Nursing Home Special Focus Facilities
According to the Centers for Medicare & Medicaid Services (CMS) nursing homes (skilled nursing facilities) are visited once a year “to determine if the nursing homes are providing the quality of care that Medicare and Medicaid requires.”
When the CMS visits determine that a nursing home has “More problems than other nursing homes, More serious problems than most other nursing homes, and A pattern of serious problems that has persisted over a long period of time” the facility is included in the “Special Focus Facility” initiative.
The Special Focus Facilities (SFF) program is a designation for properties that have extended patterns of serious health and safety violations. Facilities that are included in the SFF initiative are visited twice as much as other nursing homes (about twice a year).
The longer the problems persist, the more stringent we are in the enforcement actions that will be taken. Examples of such enforcement actions are civil monetary penalties (“fines”) or termination from Medicare and Medicaid.
As of April, 2019, there are over 80 nursing homes (skilled care facilities) that are included in the CMS Special Focus Facilities initiative. There are over 400 facilities that are candidates for the program.
As of June, 2019, here is a list of nursing homes that have been added to the SFF list, have not improved since being put on the list, have significantly improved and are being watched for continued improvement, have recently graduated and are not only improved, but they sustained significant improvement for about 12 months (through two standard surveys), or nursing homes that were either terminated by CMS from participation in Medicare and Medicaid within the past few months, or voluntarily chose not to continue such participation.
The Medicare.gov website has a search function with “detailed information about every Medicare – Opens in a new window and Medicaid – Opens in a new window-certified nursing home in the country.” You can search by zip code, city/state, or state. Ratings are included for Overall Rating, Health Inspections, Staffing, and Quality Measures. You can drill down on any listed nursing home to get more details, e.g. does the nursing home participate in Medicare and Medicaid.
Note, not all nursing homes accept Medicaid. For those of us without the funds to private pay for a nursing home, who do not have long-term care coverage, or whose long-term care coverage won’t cover the entire cost, there are fewer choices. In my state, Tennessee, both of the nursing homes included in the Special Focus Facilities initiative accept Medicaid. Of the nine nursing homes listed as candidates for the Special Focus Facilities initiative, all nine of them accept Medicaid. Don’t know if this means anything. Or, does it mean that Medicaid facilities are less able to meet the necessary requirements?
The point is, be careful out there. Do your best to pick the facility that will be the best based on your needs (or the needs of someone special to you) and will not cost more than you can handle.