GAO Report questions ability of CMS to find and monitor subpar nursing homes

The Centers for Medicare and Medicaid Services (CMS) has a program in place to follow up on nursing homes whose conditions are not adequate. Currently CMS focuses on one to six homes in each state which are performing poorly and places them on Special Focus Facilities (SFF) list which subjects them to more frequent inspections and penalties if they don’t improve.

A new report from the Government Accountability Office (GAO) concluded that the current program is missing almost four times as many homes which are among the worst performing facilities in the nation. The report recommends that they expand the list from the current 136 to 580.

Facilities rated as performing the worst tended to be larger, averaging 102 residents, were for-profit facilities, and were part of a chain of homes. These facilities had an average of 24% fewer registered nurses on duty compared to the number of patients than better performing homes. The GAO did not name any specific nursing homes in their report.

Senate Aging Committee chair Herb Kohl (D-Wis) argued that the CMS special focus program is in need of immense expansion, and that the criteria for identifying the worst performing homes should be modified.

Kohl and Finance Committee ranking member Charles Grassley (R-IA) reintroduced the Nursing Home Transparency and Improvement Act in March, where it calls for information to be available to consumers about ownership, track records of care, and business structure of the nursing homes. This would give the homes a change to improve conditions on their own. Senator Max Baucus recently included this proposal in the Senate healthcare reform bill.

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GAO Report questions ability of CMS to find and monitor subpar nursing homes

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