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

Congressional inquiries led Monday to the public disclosure of hundreds of nursing homes considered candidates for the Special Focus Facility program, which targets the nation’s poorest performing buildings for additional oversight and improvements.

Pennsylvania Sens. Bob Casey (D) and Pat Toomey (R) issued “Uncovering Poor Care in America’s Nursing Homes,” a report outlining the limited reach of the Centers for Medicare & Medicaid Services’ SFF program.

Of more than 15,700 nursing homes nationwide, a maximum of 88 are selected for the program annually because they are identified as having a “persistent record of poor care.” But more than 400 qualify for the program. Those candidates had never before been publicly disclosed and were known only to CMS and state officials.

In March, Casey and Toomey requested the full list of participating sites and candidates from CMS Administrator Seema Verna.

On Monday, the Senate Special Committee on Aging posted that list, dated May 14, online. The senators are aiming to keep similar information accessible in the future. State agencies are responsible for selecting which candidates become participants.

“If you’re on the candidate list or a participant in the program, that’s a cause for concern,” Casey told Penn Live Monday. “And if a family member is trying to make a decision about choosing a nursing home — or trying to help another family member make a decision — they need all the information possible.”

Beth Martino, vice president of public affairs for the American Health Care Association, said her provider organization supports transparency and “making information available so consumers can make informed decisions about care for their loved ones.”

“As an organization, we haven’t discussed a position on this list specifically, but we support information that is already available on Nursing Home Compare that can help consumers identify high quality facilities,” Martino said.

Casey and Toomey noted the Five Star ratings system and Nursing Home Compare website don’t clearly reveal which facilities are in SFF — and don’t identify candidates at all — nor do category star ratings necessarily align with overall performance.

The criticism follows a report from the Center for Medicare Advocacy that criticized Nursing Home Compare for leaving some information about civil money penalties off of its public-facing site.

In a letter dated May 3, Verma said CMS was reviewing its authority to release the list. She cited other ways the agency reports the status of providers in SFF, including on under “provider info” files.

While the senators said they would like to see the program expanded, Verma noted that it had previously included 167 participants that would receive additional support to improve quality. The list shrunk due to sequestrations in 2014 and has not been restored since.