Last Friday, the Biden administration announced it will immediately increase enforcement for nursing home requirements and tighten quality requirements for poor-performing facilities.
The Centers for Medicare and Medicaid Services (CMS) said that it would provide resources for poorly-performing nursing homes but maintains the threat of severing agreements with nursing homes that repeatedly fail inspections. These “citations for dangerous violations in two successive inspections” will result in immediate penalties but the penalties were not included in the announcement.
According to Inside Health Policy, CMS will also increase requirements that nursing homes in the Special Focus Facility (SFF) program, which increases oversight for underperforming nursing homes, must graduate from the program with a higher number of bars to clear. The agency will continue “close scrutiny” of a facility for at least three years, including after they graduate.
States will be in charge of referring nursing homes to the SFF program, and CMS has advised states to consider requirements for facility staffing levels, USA Today reports. More than 80 homes are already included in the program, with 13 new entrants and 26 tagged for non-improvement.
Steve LaForte, director of corporate affairs and general counsel for Cascadia Healthcare, an Idaho-based nursing home conglomerate, told Skilled Nursing News that the updates could affect incentives for operators to purchase nursing homes in the SFF program:
How do you incentivize other operators, new operators to take over those operations and maintain the care and the access for the community, especially in rural areas? You slog through it and you end up getting beat up.
The nursing home advocacy lobby was also frustrated with the Biden administration’s move to enforce penalties on nursing homes that they argue are struggling to recover from staffing shortages and funding concerns related to the COVID-19 pandemic. The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) cautioned against harsh penalties for poorly performing programs in a statement from president and CEO Mark Parkinson:
Residents are not victims of the nursing home industry. Too many were victims of a vicious virus that targets the elderly as well as terrible public policy decisions—made by both parties—that failed to support and prioritize our most vulnerable. We hope to work with the Administration to fully appreciate the role of nursing homes in our nation’s healthcare system, the dedication that our caregivers have to their residents, and the need for policy that pushes improvement, not punishment.
Review the CMS SFF list of nursing homes that have a history of serious quality issues and are included in a special program to stimulate improvements in their quality of care. Arizona has several homes listed that have shown improvement and graduated from the SFF program.
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