AGING AND DISABILITY SERVICES ADMINISTRATION

2007 NH "Dear Administrator" Letters

December 26, 2007

ADSA: NH #2007-033
Guidance on Special Focus Facilities (SFF)

Dear Nursing Facility/Home Administrator:

The purpose of this letter is to let you know about some updates to the special focus facility (SFF) program in nursing homes. In 1998, the Centers for Medicare & Medicaid Services (CMS) created the SFF program as one of the initiatives of the Nursing Home Oversight and Improvement Program. The purpose of the SFF program is to increase the probability that nursing homes which have consistently exhibited serious quality problems will significantly improve their quality of care and safety of residents in the near future.

CMS gives the department a list of fifteen facilities from which to select the SFFs. Washington is required by CMS to have three SFFs at all times. If you are selected as a SFF, the Department is required to notify you by letter and your selection as a SFF is not subject to appeal. Once a facility has been selected as a SFF, the Department is required to conduct a standard survey within six months of the selection date and must do two standard surveys per fiscal year from the time of selection into the program.

CMS has now issued additional guidance in their recent Survey and Certification letters 08-02 and 08-06. Here are the highlights of their guidance:

• CMS will make a public list of nursing homes that have been designated as a SFF and after one survey, fail to significantly improve care. This will be available on CMS website with a link from Nursing Home Compare.
• SFFs that on a subsequent survey make significant progress may have their name removed from the list when the list is updated.
• CMS has defined “significant improvement” as meaning that a SFF is able to demonstrate that its practices have no deficiencies greater than “E.”
• When a facility has been on the SFF list for greater than 18 months, the State Agency will discuss next actions with the Regional Office.
• Life Safety Code (LCS) deficiencies have been removed from the formula to calculate the SFF candidate list.

You may access the Survey and Certification clarification issued by CMS at the following link.

If you have any questions, please feel free to contact your RCS Field Manager.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services