RM, Seema Verma

Federal officials will soon affix a bright red “stop” hand icon next to facilities that have received recent abuse citations, the Centers for Medicare & Medicaid Services announced Monday afternoon.

CMS unveiled the labeling plans as part of an unfolding five-pillar plan that includes improving transparency for consumers. Starting Oct. 23, the “Do not proceed” symbol will be placed next to facilities that have been cited for abuse, neglect or exploitation. Authorities call the open-palm display in a red circle “a consumer alert icon.”

It will appear next to facilities that have been given a citation for abuse that led to the harm of a resident within the past year or cited for abuse that could have potentially led to resident harm in each of the previous two years.

Mark Parkinson, president and CEO of the American Health Care Association, said the plan should be halted until there is more clarity.

“We support transparency so that potential residents and their families can make an informed decision on care,” Parkinson said in a statement. “We appreciate CMS’ efforts to improve Nursing Home Compare but as we have previously suggested, we believe that CMS should create a standard and rational definition of both abuse and neglect and then report them separately. That would help provide consumers with the information that they need.” 

“In addition, CMS should add customer satisfaction to Nursing Home Compare because that is the best way for consumers to select facilities. It’s surprising that we can look for customer reviews of restaurants and hotels that we select, but that information isn’t available for nursing homes. We should have a way to let families and residents think of the facilities they are considering,” Parkinson added. 

Katie Smith Sloan, president and CEO of LeadingAge, called on CMS to “fix the survey system” before “adding this warning sign.” 

“Abuse and neglect must never be tolerated, in any setting. Our members support efforts to help consumers make the best choice possible when choosing nursing home care for their loved ones,” Smith Sloan said. 

“The abuse icon program in Nursing Home Compare, however well-intentioned, risks misleading consumers. It is built on the back of a flawed survey system, in which interpretations of regulations are notoriously inconsistent,” she added. “We need to fix the survey system before we start adding this warning sign. We want consistent application of regulations. We envision a system that allows flexibility to target resources where they are needed. LeadingAge members seek to work with surveyors, focusing less on punishment and more on consultation, training and continuous improvement. We all want the best quality care and quality of life for our loved ones.”

The icon will be updated on a monthly basis at the same time as inspection results. CMS said the monthly updating will come quicker than current quarterly updates and ensures that nursing facilities “will not be flagged for longer than necessary if their most recent inspections indicate they have remedied the issues that caused the citations for abuse or potential for abuse and no longer meet the criteria for the icon.” 

“Through the ‘transparency’ pillar of our five-part strategy to ensure safety and quality in nursing homes, we are giving residents and families the ability to make informed choices,” CMS Administrator Seema Verma said. 

She said the added information is meant for “incentivizing nursing homes to compete on cost and quality.”