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Feds Finally Release Complete List of Deficient Nursing Homes

  • February 14th, 2008

The Bush administration's Centers for Medicare & Medicaid Services (CMS) has released the complete list of U.S. nursing homes that have failed to meet safety and quality standards for care.

The list, which identifies 131 "Special Focus Facilities" that require additional oversight, follows the release in November 2007 of a list of 54 such facilities. At that time, CMS came under intense criticism for making public only a partial list of Special Focus Facilities while sharing the full list with three associations representing the nursing home industry. (See "Feds Publish List of 54 Poorest-Performing Nursing Homes.")

CMS created the Special Focus Facility initiative in 1998 in response to the number of facilities that were consistently providing poor quality of care. Those facilities were periodically instituting enough improvement so that they would pass one survey, only to fail the next for many of the same problems as before. Facilities with this compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies.

Serious deficiencies include such things as failing to give residents their medications in the correct dose at the correct time, not taking steps to prevent abuse or neglect, inappropriate use of restraints and failure to prevent or properly treat bed sores.

Once a facility is selected as a Special Focus Facility, state survey agencies are responsible for conducting twice the number of standard surveys and, according to CMS, will apply progressive enforcement until the nursing home either significantly improves and is no longer identified as a Special Focus Facility, is granted additional time due to promising developments, or is terminated from Medicare and/or Medicaid.

Angela Brice-Smith, Deputy Director the Survey and Certification Group at CMS, told the National Citizens' Coalition for Nursing Home Reform that the list will be updated on a quarterly basis, and that names of the Special Focus Facilities will be kept on the CMS Web site for six months indicating their status. CMS is working on a modification to its Nursing Home Compare site that will link users to the list from a Special Focus Facility's site. Brice-Smith said there are no plans to release the larger list of facilities whose names are provided to states as candidates for the Special Focus Facility status.

No doubt prompted by recent congressional inquiries, CMS recently has been on a mission to identify suspect nursing homes. As ElderLawAnswers reported, it recently released the names of thousands of nursing homes across the country that don't meet federal standards in rates of using patient restraints or preventing bedsores.

For the list of 131 Special Focus Facilities, go to: http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf

For CMS's press release on its decision to make public the complete list of the problem facilities, click here.

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Last Modified: 02/14/2008

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