Image of male nurse pushing senior woman in a wheelchair in nursing facility
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A federal watchdog will conduct a program-wide assessment of how regulators are pressuring poorly performing nursing homes and companies to clean up their acts. 

The Health and Human Services Office of Inspector General will complete the assessment in 2024, officials said in announcing an updated work plan this week. The review will look specifically at the Center for Medicare & Medicaid Services’ and state agencies’ implementation of the Special Focus Facility Program, as well as how each has incorporated recent program updates into their work. The study also will identify factors that contribute to a nursing home’s success in graduating from the program, although those facilities are still noted as having participated for three years following graduation. 

In October, CMS toughened aspects of the program to increase enforcement activities and lengthen the monitoring period for nursing homes entering into it. 

There were 89 facilities participating in the program as of a Dec. 7, 2022, CMS report. The Healthcare Center at Buck Creek in Alabaster, AL, has been on the list the longest at 47 months. Another 41 nursing homes have “graduated,” meaning they sustained improvement for approximately 12 months, which covers two standard health surveys. CMS notes that “graduation” does not mean there may not be issues in the quality of care but rather that the facility has shown a prolonged upward trend in improvement.

US Sen. Bob Casey (D-PA), chairman of the Special Committee on Aging, has criticized the program for not surveying facilities as often as the law requires. A committee investigation found that 20% of nursing homes on the list were not surveyed in six-month intervals after regular surveys restarted in August 2020.

“I applaud the HHS inspector general’s plan to study how the SFF program can improve poor-performing nursing homes,” Casey told McKnight’s Long-Term Care News on Tuesday. “I hope this study brings us closer to resolving longstanding issues at these facilities so that all nursing home residents receive the high-quality care they deserve.”