The federal government through the CMS (The Centers for Medicare & Medicaid Services) has placed hundreds of nursing homes on a list of long-term care facilities that it wants to improve systemic issues or face expulsion from the Medicaid program.

The watch list is intended to heighten efforts to bring more attention to quality deficiencies at long-term care or nursing home facilities identified on this “special focus facility,” or SFF, list.

The pressure is important because Medicaid is a significant payer for long-term care facilities. By utilizing financial leverage, CMS hopes to bring about improvements in operations at poor-quality or high risk nursing homes.

In November of 2007, CMS began highlighting nursing homes with serious quality issues on its Nursing Home Compare Web site.

The goal of the added attention is to get these facilities with quality problems to do more than just take enough steps to pass the technical requirements of subsequent inspections. In many instances although they may past follow-up inspections, such facilities have been found to have fallen back and failed future inspections, often for the same issues that were initially discovered.

Such facilities with a ‘yo-yo’ compliance history rarely address the underlying systemic problems that were giving rise to to the failures in the first place.

As watch list facilities improve their quality of care and leave the program, new homes are added to the list. Homes that fail to improve are terminated from the Medicare and Medicaid programs.

As an extension of the watch list, CMS has been working to develop their Nursing Home Compare Web sitewill help families make better purchasing decisions about long-term care. Information on the site includes performance scores on quality measures, staffing information, and a three-year history of the home’s health, safety and fire inspection reports. The site is anticipated to be updated quarterly.