Special Focus Facility Nursing Homes: The Worst of the Worst

Becoming a Special Focus Facility (SFF) is no honor in the nursing home industry. To be deemed an SFF is to be branded one of the worst nursing homes in the state when it comes to violations. Amid continuous speculation on the level of care being provided in nursing homes in general, homes which are in the SFF program are those most in the spotlight.

Special Focus Facility Program
Centers for Medicare and Medicaid Services (CMS) developed the SFF program back in 1998 to address the issue of poorly performing nursing homes and to strive to improve their performance. It started with each state labeling the two worst offenders to be added to the SFF list and in 2005 it increased that number to 6 slots per state.

Once on the SFF list, these homes are then surveyed for violations twice per year (others are only surveyed once per year) and are given stiffer penalties and fines for violations. They are then reviewed again after 18 months (3 surveys). They can then graduate out of the program if there has been significant improvement, be retained in the program if some improvement was made, or be terminated from participation in Medicare and Medicaid programs.

Special Focus Nursing Homes

The facilities on the SFF list are available to the public along with access to the five star rating program they use for nursing homes on the CMS website, www.cms.gov. The website gives the names of the homes on the list, how long they have been on the list and those newly added to the list. It also breaks down the improvement levels for each home.

Using the SFF list is helpful when doing research to find a nursing home for a loved one. It shows known offenders and whether or not they have been improving under the program. One drawback is that each state only has a limited number of “slots” available to add into the program, so although a home may be one of the worst homes on a national scale, because the state they’re in has their slots “full”, the home will not be listed on the SFF list.

The SFF list is based on each state having a list of “potential” SFF candidates based on a score rating system. The higher the score, the more violations and issues within the facility. Unfortunately, some states have many more candidates with high scores than others. For example, in 2009, Tennessee’s worst offender had a score of 1512 and their 15th worst had a score of 253. In 22 other states the worst offenders had a score less than the 15th ranked home in Tennessee. Since Tennessee only has a few slots available, only the “worst” ones made it to the SFF list. Other nursing homes are added to the SFF only because in their particular state they are the poorest performing.

The SFF program can be a way to monitor performance and hopefully improve issues in some homes. It is also a way for the public to have quick access to the names of some of the nursing homes that are consistently being cited for violations. Though it should not be the only thing you consider when looking for a nursing home, it is a good place to start.
Today’s guest post comes from Jonathan Rosenfeld is a Chicago attorney representing individuals and families in nursing home abuse and medical malpractice cases. Jonathan is the founder of Rosenfeld Injury Lawyers, a site that provides a good deal of information for nursing home victims.