Society to Administrator Verma: Red Hand Icon Could Have Unintended Consequences

November 25, 2019

The Society sent a letter on Friday, November 22, to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma about the recent addition of a red hand “consumer alert icon” on the Nursing Home Compare website. The icon is designed to call out skilled nursing centers that have received an abuse or neglect citation.

The Society affirms that any instance of abuse is unacceptable and acknowledges that some nursing homes have inadequate protections against patient and resident abuse. However, the letter states, “[We] truly believe that [the red hand] approach will have unintended consequences, and in fact be counterproductive to achieving the high-quality patient outcomes for which we strive.”

Here are some of the points raised in the Society’s letter:
⦁    The red hand icon is a violation of a fundamental patient safety principle that health care facilities must establish blame-free environments.
⦁    Ensuring a “just culture” is critical to gaining engagement in efforts to prevent patient harm as well as improve quality.
⦁    The red hand approach has not been tested and is not evidence-based.
⦁    The red hand undermines preferred skilled nursing facility (SNF) networks that have been established by Accountable Care Organizations (ACOs) and other groups.
⦁    CMS needs to create a public registry of nursing home medical directors to gain a greater understanding of the latest developments and issues with nursing home abuse and neglect; the red hand icon is counterproductive to those important efforts.

“As we state clearly in our letter, as advocates for post-acute and long-term care patients and families, we want to work with CMS and other stakeholders to help create and implement effective strategies for reducing neglect and abuse in nursing homes,” said Society Executive Director Christopher E. Laxton, CAE. “The red hand icon should not be one of those strategies, and we urge CMS to adopt a more productive approach.”

You can read the full text of the Society’s letter here


About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.