CMS officials on Wednesday said they will publish a previously undisclosed list of more than 400 nursing homes that have been cited for persistent health and safety violations but haven't received increased federal scrutiny.
The agency has been criticized for its lack of transparency and failure to report some underperforming nursing homes. The list includes "candidates" for the CMS' Special Focus Facility initiative, which gives operators with persistently poor care records incentives to improve their performance. The nursing homes undergo increased site inspections and incur penalties up to being excluded from Medicare and Medicaid.
CMS Chief Medical Officer Dr. Kate Goodrich did not provide a time frame for when the agency would post the list.
Sens. Bob Casey (D-Pa.) and Pat Toomey (R-Pa.) on Monday released a report that published the names of Special Focus candidates, citing the need for greater transparency for patients and their families.
"Oversight of America's poorest quality nursing homes falls short of what taxpayers should expect," the report said.
Goodrich welcomed the transparency discussion but noted there is more detailed quality information available on the agency's "consumer-friendly" Nursing Home Compare website.
"Improving safety and quality in America's nursing homes is one of CMS' top priorities," she said.
But the Nursing Home Compare site doesn't mention whether nursing homes are candidates for Special Focus. The Senate report found the star ratings of candidate nursing homes did not always reflect their status. More than a quarter of candidate facilities had a two-star rating and 48% achieved three stars or higher for quality. Nine Special Focus candidates scored a five-star rating for staffing and quality, according to the report.
The CMS usually chooses approximately five of the poorest-performing nursing homes to participate in Special Focus, and states pick the best candidates. The selected nursing homes usually have similar quality and safety performance compared with other candidates.
Special Focus nursing homes receive an inspection every six months compared with at least once every 15 months for all other facilities, including Special Focus candidates.
Approximately 3% of nursing homes participate or are candidates for Special Focus. Goodrich said more than 90% of participants end up "graduating" from the program by sustaining significant improvements for about 12 months. About 10% of program participants end up being banned from receiving Medicare and Medicaid, which often times leads to a nursing home shutting its doors soon after.
The agency is still looking at better ways to publish candidate information, and it wants to update the list monthly, Goodrich said. CMS Administrator Seema Verma in April named increasing transparency as one of her priorities in a five-part plan to improve care quality in nursing homes. Other priorities include enhancing enforcement and reducing providers' administrative burdens.
