|
E-mail this page to a friend!
Medicare News
Ouch! CMS Publishes Online List of Poorest
Performing Nursing Homes
Wants to help people choose nursing homes for long-term care
 Nov. 29, 2007 – Ouch! The Centers for Medicare &
Medicaid Services (CMS) today released the first ranking of the nation’s
poor-performing nursing homes, which it identifies as “Special Focus
Facilities.” CMS says the purpose is to help people choose nursing homes
for long-term care.
As of October 2007, there were 128 SFFs, out of
about 16,000 active nursing homes, according to CMS. The number of SFFs
in each state varies according to the number of nursing homes in the
state. These nursing homes, at the time of their selection as an SFF,
had survey results that were among the poorest five or 10 percent in
each state.
Today’s list includes 54 facilities that are at the
top of the poorest performers in those states and among those facilities
that have failed to improve significantly.
Typically, these facilities achieve improved survey
results after being selected for the initiative. The CMS data indicate
that about 50 percent of the nursing homes identified as SFFs
significantly improve their quality of care within 24-30 months, while
about 16 percent are terminated from Medicare and Medicaid.
In addition to publishing the list of SFFs, CMS is
taking many other steps to improve the quality of care in the nation’s
nursing homes including a new program that will make the payment system
more sensitive to quality improvements; developing new, more stringent
systems for criminal background checks on facility workers and
applicants; unprecedented focus on preventing catastrophic pressure
ulcers in nursing home residents; and improving the state survey
process.
| |
Senate Aging
Committee Chair Commends CMS
U.S. Senate Special Committee on Aging
Chairman Herb Kohl (D-WI) quickly commended today’s public
disclosure of the worst nursing homes in the nation by CMS.
Kohl and Senator Charles Grassely (R-IA)
are drafting a nursing home bill and say they will require
continued release by CMS of the most troubled nursing homes in
the county.
“I am pleased to say CMS is beating us to
the punch: disclosing this list is a provision in our
forthcoming bill,”said Sen.Kohl. “CMS understands what we
understand—that it is in everybody’s best interest to let
consumers know which nursing homes repeatedly demonstrate
deficiencies and violate government standards.”
The Nursing Home Transparency and
Improvement Act of 2007 is the most recent example of policy put
forth by Senator Kohl’s office that utilizes the powerful tool
of disclosure as a means to educate and empower consumers, noted
a statement from Kohl’s office. |
|
“Nearly three million Americans, most of who are
enrolled in Medicare or Medicaid, depend on the nation’s 16,000 nursing
homes at some point during each year to provide life-saving care,” said
CMS Acting Administrator Kerry Weems.
“Release of this national list of special focus
facilities reinforces CMS’ commitment to provide beneficiaries and their
families the information they need when making long-term care choices.”
CMS says release of the list was prompted by the
number of facilities that were consistently providing poor quality of
care, yet were periodically instituting enough improvement that they
would pass one survey only to fail the next (for many of the same
problems as before). Such facilities with a “yo-yo” compliance history
rarely addressed underlying systemic problems that were giving rise to
repeated cycles of serious deficiencies.
Once a facility is selected as an SFF, the state
survey agency conducts twice the number of standard surveys and will
apply progressive enforcement until the nursing home either
(a) significantly improves and is no longer identified as an SFF,
(b) is granted additional time due to promising developments, or
(c) is terminated from Medicare and/or Medicaid. CMS and the state
can more quickly terminate a facility that is placing residents in
immediate jeopardy.
| |
Aging Committee Highlights Need for More Open Info
About Nursing Homes
Finance committee ranking member Grassley, top CMS
official Kerry Weems to testify
 Nov. 15, 2007 - Today, U.S. Senate Special
Committee on Aging Chairman Herb Kohl (D-WI) will hold a hearing to
highlight the need for increased transparency and accountability with
respect to information that is publicly available about nursing homes.
Key testimony is expected from Senator Charles Grassley (R-IA) on the
need to strengthen the federal government’s system of nursing home
regulation, outlining the main objectives of the Nursing Home
Transparency and Improvement Act of 2007.
Read
more...
|
|
The CMS policy of progressive enforcement means
that any nursing home, not just those identified as an SFF, that reveals
a pattern of persistent poor quality is subject to increasingly
stringent enforcement action. If problems continue, the severity of
penalties will increase over time, ranging from civil monetary
penalties, denial of payment for new admissions and, ultimately, removal
from Medicare and/or Medicaid.
“CMS’ effort to identify poor performing nursing
homes is intended to promote more rapid and substantial improvement in
the quality of care in identified nursing homes and end the pattern of
repeated cycles of non-compliance,” Weems noted.
In addition to consulting the CMS list of SFFs (see
link below) beneficiaries and their families looking for a nursing home
are encouraged by CMS to take other steps including:
● Visit the nursing home.
> Talk to staff, residents, and other families.
> Request to see the results from the last state or CMS
survey.
● Prior to a visit, review the survey history of
the nursing home on Nursing Home Compare to better understand any
areas that may be problematic.
● Ask the nursing home staff what they are doing
to improve the quality of care for residents in the nursing home.
● Call the state survey agency to learn more
about the nursing home. If the facility is in the special focus
initiative, find out how long it has participated. Facilities in the
program for 18-24 months are either close to “graduating” because of
significant improvements to care, or ending their participation in
Medicare and Medicaid.
● Call your local state nursing home ombudsman,
Administration on Aging, and local groups to learn more about the
nursing home.
● Use the Nursing Home Brochure (click
here) and “Guide to Choosing a Nursing Home” (click
here) - both publications are available on Nursing Home Compare.
Links
>> List of 128 Special
Focus Facilities
http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf
>> Nursing Home Brochure
http://www.medicare.gov/Publications/Pubs/pdf/nursinghome.pdf
>> Guide to Choosing a Nursing Home
http://www.medicare.gov/Publications/Pubs/pdf/02174.pdf
>> Home page on
CMS site for SFF information
http://www.cms.hhs.gov/CertificationandComplianc/12_NHs.asp#TopOfPage
Links on
page above to:
> Special
Focus Facility Initiative and List
> Appropriateness of minimum nurse staffing ratios in nursing
homes - Phase I
> Appropriateness of minimum nurse staffing ratios in nursing
homes - Phase II
> 2005 Nursing Home Data Compendium
> 2006 Nursing Home Data Compendium
> 2007 Nursing Home Data Compendium
> 2005 Nursing Home Action Plan
> 2007 Nursing Home Action Plan
> 2007 Study of Paid Feeding Assistant Programs
>> Nursing Home Compare - Medicare Website
with detailed information on every nursing home in the U.S. -
Click
>> How to Choose a Nursing Home – U.S.
government site
http://www.seniors.gov/retirementplanner/ltc/nhguide.htm
More about the SFF Initiative by CMS
The Centers for Medicare & Medicaid Services (CMS),
together with States, visit nursing homes on a regular basis to
determine if the nursing homes are providing the quality of care that
Medicare and Medicaid requires. These “survey” or “inspection” teams
will identify deficiencies in the quality of care that is provided, as
well as deficiencies in meeting CMS safety requirements (such as
protection from fire hazards). When deficiencies are identified, we
require that the problems be corrected. If serious problems are not
corrected, we may terminate the nursing home’s participation in Medicare
and Medicaid.
Most nursing homes have some deficiencies, with the
average being 6-7 deficiencies per survey.
Most nursing homes correct their problems within a
reasonable time period. However, we have found that a minority of
nursing homes have more problems than other nursing homes (about twice
the average number of deficiencies), have more serious problems than
most other nursing homes, and continue to have serious problems over a
long period of time. Although such nursing homes periodically instituted
enough improvements in the presenting problems that they would be in
substantial compliance on one survey, they would be determined as
providing substandard quality of care on the next. Such facilities with
a “yo-yo” compliance history rarely addressed underlying systemic
problems that were giving rise to repeated cycles of serious
deficiencies. To address this problem CMS created the “Special Focus
Facility” (SFF) initiative.
CMS requires that SFF nursing homes be visited in
person by survey teams twice as frequently as other nursing homes (about
twice per year). The longer the problems persist, the more stringent we
are in the enforcement actions that will be taken. Examples of such
enforcement actions are civil monetary penalties (“fines”) or
termination from Medicare and Medicaid.
Within about 18-24 months after a facility is
identified by CMS as an SFF nursing home, we expect that there will be
one of 3 possible outcomes:
(a) The nursing home graduates from the SFF
program because it has made significant improvements in quality of care
- and those improvements are continued over time.
(b) The nursing home is terminated from
participation in the Medicare and Medicaid programs. While such a
nursing may continue to operate (depending on State law), usually it
will close once Medicare and Medicaid funding is discontinued. In such a
case the State Medicaid Agency (and others) will assist all nursing home
residents to transition to another residence that can provide a better
and acceptable quality of care. This may include a variety of
possibilities, such as another nursing home, a community-based setting,
or apartment with good support services.
(c) The nursing home is provided with some
additional time to continue in the SFF program because there has been
very promising progress, such as the sale of the nursing home to another
owner with a much better track record of providing quality care.
The State survey agencies are responsible for
entering survey information into CMS’ databases and providing updates as
needed. Every attempt is made to assure the accuracy and timeliness of
the information on the list. However, data lags of up to several months
can occur between completion of a survey and posting of data on this
list. We advise interpreting this information cautiously and
supplementing it with information from the ombudsman's office, the State
survey agency, or other sources.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
