CMS names underperforming nursing homes for 'Special Focus Facility' program

The Centers for Medicare and Medicaid has published a list of more than 400 poor performing nursing homes that are candidates for federal intervention, six weeks after pledging to make the secret list publicly available following its disclosure last month by Pennsylvania’s U.S. senators.

The list, released July 16, identifies 440 facilities nationwide with a history of serious quality issues.

The quality of nursing home care has long been an issue. Nearly one in four Pennsylvanians by 2040 are expected to be 65 and older, the cohort most likely to need skilled nursing care . In an effort to improve care at the nation’s 16,000 nursing homes, CMS created its “Special Focus Facility” program, which targets poor performing homes for more frequent inspections to encourage improvement. The program has the capacity for 88 facilities at a time.

Roughly one in five of the facilities singled out for the list have been waiting a year or more for entry into the federal program. A handful of the facilities have been waitlisted for as long as four and five years. Two Arizona homes, for example, were put on the list under the Obama administration.

Advocates for the elderly expressed dismay that regulators could have identified persistent quality issues five years ago at a troubled home that is still waiting for greater federal oversight.

“This is unreal,” said Toby S. Edelman, an attorney with the Center for Medicare Advocacy in Washington, D.C. “The idea that these facilities can be candidates for 62 months is frightening.”

Last month, U.S. Sen. Bob Casey Jr., D-Scranton and U.S. Sen. Pat Toomey, R-Lehigh Valley, released the agency’s April list, which identified 400 troubled homes. At that time, Pennsylvania had 16 candidates for the Special Focus Facility program.

Now there are 20. Of these, four are from the southwestern region, with one in Allegheny and three in Westmoreland counties.

The Grove at Latrobe – a 107 bed-facility in Westmoreland County – has been a candidate for federal intervention for 31 months. Only the Spring Creek Rehabilitation and Nursing Center in Harrisburg has been waiting longer at 32 months. Its adminstrators could not be reached for comment.

Here are the other homes in Allegheny and Westmoreland County that made the list:

• Loyalhanna Care Center in Latrobe is a new candidate for federal intervention.

• Corner View Nursing and Rehabilitation Center in the Pittsburgh neighborhood of Larimer has been on the list for three months.

• William Penn Care Center in Jeannette is also a three-month candidate.

Twin Lakes Rehabilitation and Healthcare Center in Greensburg, which had been in the Special Focus Facility program, showed improvement and graduated from the list in June.

Following the senators’ disclosure in early June, CMS Chief Medical Officer Kate Goodrich promised to release the internal list.

A CMS spokesperson said the list will be updated monthly.

Casey applauded CMS for releasing the previously undisclosed list, saying he will continue pushing for greater transparency.

The list shows how long nursing homes have been waiting to be placed in the program, those that have successfully graduated and those marked for improvement.

“It is of significant concern to Senator Toomey that some of these facilities have been on this list for multiple years,” said Steve Kelly, a Toomey spokesman. “This underscores why Senator Toomey worked with Senator Casey to make the full list of underperforming nursing homes public.”

“I think that what all of us could use more explanations about what the list is and how they’re using it,” said Diane Menio, executive director of the Philadelphia-based Center for Advocacy for the Rights and Interests of the Elderly, or CARIE. “It certainly would make a lot of sense to keep an eye on some of these places that are either chronically mediocre or bad.”

The release marked the first time the agency has made it publicly available, which consumers can access on CMS’s Nursing Home Compare website (medicare.gov/nursinghomecompare), which gives facilities hotel-like star ratings to help families evaluate the quality of care.

Although Nursing Home Compare identifies homes in the Special Focus Facilities program, it doesn’t flag those with persistent problems on the waiting list.

“I think CMS is somewhat hamstrung by the finite number of spots, but they could certainly make this more public,” said Sam Brooks, an attorney with Community Legal Services in Philadelphia and a leading advocate for better state oversight.

Brooks added, “Remember that these determinations are made by the state initially, and we know how poorly the state regulates nursing homes.”