that have entered the program, 90% have graduated from it after passing consecutive inspections and 10% have been terminated from qualifying to receive Medicare funds, she said.
“Certainly we think this is an important program that can lead to improved quality for nursing homes that are poor performers. But we are limited in the number of slots that we have available for the Special Focus Facilities program due to budgetary constraints,” she said.
President Donald Trump’s fiscal year 2020 budget also requests a $45 million increase for survey and certification—for an overall request of $442 million—to enable CMS to meet the statutory survey requirements while dealing with the increase in volume and severity of complaints as well as rising survey costs.
Officials said they’ve already made changes in nursing home oversight.
In April, CMS announced it was undertaking a comprehensive review of its regulations and processes when it came to ensuring safety and quality in nursing homes. The announcement came the same day the Government Accountability Office released a report saying CMS needs to do more to address gaps in federal oversight of nursing home investigations in Oregon.
At the time, CMS Administrator Seema Verma said her team has begun executing a five-point plan, including strengthening its oversight of nursing homes and improving enforcement of quality and safety policies by nursing homes.
Goodrich said the agency also began requiring a more “robust, standardized survey process, strengthened the staffing requirements for nursing homes, updated the way nursing homes report their staffing to CMS, then targeting nursing homes with staffing problems for off-hours and weekend surveys; and began to post all of the agency’s surveyor training online.”
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