The Biden administration is increasing scrutiny of nursing homes that fail to meet quality standards or make improvements, the latest bid to overhaul how such facilities are evaluated.
The Centers for Medicare & Medicaid Services (CMS) announced Friday new requirements of the Special Focus Facility (SFF) Program, which seeks to boost quality for poor-performing nursing homes. CMS has cranked up oversight of nursing homes since the onset of the COVID-19 pandemic, including crafting staffing minimums that have generated major pushback from the industry.
“People in this country’s nursing homes deserve access to safe and high-quality care, and facilities that aren’t providing that level of service need to improve their performance or face the consequences,” said CMS Administrator Chiquita Brooks-LaSure.
CMS is making it harder for a low-quality nursing home to make it out of the SFF, notably forcing the facility to prove systemic improvements in quality.
Any facility that doesn’t improve will also get their federal funding terminated. The agency will consider all facilities that get an “Immediate Jeopardy” warning during two surveys while in the SFF to cut them off from Medicare and/or Medicaid.
It will also impose “more severe, escalating enforcement remedies for SFF Program facilities that have continued noncompliance and little or no demonstrated effort to improve performance,” a release on the new enforcement findings said.
CMS is asking states to consider a facility’s staffing level when it is selecting a nursing home for inclusion in the SFF program.
The request comes amid increased scrutiny among regulators over staffing capabilities in the nursing home industry. Back in August, CMS launched a staffing study to help inform any minimum requirements for nursing homes.
Even though there are existing staffing requirements for such homes, “understaffing continues to be a concern,” CMS said in a frequently asked questions document. “For that reason, CMS believes it is essential to patient safety that it conduct the new rulemaking to establish more specific, detailed and quantitative minimum staffing requirements.”
The nursing home industry has vociferously opposed such staffing requirements, noting that facilities continue to be strained by the pandemic and that new mandates will force more homes to close.
The American Health Care Association and National Center for Assisted Living—which represents more than 14,000 nursing homes and assisted living centers—said Friday that escalating penalties in the SFF program won’t turn around facilities. It also slammed the prospect of a future federal staffing minimum.
“Analysts have projected that it will require billions of dollars to hire more than one hundred thousand more nurses and nurse aides if a federal staffing minimum moves forward. Long term care needs a concerted and considerable investment to recruit and retain more frontline caregivers and address access to care issues for millions of seniors,” said Mark Parkinson, the group’s president and CEO, in a statement.