Nursing Homes to See Tougher Federal Oversight

Revisions to Special Focus Facility program aims to increase enforcement actions for facilities that fail to demonstrate improvement.

By HFT Staff


The Centers for Medicare & Medicaid Services (CMS) recently announced it is increasing scrutiny and oversight over the country’s poorest-performing nursing facilities in an effort to immediately improve the care they deliver. In a series of revisions to the Special Focus Facility (SFF) program, CMS will toughen requirements for completion of the program and increase enforcement actions for facilities that fail to demonstrate improvement. CMS is also calling on states to consider a facility’s staffing level in determining which facilities enter the SFF Program.  

The action aims to overhaul the SFF program to strengthen scrutiny over more poor-performing nursing homes, improve care for the affected residents more quickly, and better hold facilities accountable for improper and unsafe care.  

CMS is announcing the following revisions to the SFF Program: 

  • Make requirements tougher. CMS is strengthening the criteria for successful completion of the SFF program by adding a threshold that prevents a facility from exiting based on the total number of deficiencies cited. 
  • Terminate federal funding for facilities that do not improve. CMS is considering all facilities cited with Immediate Jeopardy deficiencies on any two surveys while in the SFF program for discretionary termination from the Medicare or Medicaid programs. 
  • Increase enforcement actions. CMS is imposing 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. CMS is extending the monitoring period and maintaining readiness to impose progressively severe enforcement actions against nursing homes whose performance declines after graduation from the SFF program. 


October 26, 2022


Topic Area: Industry News , Maintenance and Operations


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