Worst nursing homes in America rated

After initially resisting their disclosure, the Bush administration on Tuesday published the names of 131 nursing homes with poor inspection records and said some were already showing signs of improvement.

The list released by the Centers for Medicare and Medicaid Services represents troubled facilities cited as a “special focus facility,” a designation used to identify those that merit more oversight. For these homes, states conduct inspections at six-month intervals rather than annually.

Last November, the government released a partial list of 54 nursing homes that ranked among the worst in their states, balking at releasing the full list of homes with the “special focus” designation. After a group of Democratic lawmakers began pushing for full disclosure, CMS said Tuesday it was publishing the names after cross-checking information to ensure the release of the most accurate data.

CMS will update its list of troubled nursing homes on a quarterly basis, with its next release scheduled for April.

“This is the latest in a series of steps we will be taking to improve quality and oversight in nursing homes,” said Kerry Weems, CMS acting administrator. “We are issuing more information on special focus facilities 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.”

“This should just be one of the tools,” Weems added. “There is no substitute for visiting the nursing home in person.”

The list released Tuesday shows 52 nursing homes as not showing improvement after they were cited as a higher-risk nursing home, while another 52 did show some improvement. Twenty-seven nursing homes were added to the list in the last six months.

Out of the 54 nursing homes initially disclosed as poor performers last November, 21 have shown improvement, CMS said, adding that publicity about the problems might have played a factor.

There are about 16,400 nursing homes nationwide, and taxpayers spend about $72.5 billion annually to subsidize nursing home care.

While most nursing homes have some deficiencies, with the average being six to seven deficiencies per survey, the special focus facilities typically have about twice that number, and continue to have problems over a long period of time. However, the states determine which nursing homes should get the designation, and inspection standards vary among the states.

The offenses typically involve unnecessary use of medication for elderly residents, or inadequate safeguards to protect residents such as those with Alzheimer’s from day-to-day hazards in the nursing home.

Sen. Herb Kohl, D-Wis., who chairs the Senate Special Committee on Aging, applauded CMS’ move.

“We believe that Americans should have access to as much information about a nursing home as possible,” he said. “We also agree that giving consumers more information about our nation’s nursing homes is a good idea, but that doing so in a manner that causes a panic is not.”

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