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US program misses problem nursing homes

Associated Press / September 28, 2009

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WASHINGTON - A government program that brings extra scrutiny to poorly performing nursing homes leaves out hundreds of troubled facilities, investigators report.

The Centers for Medicare and Medicaid Services identifies up to 136 nursing homes as “special focus facilities’’ subject to more frequent inspections because of their living conditions. In every state except for Alaska, there are one to six such facilities. But investigators said four times as many homes, or 580, could be considered among the nation’s worst.

The report from the Government Accountability Office does not identify the homes.

The chairman of the Senate Aging Committee said it indicated to him that the special focus is too limited. At the least, Senator Herb Kohl, Democrat from Wisconsin, wants more explicit warnings about nursing homes.

“If far more than 136 nursing homes boast the bleakest conditions, then perhaps we should consider expanding’’ the program, said Kohl, who requested the study with Senator Charles Grassley, Republican from Iowa.

The GAO said it made just that recommendation two years ago. Federal officials agreed with the concept, but said they didn’t have the resources to do so.

The report being released today also suggests adjusting the methods used to identify the worst performing nursing homes. The homes now under special attention are the worst performing in their state. But not all states are created equal when it comes to nursing home quality. Comparing the homes nationally would ensure that scarce resources go to inspecting the nursing homes that truly need the most attention, according to the report.

CMS officials told the GAO they disagreed with relying solely on a national comparison. The agency said it would consider an approach that allows for a national comparison to have more weight.