Wednesday, June 12, 2019

Report reveals nearly 400 poor-performing nursing homes; government website doesn't make their problems clear

The Senate Special Committee on Aging, led by Pennsylvania's senators, Democrat Bob Casey and Republican Pat Toomey, has released a report listing nearly 400 nursing homes with a "persistent record of poor care" that had not been publicly available. Almost every state has facilities on the list.

The report is "one of the most damning reports on the nation’s nursing homes that I’ve seen in a long time" and "should be required reading for any family thinking of moving a relative to a nursing facility," Trudy Lieberman writes in "Thinking About Health" for the Rural Health News Service.

Nursing homes that score poorly in state inspections qualify for extra oversight under the federal Special Focus Facility program until their issues are resolved. Of the nearly 400 facilities that are candidates for the program, only 88 have been selected as participants because of limited resources at the Centers for Medicare and Medicaid Services. But even though candidates are indistinguishable from participants in terms of quality, the list of candidates is not published. "As a result, individuals and families making decisions about nursing home care for themselves or for a loved one are unlikely to be aware of these candidates," the report says.

They may not be aware of the Special Focus participants, either. "The names on the participant list are public, but . . . CMS doesn’t make it easy to identify them," Lieberman writes. "On the CMS website these problematic facilities are not given star ratings as are most other facilities. Instead they are designated with a small yellow triangle that looks like a caution traffic sign."

The report found several other issues with CMS' Nursing Home Compare site. The star ratings on the website are also sometimes misleading, the report says, which is a problem since families and hospital discharge planners often use the star ratings in choosing a facility. The report also notes that CMS hasn't consistently updated data on the website and that nine troubled nursing homes are listed as having perfect scores for staffing and quality of care. 

For some rural people, participants in and candidates for the Special Focus program may be the only facilities nearby. Lieberman advises shunning such facilities, but "If they are the only game in town, then proceed with caution and keep a very close eye on any relative you send to one of them."

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