Federal regulators said Wednesday they plan to go public with lists of troubled nursing homes in the future, days after Pennsylvania lawmakers unveiled a secret list of 400 such facilities.
Kate Goodrich, the chief medical officer for the Centers for Medicare and Medicaid Services, or CMS, said on a call with reporters the agency would release its list of chronic, underperformers “soon,” but stopped short of committing to a timeline. Goodrich said improving the quality and safety of the nation’s nursing homes was one of the agency’s top priorities.
“CMS’s work isn’t done,” Goodrich said. “In fact, we’re just getting started.”
The federal agency came under fire earlier this week following the release of a report by U.S. Sens. Bob Casey Jr., D-Scranton, and Pat Toomey, R-Lehigh Valley. The report highlighted continuing shortfalls and included a wait list of roughly 400 poor performing nursing homes for a federal corrective program called the Special Focus Facility, which is limited to 88 facilities because of budget constraints.
Goodrich did not say how long facilities wait to be added to the program. She also did not know how April’s list of 400 poor-performing nursing homes compares with previous waits.
She said President Trump has requested an additional $44 million for the agency. She was unsure how much would be allocated for the corrective program.
Although CMS compiles the wait list monthly, the agency has not made it publicly available.
“There are few decisions more serious or life-altering than that of choosing a nursing home,” Casey said in a statement. He said he was pleased with the agency’s move to release its list of homes with persistent problems.
Casey added, “Now we must work in a bipartisan fashion to ensure the SFF program is working properly and that CMS has the funding it needs to improve under-performing nursing homes nationwide.”
To help consumers navigate the complexities of choosing a nursing home, CMS created a website – Nursing Home Compare – that gives hotel-style ratings to facilities. The higher the star count, the better the quality of care.
The star rating system, however, has been beleaguered with complaints from advocates following previous news investigations that found nursing homes were gaming the system by staffing up for annual inspections to appear better able to meet resident demands, for example.
CMS responded by tweaking how it scores facilities, something Goodrich echoed Wednesday.
While consumers can see if a home with systemic problems is a Special Focus Facility, there is nothing yet that identifies those 400 facilities that should be in the program.
“When a family makes the hard decision to seek nursing home services for a loved one, they deserve to know if a facility under consideration suffers from systemic shortcomings,” Toomey said in a statement Tuesday. “While the vast majority of nursing homes provide high-quality care, there are some that are consistently failing to meet objective standards of adequacy.”
Pennsylvania has 16 homes identified as candidates for federal intervention, and all but two have a 1-star overall rating, the worst a facility can receive. Three of those homes on the wait list, all rated 1 star, are in Allegheny and Westmoreland counties.
These facilities represent the worst of the worst.
About 20 percent of Pennsylvania’s nearly 700 homes are rated 1 star for overall quality of care.
Four Pennsylvania homes – two in Westmoreland County – already have the Special Focus Facility designation.