The pandemic gave much of the country a glimpse of the sorry state of some nursing homes. But there have always been troubled nursing homes, places you wouldn’t choose for a dear relative. Driving by the typically squat, nondescript buildings on your daily commute or weekend errands, you don’t think about them — that is until you find yourself confronted with a set of circumstances requiring hard decisions about where to place a family member.
More than 25 years ago, the Clinton administration created a program to tackle the worst-of-the-worst facilities. The Special Focus Facility program, or SFF, was intended to improve those nursing homes with an ultimatum of sorts — either improve through a process that included more frequent inspections and enforcement actions or risk losing Medicare and Medicaid funding. That, in effect, would be a death knell for these businesses.
It would be an understatement to say the program has not lived up to its promise. In a series of three stories, a team at Modern Healthcare uncovered just how broken it is. What they found is there isn’t enough federal and state funding, oversight and desire to improve. In addition, more transparent data now available on nursing home ownership reveals the complex, tangled webs of for-profit owners, including several who are tied to multiple poorly performing properties with chronic patient safety and quality transgressions. The Centers for Medicare and Medicaid Services acknowledges the deficiencies.
Read our series on nursing home challenges
To be sure, there are some success stories, places that have improved, but they are in the minority of outcomes. Even in those successes, there’s recidivism.
It’s a complex problem. Forcing closures would put the most vulnerable populations at risk because if patients are in these troubled skilled nursing facilities, they likely have nowhere else to go. It also would mean job loss. This isn’t just a nursing home problem. It’s a healthcare problem, and it’s time for providers, payers, legislators and vendors, not just underfunded agencies and overworked patient advocates, to address it.
I urge you to read the stories. And as you do, imagine it’s your mom, dad, sibling or child in these facilities.
