In a rare bipartisan gesture, the two chairs of the U.S. Senate Committee on Aging released a list of nursing homes across America that the federal government itself thinks need closer oversight. The so-called “secret list” includes facilities in Texas.

There are differences of opinion about the meaning of the list, but all agree it release is designed to agitate for better federal oversight of nursing homes. The move also suggests the U.S. Senate is noticing that angry voters are calling for nursing home reform.

Getting on a list few were allowed to see

Of the 33 Texas facilities included on the list, 5 were already known to be Special Focus Facilities (SFF), meaning among other things that inspections are doubled and their access to federal money is in jeopardy if conditions don’t improve.

The remaining 28 Texas facilities are designated as SFF Candidates and their identities were not previously public. The designation means they had a pattern of health and safety violations and need to be kept on a shorter leash.

The CMS (Centers for Medicare & Medicaid Services) make these decisions based on four criteria.

  • Staffing.
  • Results of health inspections.
  • Specific quality measures.
  • Overall quality.

Keeping these underlying results private makes it hard for consumers, state regulators and advocates to understand the final status, when even those are available. A few temporary staffing crunches, for example, might be easier to forgive when the other three measures are high.

The chief medical officer of CMS vows to release the longer lists going forward, saying “CMS welcomes the recent attention on nursing home quality of care that has amplified the important national dialogue.”

Lack of funding and poor oversite

According to policy experts, the current number of nursing homes getting the increased SFF scrutiny (88) was never intended to be so low. Many of the SFF Candidates on the “secret” of 400 would also be SFF if the program wasn’t drastically underfunded.

The lead senators of the Committee on Aging, Patrick Toomey (R) and Bob Casey (D), have criticized the government’s unwillingness to share information about substandard nursing homes.

Together, they recently released a 26-page report arguing for transparency entitled Families’ and Residents’ Right to Know: Uncovering Poor Care in America’s Nursing Homes.