The Biden administration announced plans Friday to toughen oversight of the nation’s poorest-performing nursing homes with escalating fines and terminating federal funding for the homes that fail to improve.
The administration will overhaul the Centers for Medicare and Medicaid Services “special focus facility” program of homes with poor safety records. Homes in the program that fail to improve will be fined escalating penalties for violations. Those facilities with safety violations that generate at least two “immediate jeopardy” warnings could be terminated from Medicare or Medicaid funding – a potential death blow for homes that rely on federal funding to sustain operations.
The agency that oversees Medicare and Medicaid will also advise states to consider a facility’s staffing level when deciding whether to assign homes to the special focus program.
With more than 200,000 patients and staff dying from COVID-19 since 2020, administration officials said the reforms are necessary to fix longstanding safety and staffing challenges.
More:This nursing home chain stood out for nationally high death rates as pandemic peaked
Health and Human Services Secretary Xavier Becerra said his agency is “cracking down on enforcement of our nation’s poorest-performing nursing homes.”
“We are demanding better, because our seniors deserve better,” Becerra said.
CMS lists more than 80 homes in the special focus program, including 13 new entrants and another 26 that have not improved. Homes in the program have about twice the number of deficiencies, more serious safety problems, including patient harm and injury, and a pattern of serious problems, according to CMS.
Once selected for the special focus program, CMS said nursing homes will face tougher requirements before exiting. Homes that graduate will receive close scrutiny for another three year to ensure they meet standards.
The administration also announced nonprofits, industry organizations, trade groups, labor unions and others can apply for $80 million in Department of Labor grants to address nurse staffing and training shortages. The grants can be used to fund nursing instructors, train health-care workers and aid workers to achieve nursing credentials to become licensed practical nurses or registered nurses.
Other grant programs will target nurse staffing and training, aid dislocated workers and assist local governments and colleges to promote workforce development and jobs.
Earlier this year, the Biden administration announced sweeping reforms that would require minimum staffing levels and improved oversight of infection control. The administration vowed to wage the most ambitious effort to address nursing home quality, safety and staffing in decades.
A 577-page report issued by the National Academies of Sciences, Engineering and Medicine on April 6 cited decades of underfunding and a lack of accountability on how those funds are spent. One result has been low salaries and benefits that made nursing homes “highly undesirable” places to work, the report said.
In March, a USA TODAY investigation found one of the nation’s largest chain of 113 facilities collectively reported some of the worst death rates in the nation to the federal government.
Last month, CMS released federal data showing ownership of about 15,000 nursing homes nationwide, information that will allow state regulators, researchers and the public to better track common owners.
Ken Alltucker is on Twitter at @kalltucker, or can be emailed at alltuck@usatoday.com