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Capitol Health Call
November 11, 2009

Worst Nursing Homes

JAMA. 2009;302(18):1960. doi:10.1001/jama.2009.1591

The Centers for Medicare & Medicaid Services (CMS) should do a better job of identifying poorly performing nursing homes, said the Government Accountability Office (GAO) in a report released September 28 (http://www.gao.gov/new.items/d09689.pdf).

At issue is the CMS's Special Focus Facility Program, which currently designates only 136 homes as performing poorly, the maximum number that the agency is able to handle. Such facilities face closer monitoring by the CMS and more stringent enforcement actions if problems continue. But the GAO estimated that 580 (almost 4%) of the approximately 16 000 nursing homes in the United States could be considered poorly performing. Because every state except Alaska is required to have at least 1 nursing home in the program, some of those being monitored may not be among the worst 136 homes in the country.

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