CMS Releases List of Poor Performing Nursing Homes

On November 29, 2007, the Centers for Medicare & Medicaid Services (CMS) announced in a Press Release that it has released a list of 54 poor performing nursing homes as part of the "Special Focus Facility" (SFF) initiative.

According to the Press Release, the list was prompted by the number of facilities that were consistently providing poor quality of care, yet were periodically instituting enough improvement to pass one survey only to fail the next.  Further, CMS reports that its effort to identify poor performing nursing homes is intended to "promote more rapid and substantial improvement in the quality of care" and "end the pattern of repeated cycles on non-compliance."

In recent testimony before the Senate Special Committee on Aging, the Acting CMS Administrator stated that:

"Nursing homes on the Special Focus list represent those with the worst survey findings in the country, based on the most recent three years of survey history.  The selection methodology takes into account for the severity of deficiencies and the number of deficiencies.  Deficiencies identified during complaint investigations are also included in the computation.  Each state selects its Special Focus nursing homes from a CMS candidate list of approximately 15 eligible nursing homes in their own State, using additional information available to the State regarding the nursing homes' quality of care in order to make the final selection."

Once a nursing home is selected as a SFF, CMS reports that a state survey agency will conduct twice the number of standard surveys and apply aggressive enforcement until the nursing home: significantly improves and is no longer identified as a SFF; is granted additional time due to promising developments; or is terminated from the Medicare and/or Medicaid programs.

In the Press Release, CMS indicates that nursing homes typically achieve improved survey results after being selected for the SFF initiative, with about 50 percent significantly improving their quality of care within 24-30 months.  However, CMS also reports that about 16 percent are terminated from the Medicare and Medicaid programs. 

Additional information on the SFF initiative can be found in a December 16, 2004 memorandum and November 2, 2007 memorandum to State Survey Agency Directors.