Every month, the Centers for Medicare & Medicaid Services (CMS) identifies nursing homes with an extremely poor record of resident care for inclusion in the Special Focus Facility (SFF) program. This program is a federally mandated initiative to address persistent problems through enhanced oversight. Over an 18 to 24-month period, CMS expects SFFs to significantly improve quality of care and implement practices to ensure that poor performance does not reoccur. Facilities that succeed graduate from the program. Facilities that do not face termination from participating in Medicare and Medicaid. Termination from Medicare and Medicaid typically results in a facility’s closure.
While there are many nursing homes with persistent, serious problems, CMS presently limits the SFF program to just 88 facilities nationwide. A June 2019 report by U.S. Senators Bob Casey and Pat Toomey, entitled Families’ and Residents’ Right to Know: Uncovering Poor Care in America’s Nursing Homes, found that an additional 2.5 percent of all certified nursing homes (about 400 facilities) are identified as SFF candidates by CMS based on their “persistent record of poor care.” CMS does not select these facilities to participate because it limits the resources dedicated to the SFF program. The report notes, “[a]s a result, individuals and families making decisions about nursing home care for themselves or for a loved one are unlikely to be aware of these candidates.”
With the publication of the report, Senators Casey and Toomey released the names of the April 2019 SFF candidates. The Senators state that they would work with CMS to make future lists public. Days after the report’s release, Dr. Kate Goodrich (Director, Center for Clinical Standards and Quality and CMS Chief Medical Officer) issued a statement noting that CMS is committed to posting the list of SFF candidates moving forward. However, she gave no indication as to when and where CMS will begin posting the list. Dr. Goodrich’s statement adds, “CMS urges all Americans to consult their physician, family, and Nursing Home Compare before choosing a nursing home for their loved ones.”
Our organizations respectfully urge CMS to prominently identify when a nursing home is a SFF candidate on the facility’s Nursing Home Compare page. As Dr. Goodrich’s statement acknowledges, Nursing Home Compare is the premier resource seniors and families use when choosing a nursing home. Thus, it is essential that the website provide the best information possible about a facility’s safety record. Given that SFF candidates have comparable quality and safety concerns— and are only absent from the SFF list due to a lack of resources allocated to provide for enhanced oversight—it is unconscionable not to properly alert the public when a facility has been identified as meeting the SFF criteria. In fact, if anything, it is more important for people to know when a facility is an SFF candidate, since those facilities are not receiving the enhanced oversight that SFFs in the program are undergoing.