“Special Focus Facilities”

The AP had an article about the federal program that identifies problem nursing homes.  The program brings extra scrutiny to poorly performing nursing homes but leaves out hundreds of troubled facilities, investigators report.  The Centers for Medicare and Medicaid Services identifies up to 136 nursing homes as “special focus facilities” subject to more frequent inspections because of their living conditions. In every state except for Alaska, there are between one and six such facilities. But investigators said four times as many homes, or 580, should be considered among the nation’s worst.

Sen. Herb Kohl, the chairman of the Senate Aging Committee, said it indicated to him that the special focus is too limited. At the least, he wants more explicit warnings about nursing homes as people study quality ratings on a Medicare Web site, Nursing Home Compare

The report being released Monday also suggests adjusting the methods used to identify the worst performing nursing homes. The home now under special attention are the worst performing in their state. But not all states are created equal when it comes to nursing home quality. Comparing the homes nationally would ensure that scarce resources go to inspecting the nursing homes that truly need the most attention.

Some states have far more poorly performing nursing homes than are designated as special focus facilities.   Investigators also found that the worst-performing ones tend to be for-profit facilities affiliated with a chain of nursing homes. They are more likely to be a larger facility, averaging 102 residents, while other nursing homes not identified as among the worst had 89 residents on average.

Nationally, there are about 16,000 nursing homes. So the 580 homes that GAO describes as the worst-performing represents almost 4 percent of the nation’s nursing homes.