A pair of senators who commissioned a damning report on the worst performing U.S. nursing homes in 2019 reintroduced follow-up legislation Monday that would bring more scrutiny — and assistance — to the worst of the lot.

The Nursing Home Reform Modernization Act of 2021 is aimed at getting more accountability out of nursing homes placed on the Special Focus Facility list, creators said. The bill’s authors said that improvements are needed, especially in light of 178,000 nursing home-related COVID-19 deaths, which account for 34% of the U.S. total.

The same lawmakers introduced a similarly focused bill last fall. Providers advocates have balked at expanding the SFF list in the past, noting such publicity can impugn improving facilities.

LTCN February 2019, page 12, Payment Policy, Senator Bob Casey
Sen. Bob Casey (D-PA)

“We have a moral obligation to learn from this profound tragedy and deliver common sense solutions,” said Sen. Bob Casey (D-PA), chairman of the Special Committee on Aging and one of the bill’s co-authors. “We must also improve the quality of care in nursing homes — especially those that are consistently failing to meet health and safety standards required by the federal government.”

He urged fellow lawmakers to pass the bipartisan bill “immediately.” 

“Unfortunately, some of the largest outbreaks occurred in facilities with records of persistent failure to protect their residents,” said bill co-author Sen. Pat Toomey (R-PA), noting that more than half of Pennsylvania’s cases have been tied to nursing homes. “Even while vaccinating seniors helps us turn the corner on the pandemic, this bipartisan legislation remains as important as ever.”

Currently, a maximum of 88 facilities are chosen for the SFF list, despite more than 500 nationwide being identified as eligible for it, the senators said in a statement. SFF members typically show patterns of poor survey results over a three-year period and register more serious infractions and double the national average six or seven deficiencies per survey.

SFF members are given additional oversight and extra inspections. The new measure would put all of the 500 SFF-nominated candidates on a list to get more oversight and enforcement — as well as technical assistance and educational programming.

The proposal calls for an independent advisory council to be created to direct the Department of Health and Human Services on how to best rank nursing homes to line them up for greater scrutiny and educational offerings. It also would rename SFF as the “Low-Rated Facility Program.”

Monday’s unveiling is a follow-up to Casey and Toomey’s 2019 report “Uncovering Poor Care in America’s Nursing Homes,” which focused on U.S. nursing homes with persistent problems. For the first time, it publicized the aggregated list of all facilities that qualified for the SFF badge, and the increased scrutiny that comes with it. Afterward, the Centers for Medicare & Medicaid Services agreed to release the list of names on a monthly basis. 

CMS also said at the time that more than 88 facilities could be put on the SFF list if more funding were available.