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Medicare will identify 400 nursing homes with serious health and safety violations 

Written by Diane Archer

It is a travesty how little information is available to Americans about the quality of particular health care providers. We spend a tremendous amount of money on health care. And, we often put our lives in the hands of health care providers. Commercial health insurers rarely if ever disclose the bad actors. Under Senate pressure, Medicare is naming an additional 400 nursing homes with serious health and safety violations.

Earlier this month, Senators Bob Casey (D-PA) and Pat Toomey (R-PA) released a report on nursing homes with serious health and safety violations. The report focuses on poor federal oversight of hundreds of nursing homes found by state survey agencies to abuse and neglect patients. In some of these facilities, investigators found residents were left without proper nutrition or languishing in filthy conditions. In other facilities, residents were physically abused and sexually assaulted. Consequently, in some instances, residents have died prematurely.

Given budget cuts, the report asks whether Medicare has the needed resources to properly oversee and inspect these nursing homes and help improve conditions.

Even though state agencies have flagged these nursing homes for their poor performance, the Centers for Medicare and Medicaid Services (CMS) has not identified them to the public nor has CMS acted to ensure they improve their quality. As a result of limited resources, CMS has named only 88 poor-performing nursing homes as “Special Focus Facilities,” SFF, to which it is directing its attention.  But, 400 additional nursing homes qualify as SFF because they have been found to have a “persistent record of poor care.”

Since CMS has not been treating these 400 nursing homes as in need of special oversight, it had not identified them to the public. In the wake of the report’s release, however, the federal government has agreed to post a list of these 400 underperforming nursing homes.

Ensuring the public has good quality information to make smart decisions about nursing homes is a priority of Congress.  The CMS Nursing Home Compare site offers some good information through its star-ratings. The 2,900 nursing homes with one star perform the poorest relative to the other nursing homes with star ratings.

SFF participants do not have a star rating. Rather, they have a warning sign beside their names on Nursing Home Compare. Casey and Toomey’s report argues that the other 400 candidates for SFF also should have a warning sign by their names. Like the SFF participants, they should not have a star rating.

If at all possible, avoid nursing homes that do not have five-star ratings. And, keep in mind that even they may have issues, though perhaps fewer than others. The Senators point out that almost 30 percent of the poor performing homes they identified had two-star ratings.

For more good information on nursing homes, check out Informed Patient Institute. It gives both Nursing Home Compare and the US News and World Report ratings a B grade. You should also check out Pro Publica’s Nursing Home Inspect.

Today, there are nearly 16,000 nursing homes, with 1.3 million residents. Fewer than one percent of them reside in a SFF nursing home or the 400 additional nursing homes that are SFF candidates.

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