On October 21, 2022, CMS released a Revisions to Special Focus Facility (SFF) Program memo. These revisions are part of the Biden Harris Administration’s priority to improve the safety and quality of care in nursing homes, as outlined in a FACT SHEET: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes.
CMS has made the requirements for completion of the program tougher and has increased enforcement actions for facilities that fail to demonstrate improvement. The revisions include:
- Making requirements tougher: Strengthened the criteria for successful completion by adding a threshold that prevents a facility from exiting based on the total number of deficiencies cited—no more “graduating” from the program’s enhanced scrutiny without demonstrating systemic improvements in quality.
- Terminating federal funding for facilities that don’t improve: Facilities cited with Immediate Jeopardy deficiencies on any two surveys while in the SFF Program will be considered for discretionary termination from the Medicare and/or Medicaid programs.
- Increasing enforcement actions: Imposition of more severe, escalating enforcement remedies for SFF Program facilities that have continued noncompliance and little or no demonstrated effort to improve performance.
- Incentivizing sustainable improvements: Extending the monitoring period and maintaining readiness to impose progressively severe enforcement actions against facilities whose performance declines after graduation from the SFF Program.
CMS has advised State Survey Agencies to consider a facility’s staffing level, in addition to its compliance history, when selecting candidates for inclusion into the SFF Program.