The names of hundreds of nursing homes across the country with poor performance records have been made public. The Centers for Medicare and Medicaid oversees a program called the Special Focus Facility program, which aims to improve quality of care.

The list contains program participants and candidates, including some from Arizona.

Kate Goodrich, director of the Center for Clinical Standards and Quality at CMS, said CMS works with the states to decide which facilities participate in the SFF program.

"States certainly know their communities; they know the nursing homes better than we do from CMS central office. So we ask them to select the nursing home they believe of those five is the best candidate for that list and then they bring it back to us and we make the final approval," she said.

Until now, CMS did not disclose the names of SFF candidate facilities, nor were they subject to additional oversight, despite being identified as having a “persistent record of poor care.” There are 400 facilities that have a record of poor care, but CMS can only work with a maximum of 88 facilities — leaving the rest subject to no additional oversight. But how do these facilities even get to this point?

"And we’ve seen in the last five years the number of surveys has increased by 18 percent we’ve also have seen an increasing number of long term care providers and so with a flat lined budget that has made it challenging to do all of the work that is necessary to oversee," Goodrich said.

David Voepel is with the Arizona Health Care Association, which represents some long term care facilities.

"I have yet to see a facility that does not want to improve. Typically they have a tough time finding resources, whether its staff, RNs, CNAs and so forth, or it’s a question of dollars," he said."

Both Voepel and Goodrich said the information on the list can be found on Medicare's database of nursing homes called Nursing Home Compare. Arizona also posts CMS citations and reports on its database AZ Care Check.

Goodrich said at this point, there is no way to expand the number of slots.

"We are limited in the number of slots that we have available for the special focus facility program due to budgetary constraints," she said.

There are some 15,000 nursing homes in the U.S.; 3,000 have receive a one-star rating out of five from CMS. The list became public earlier this week after Pennsylvania Senators Bob Casey and Pat Toomey pushed CMS to provide the list of candidate facilities.