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This
webpage offers a list of nursing homes that have had a history of serious
quality problems. We have included these nursing homes in a special
program to stimulate improvements in their quality of care. Please take a
minute to review this background information on our “Special Focus Facility”
initiative so you can be as informed as possible when you discuss your long
term care options with any nursing home that is listed here – and what they
are doing to improve their quality of care.
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.
If you are considering admission to a nursing home
included on this list you may want to:
1. Above all, visit the nursing home. Talk to staff, residents, and other
families. You may request to see the results from the last State or CMS
survey (it should be in a place that is easily accessible.)
2. Before your visit, look at the survey history of the nursing home on
Nursing Home Compare to see what areas may be problematic. Ask the nursing
home staff what they are doing to improve the quality of care for residents
in the nursing home.
3. Call the State survey agency (link to Nursing Home Compare) to find out
more about the nursing home. Look at the length of time that a nursing home
has been on the SFF list. This is particularly important if the nursing home
has been an SFF nursing home for more than 18-24 months, since such nursing
homes are closer to either graduating (due to improvements) or ending their
participation in Medicare and Medicaid.
4. Call your local State Ombudsman, Administration on Aging, and local groups
to find out more about the nursing home.
5. Use the Nursing Home Brochure found at http://www.medicare.gov/Publications/Pubs/pdf/nursinghome.pdf
and “Guide to Choosing a Nursing Home” http://www.medicare.gov/Publications/Pubs/pdf/02174.pdf
-both publications are available on Nursing Home Compare.
If you currently reside in a SFF nursing home, please know that this home is
being closely monitored (it is inspected twice as often as other nursing
homes). You may also direct any questions you have to the contacts above.
The good news is that about 50% of the nursing homes in the SFF program
significantly improve their quality of care within 24-30 months after being
selected for the SFF initiative, while about 16% tend to be terminated from
Medicare and Medicaid.
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