America's 52 Worst Nursing Homes

The Centers for Medicare & Medicaid Services has released the first-ever official list of America’s Worst Nursing Homes— a move that leads us to suspect that the Department of Health & Human Services must be getting pretty fed up if they are resorting to public shaming. The list includes the 52 most egregious health and safety violators of the 128 SFF, or “Specialty Focus Facilities,” in the U.S.

A Special Focus Facility is basically a nursing home that is on double-secret probation— subject to twice as many inspections as a non-SFFs, with the threat of funding cuts for non-compliance.

According to the CMS, the average facility isn’t perfect (6-7 violations is the national average.) Those designated as SFFs are guilty of either more violations or more serious violations than usual, as well as a history of fixing problems just long enough to pass inspection, then going right back to business as usual. The CMS dubs this “yo-yo compliance,” and the SFF program is designed to deal with it by combining more frequent inspections with more stringent enforcement until the nursing home falls back in line.

If the facility in question doesn’t shape up, correct the underlying problems that lead to violations and “graduate” from the SFF program (in about 18-24 months) their funding is cut and they will likely close.

How To Use The List:

The CMS offers some tips to people who may be considering a nursing home on the list.

1) Use Nursing Home Compare to look up the CMS survey results and see what “areas may be problematic.” It’s important, says the CMS, to pay attention to how long the facility has been on the SFF list. If they have been listed for more than 18-24 months, they are either close to graduating or close to losing their funding completely. It’s important to know which.

We looked up a random nursing home in Philadelphia that has been on the list for 34 months. There were 24 violations listed, including: Failing to “keep each resident free from physical restraints unless needed for medical treatement,” “Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores,” “Make sure that each resident’s nutritional needs were met,” “Provide proof that all residents’ personal money which is deposited with the nursing home, is secure,” and “Store, cook, and give out food in a safe and clean way.”

Most of the violations have been corrected, but a few, including the last three mentioned above, are still pending.

2) Visit the nursing home. While you’re visiting, feel free to discuss the violations and ask what the nursing home is doing to improve their patient care. You can contact your local State Ombudsman or Administration on Aging and ask them for more information on the nursing home.

Without further ado, the list of America’s Worst Nursing Homes (PDF).

America’s Worst Nursing Homes (PDF) [CMS]
Special Focus Facility (“SFF”) Initiative – Background (PDF) [CMS]
Nursing Home Compare []

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