GAO reports on weak nursing homes

WASHINGTON – A recent report from the Government Accountability Office urges the Centers for Medicare & Medicaid Services to take several steps to improve its “special focus facility” program, which targets poor-performing nursing homes for extra attention and support.
CMS created the program in 1998. Nursing homes are nominated for the program by the states, which get a list of the 15 poorest-performing homes; a total of 136 facilities nationwide can be targeted at any given time.
The GAO analyzed CMS data from 2005 through 2009 and interviewed officials in 14 states, and it found that some states don’t consistently follow the basic program requirements, from doubling inspections (“surveys”), to giving homes no more than 18 months to fix problems.
The GAO also found that CMS’s enforcement guidance “is vague and results in inconsistent interpretations,” so some homes were avoiding fines while others paid big penalties.
On the positive side, the review found that in some regions, CMS was working with states to give their SFF programs a boost by hiring quality improvement consultants, and states themselves are helping by providing nurse consultants or monthly training opportunities.
The GAO recommended that CMS take six actions to strengthen the SFF program, including notifying homes that are on the SFF candidate list and seeking legislative authority to charge SFFs for the cost of more frequent inspections.
The full report is available on the GAO website.