On October 21, 2022, the White House announced a series of additional steps to implement the nursing home reform agenda that it launched in February 2022. The October announcement begins with a strong statement describing nursing homes’ longstanding lack of accountability:
For far too long, nursing home residents have been victims of an industry with little accountability to keep American seniors safe and protected. COVID-19 has laid bare the challenges in America’s nursing homes, with over 200,000 residents and staff dying from COVID-19.
The Administration first calls for “more aggressive enforcement for the worst-performing nursing facilities” – the 88 facilities in the country that are designated “Special Focus Facilities” (SFFs). SFFs are facilities with a multi-year history of serious failure to provide residents with high quality care. New guidance considers staffing levels in selecting SFFs, increases penalties for SFFs that fail to improve, increases requirements for “graduation” from the SFF program, and extends the monitoring period for graduates, among other changes.
In the past, many SFF graduates have had poor records. The New York Times reported in July 2017 that 52% of 528 SFFs that “graduated” before 2014 were cited with serious harm or jeopardy (the highest levels of noncompliance) in the years after they graduated, and more than one-third of the graduates received the lowest federal rating for health and safety. In June 2019, the Center for Medicare Advocacy made similar findings – six of the 21 graduates on CMS’s May 16, 2019 graduate list were cited in calendar year 2018 with one or more harm or immediate jeopardy deficiencies. SFF graduates also had low nurse staffing levels.
The October announcement also identifies multiple newly-available funding programs from the Department of Labor to support the nursing home workforce and describes other actions taken by CMS since February 2022 to implement the President’s nursing home reform agenda.
For additional information see:
- White House, “FACT SHEET: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes” (Feb. 28, 2022), https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/
- White House, “FACT SHEET: Biden-Harris Administration Announces New Steps to Improve Quality of Nursing Homes,” at https://www.whitehouse.gov/briefing-room/statements-releases/2022/10/21/fact-sheet-biden-harris-administration-announces-new-steps-to-improve-quality-of-nursing-homes/
- Centers for Medicare & Medicaid Services, “Biden-Harris Administration Strengthens Oversight of Nation’s Poorest-Performing Nursing Homes” (Press Release, Oct. 21, 2022), https://www.cms.gov/newsroom/press-releases/biden-harris-administration-strengthens-oversight-nations-poorest-performing-nursing-homes
- CMS, “Revisions to Special Focus Facility (SFF) Program,” QSO-23-01-NH (Oct. 21, 2022), https://www.cms.gov/files/document/qso-23-01-nh.pdf
- Jordan Rau, “Poor Patient Care at Many Nursing Homes Despite Stricter Oversight,” The New York Times (Jul. 5, 2017), https://www.nytimes.com/2017/07/05/health/failing-nursing-homes-oversight.html
- Center for Medicare Advocacy, “Special Report – ‘Graduates’ From the Special Focus Facility Program Provide Poor Care” (Jun. 20, 2019), https://medicareadvocacy.org/graduates-from-the-special-focus-facility-program-provided-poor-care/
October 27, 2022 – T. Edelman