Sen. Casey, Toomey release government list of some of the nation’s worst nursing homes

“If you’re on the candidate list or a participant in the program, that’s a cause for concern,” Casey said.

• Daniel Simmons-Ritchie/PennLive
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  Investigative/enterprise reporter for the Patriot News/PennLive.

Sixteen Pennsylvania nursing homes are among a previously-undisclosed federal list of some of the worst nursing homes in the nation.

The national list of 395 homes was released Monday by Pa. Senators Bob Casey Jr. and Pat Toomey as part of an investigation by the senators into aspects of federal oversight of nursing homes. Their investigation follows years of media reports of poor care in America’s nursing homes, including a 2016 PennLive series on chronic problems in Pennsylvania facilities and a follow-up 2018 investigation.

The list released Monday by the senators consists of nursing homes that are “candidates” for a little-known program designed to improve the nation’s most troubled nursing homes.

Homes in the program are known as ‘special focus facilities’ and are chosen based on a history of consistently poor care. Those homes face more oversight, like extra inspections, and can face potential closure if they don’t improve. The number of facilities in the program is currently capped at 88 – less than 1 percent of the nation’s 15,000 nursing homes.

While an updated list of special focus facilities is posted publicly each month by the Centers for Medicare and Medicaid Services, Sen. Casey and Toomey discovered earlier this year that the agency keeps an internal list of roughly 400 homes that it considers candidates for the program. Those homes typically have a history of care-related problems identical to special focus facilities but receive no extra oversight.

In response to questions by Casey and Toomey, the agency this month provided a copy of its candidate list for April to the senators. The senators say they released the list on Monday in the interest of transparency.

“If you’re on the candidate list or a participant in the program, that’s a cause for concern,” Casey said in a phone interview. “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.”

The senators say they are now advocating for the Centers for Medicare and Medicaid Services to release updated candidate lists each month alongside its regular list of special focus facilities.

Among the four Pennsylvania homes on April’s special focus facility list, only one is based in central Pennsylvania: The Gardens at West Shore in Camp Hill. Chronic problems at the home were highlighted in PennLive’s 2018 series, ‘Still Failing the Frail’.

Among the 16 homes on the candidate list released by Casey and Toomey, three are in central Pa.: Spring Creek Rehabilitation and Nursing Center in Harrisburg, The Gardens at Blue Ridge in Harrisburg, and Shippensburg Health Center in Shippensburg.

Beyond failing to disclose the list of candidate facilities, Sen. Casey and Toomey have faulted the agency for other aspects of how it has administered the special focus facility program.

Those concerns are detailed in a report the senators also released Monday. The report’s findings include:

• Nursing Home Compare, the federal government’s nursing home comparison website, fails to properly explain to consumers what “special focus facility” status means. The senators say the website also provides no information about how long a home has been in the program or whether it formerly was in the program.
• The Centers for Medicare and Medicaid Services need to do a better job of updating Nursing Home Compare to reflect changes to the special focus facility list. In March, Casey and Toomey’s staff found that the profiles of five of 17 homes hadn’t been updated to show they were added to the special focus facility list.
• Candidate facilities are not required to provide any additional information about their operations to regulators and face no additional scrutiny or education to help them improve. Furthermore, the senators found, the government does not have a way to add candidate facilities to its list of special focus facilities if a particularly egregious incident occurs.

Casey said a number of those changes, like improving public information about special focus facilities, are issues that the Centers for Medicare and Medicaid Services could fix themselves almost immediately.

Other issues, like potentially expanding the agency’s oversight to include candidate facilities or changing how it conducts oversight, may require additional funding, Casey said.

Larger questions remain about the overall effectiveness of the special focus facility program. A 2017 analysis by Kaiser Health News found that of 528 nursing homes that graduated from the program before 2014 and are still operating, slightly more than half — 52 percent — later harmed patients or put them in serious jeopardy.

Given the importance of improving poorly-performing nursing homes, Casey said he was open any changes that might improve the program.

“This should be the focus of both parties, both houses, and both branches of government,” Casey said.

 

PennLive and The Patriot-News are partners with PA Post.