CMS: No ‘Secret List’ of Troubled Home Health Agencies

Earlier this week, a bipartisan pair of U.S. senators released a “secret list” of nursing homes under consideration for placement on the federal government’s roster of properties with serious quality issues.

Maintained by the Centers for Medicare & Medicaid Services (CMS), the list features more than 400 nursing homes that are “candidates” for the Special Focus Facilities (SFF) program, which targets properties with a history of serious health and safety violations. CMS has typically kept that group of potential SFF nursing homes to itself — until Pennsylvania Senators Pat Toomey and Bob Casey leaked it on Monday.

“While the vast majority of nursing homes provide high-quality care, there are some that are consistently failing to meet objective standards of adequacy,” Toomey, a Republican, said in a statement. “To date, CMS has arbitrarily excluded from public disclosure a subset of these underperforming nursing homes. Moving forward, I hope CMS will give the public this particular list, as well as all relevant information about nursing home quality.”


Although the list does not directly affect home health providers, it has raised questions about the extent to which CMS is keeping tabs on the industry and sharing its findings with the public.

It appears, however, that home health providers can rest assured.

CMS does not have a Special Focus Facilities-type program for home health agencies, a spokesperson confirmed to Home Health Care News via email on Thursday. Additionally, according to the spokesperson, creating one is not something the agency is currently considering.


When it comes to nursing homes, SFFs receive twice the normal amount of inspections from federal regulators and — if conditions do not improve — are subject to civil monetary penalties, as well as expulsion from Medicare and Medicaid eligibility. Nursing homes flagged under the SFF program also receive a special identification icon on the consumer-focused Nursing Home Compare website.

Only 88 of the nation’s 15,700 nursing homes end up on the SFF list, according to a report released by the senators in conjunction with the CMS data. An additional 435 are listed as potential candidates.

CMS’s secret list has prompted criticism over the past week, as some argue that agency should be more transparent to protect the health and safety of America’s aging population. In response to that criticism, CMS Chief Medical Officer Kate Goodrich said the agency will soon begin releasing a monthly list of candidates for inclusion in the SFF program.

“CMS’s work isn’t done,” Goodrich said during a Wednesday press conference. “In fact, we’re just getting started.”

CMS officials — along with watchdog colleagues at the HHS Office of Inspector General — repeatedly stated their intent to ramp up oversight of the home health and hospice industries throughout 2018.

So far in 2019, though, nursing homes have seemed to take center stage.

Additional reporting by Alex Spanko

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