Medicare Lists Poor-performing Nursing Homes

The Centers for Medicare and Medicaid Services (CMS) has just published its first ever nationwide list of poor-performing nursing homes (.pdf).

Identified as special focus facilities (SFFs), the nursing homes on the poor-performers list display what CMS calls a "yo-yo" compliance history of providing consistently poor care, while instituting just enough improvement to pass their next survey.

Once tagged as an SFF, the nursing homes are subject to double inspections by state health officials and risk losing their eligibility to receive Medicare or Medicaid reimbursements.

As of October 2007, CMS had identified 128 poor performing nursing homes, out of about 16,000 active nursing homes in the United States.

To receive payment under the Medicare or Medicaid programs, nursing facilities must comply with the requirements in Title 42, Part 483, Subpart B of the Code of Federal Regulations (CFR).

What can consumers do? Along with visiting the facility, talking to staff, residents, and other families, consumers considering nursing home options should check out CMS' Nursing Home Compare. Nursing Home Compare provides detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country. In addition, CMS offers its publication Guide to Choosing a Nursing Home (.pdf)

Also See:
Medicare Primer
How to Appeal a Medicare Refusal to Pay
Order a Replacement Medicare Card Via the Internet