The Centers for Medicare and Medicaid Services (CMS) & Nursing Homes
The Centers for Medicare and Medicaid Services (CMS) performs deficiency inspections at nursing homes. These inspections occur roughly every year and are conducted to identify problems with care including failure to institute basic health and safety requirements (i.e., fire safety) and resident neglect, abuse, etc.
It is important to note that the CMS only performs these inspections on nursing homes which participate in Medicare and Medicaid; not every nursing home participates in these government programs.
Deficiencies in Nursing Home Care
When the CMS identifies a problem, it will require the given nursing home to rectify the problem. According to the CMS, practically all nursing homes have deficiencies, with the average being 6-7 deficiencies per inspection. However, some nursing homes have serious issues, including:
- more deficiencies,
- more serious deficiencies, or
- a pattern of problems over a long period of time.
The Special Focus List
These nursing homes would show improvement and then decline with the next inspection. Concerned about the yo-yo pattern, the CMS developed the Special Focus Facility Initiative (SFF), designed to closely monitor specific nursing homes over a longer period of time. SFF nursing homes are subject to bi-annual inspections and are expected to show improvement. SFF nursing homes may also be fined and if problems persist, terminated from Medicare and Medicaid.
Within the first 2 years after being placed in the SFF list, a nursing home may be subject to the following 3 actions:
- graduation from the SFF program after marked improvement,
- termination from Medicare and Medicaid, or
- extension of time in the SFF program.
Pennsylvania & New Jersey Nursing Homes on the SFF List
A handful of nursing homes in Pennsylvania and New Jersey are in the SFF program. Two nursing homes in Pennsylvania have recently graduated from the SFF program. One is located in Hazelton, outside of Allentown, and the other is located in Apollo, outside of Pittsburgh. Another nursing home in Mountain Top, also outside of Pittsburgh, is also on the SFF list, but has shown improvement.
In addition, one nursing home in each state has failed to show improvement. One nursing home is located in Sewell, New Jersey, which is located about 20 miles outside of the Camden-Cherry Hill area. The nursing home in Pennsylvania is located in Lancaster, roughly 70 miles outside of Philadelphia.
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