Agency names poor-performing homes

Facing an effort in Congress to force the release of information about the nation's poorly performing nursing homes, the U.S. Centers for Medicare and Medicaid Services on Tuesday reversed its earlier decision to keep some of that information confidential.

Last November, the agency publicized the names of half of the 128 nursing homes that appeared on the agency's list of "special-focus facilities" due to a history of putting residents' health and safety at risk.
At the time, the agency refused to make public the complete list of troubled homes, with Administrator Kerry Weems saying some of the homes had not been given a chance to graduate from the list by improving their care of their residents.

After The Des Moines Register reported that the full list had been shared with industry lobbyists but was being kept from the public, Democratic presidential candidates Hillary Clinton and Barack Obama, both U.S. senators, called for public disclosure of the complete list.

They said the nation's seniors need that information about facilities having a history of questionable care so they and their families can make wise choices about where to live.

Clinton and Sen. Tom Harkin, an Iowa Democrat, introduced legislation that, if approved, would force the Centers for Medicare and Medicaid Services to make public the complete list.

On Tuesday, Weems announced that from now on the agency will be making public the complete, national list of special-focus facilities as it is updated each quarter. There are 131 nursing homes now on the list, including four in Iowa, and all were publicly identified Tuesday.

Asked whether the announcement renders the Clinton-Harkin bill moot, Weems said, "I would say it's up to the senators to decide whether or not, you know, what we've done today would have them continue to press their legislation."

He said the newly disclosed list is "the latest in a series of steps we will be taking to improve quality and oversight in nursing homes." The agency will be releasing more information on special-focus facilities, he said, "to better equip beneficiaries, their families, and caregivers to make informed decisions and stimulate robust improvements in nursing homes having not improved their quality of care."

Agency officials said that since the partial list of troubled homes was made public in November they have been working with states to make sure the list is up-to-date and provides consumers with the information they need to distinguish between facilities that are improving and those that are not.

The new list also indicates which homes have been recently designated as special-focus facilities and which have recently moved off that list.

About 50 percent of the nursing homes identified as special-focus facilities significantly improve their quality of care within 2years, according to the Centers for Medicare and Medicaid Services. About 16 percent are eventually kicked out of the program that provides them with Medicare and Medicaid money to pay for resident care.

Although the full list has now been made public, it has yet to be incorporated into the federal Web site where nursing home inspection data are shared with the public.

Weems said he expects that the site, called "Nursing Home Compare," will include information about special-focus facilities later this spring.

"I think one of the best ways to look at the November announcement and then (today's) announcement is that we're in a process of continuous improvement," Weems said. "This and what happened in November should not be viewed in isolation. These are part of a series of improvements this agency is committed to making to the nation's nursing homes."