Stricter oversight and citations do not eliminate poor patient care practices and many facilities that are cited have a long history of providing deficient care. Even when facilities are fined and penalized, or marked for “special focus,” there exist many instances where the culture of neglect and abuse is so ingrained in the culture of a facility that they revert to old habits. Even after a facility is deemed rehabilitated, family members and caregivers should remain alert as it is very easy for these facilities to return to their previous bad habits.
Special Focus Status
The Centers for Medicare and Medicaid Services closely monitor poor-performing nursing home facilities. Those facilities that receive significantly poor evaluations are placed within “special focus” status. During this period of intensified scrutiny, the facility is required to show improvement in the quality of care they provide. If they do not, they lose their Medicare and Medicaid funding. However, each state is allocated a limited number of slots to include facilities on the special focus list, and it is up to the state to determine which facilities to include. This means that many poor performing facilities that should be on the list are not included simply because funds aren’t allocated to monitor them.
Nationwide, more than 528 nursing homes were released from special focus status prior to 2014. Of these, 52% had harmed patients between then and mid-2017. Negligent actions included administering the wrong medications, physical or emotional abuse, failure to notify family members and caregivers of injuries, and failure to maintain accurate patient records. In precious few cases, nursing homes were returned to the special focus watch list. In most cases, subsequent violations were addressed with fines and other penalties.
Protecting Loved Ones from Harm
Family members and caregivers should take proactive steps to protect their loved one from harm. These steps include visiting the facility in-person and speaking with facility operators as well as current residents and their family members. These visits provide an invaluable opportunity to determine whether or not a facility is safe or not.
It’s also crucial to review the most up-to-date CMS or state survey of the facility. This shows the problems cited and any corrective measures. It also provides an opportunity to read previous surveys, determine whether or not the facility has a history of recurring problems, and determine how long these problems have existed.