November 8, 2022 | Comments Off on Revisions to Special Focus Facility Program
Posted by Anjali Baxi
In October 2022, Centers for Medicare & Medicaid Services (CMS) made some significant changes to the Special Focus Facility (SFF) program that raise the bar for completion of the program and that increases enforcement actions for nursing homes that fail to demonstrate improvement.
The Affordable Care Act mandated that underperforming nursing homes undergo increased inspection and progressive enforcement actions through the SFF program. Sections 1819(f)(8) and 1919(f)(1) of the Social Security Act require CMS to conduct an SFF program which analyzes nursing homes that demonstrate persistent noncompliance with CMS regulations leading to a substantial quality of care. See 42 U.S.C. §§ 1819(f)(8), 1919(f)(1). The CMS SFF program requires the persistently poor performing facilities selected in each state to be inspected at least once every six months and that enforcement actions are taken when warranted. Despite the current SFF program and demonstrated improvement from certain facilities, CMS has found that some facilities remain on the program by failing to show the necessary improvement needed to graduate from the program. CMS has seen certain facilities graduate from the SFF program only to backslide into a non-complaint state, rendering the facility in question to be placed back on the SFF program. To combat this, CMS has authorized revisions to the SFF program to improve quality of care that residents living in a non-compliant facility receive. Additionally, because of CMS’ belief that staffing levels have a significant impact on quality of care, CMS is advising State Survey Agencies to consider a facility’s staffing level, in addition to its compliance history, when selecting candidates from their state for inclusion into the SFF program.
Effective Date: Immediately (Date of Issuance: Oct. 21, 2022)
Summary of Special Focus Facility Program:
The SFF program has been revised to include:
New Jersey has no facilities that have been newly added to the SFF program as of October 2022; two facilities have completed the SFF program and two facilities have shown improvement within the SFF program. Additionally, New Jersey has four facilities included on the SFF program candidate list. You can access the state-by-state breakdown of facility SFF program placement at CMS Document Ref: QSO-23-01-NH available at https://www.cms.gov/files/document/qso-23-01-nh.pdf.
Special Thanks to Trenton Rawdan, Penn State Legal Extern