Feds Respond To Toomey-Casey Nursing Home Report, Say Lack Of Funding Prevents Oversight

Jun 6, 2019

The Centers for Medicare and Medicaid Services announced that it will post a monthly list of underperforming nursing homes. This comes after Pennsylvania’s two US Senators released a report highlighting a lack of federal oversight of these facilities.

CMS said that roughly once a year, it performs a health and safety survey of all nursing homes that care for Medicare and Medicaid patients. But the senators’ report found that of the more than 500 facilities identified with significant health and safety issues, less than 20 percent are subject to additional oversight.

CMS maintains the list of facilities that perform poorly on the survey, but only public discloses which nursing homes are receiving the oversight. That’s despite the two groups “being indistinguishable” in terms of quality, according to the report.

“As a result," said the report, "individuals and families making decisions about nursing home care for themselves or for a loved one are unlikely to be aware,” of a facility’s poor health and safety rating.

Dr. Kate Goodrich, CMS’s chief medical officer, said this lack of surveillance is due to funding limitations and an increase in the number of long-term care facilities.

“That has made it challenging … to do all the work that is necessary to oversee these nursing homes,” said Goodrich. “But we do believe that if we had an increase in our budget, that we would be able to have more robust oversight with this increase in our workload.”

CMS selects facilities for the Special Focus Facility program, which provides additional oversight, with input from state officials. The federal agency said it asks a state which of several nursing homes most needs additional surveying, which occurs every six months.

Goodrich said under-performing facilities that don’t receive oversight are still subject to penalties.

“They may be levied a civil monetary penalty, which is essentially a fine, or we may not allow them to get paid for new admissions into their facility,” she said.

The report identified 16 Pennsylvania nursing homes that might qualify for CMS oversight if funding was available.

CMS said the best way to evaluate a facility’s quality is its online comparison tool for nursing homes, which bases rankings on not only the health survey, but also on staffing levels and performance measures. It is possible for a nursing home to have a low survey score, but still rank well due to higher numbers in the other two categories.