New York Nursing Home Placed on CMS Special Focus Facility List
After federal regulators designated a New York nursing home as one of the country’s most deficient in terms of patient care and safety, the Centers for Medicare & Medicaid Services (CMS) has added the facility to its Special Focus Facility (SFF) list.
CMS aligns the SFF selection process for choosing each state’s candidate pool with the health inspection domain of the Five-Star Quality Rating System. The health inspection domain is computed based on these three aspects:
- Number, scope, and severity of deficiencies on annual inspection surveys for the 3 most recent standard surveys,
- Number of substantiated findings, with their scope/severity for the most recent 36 months of complaint investigations, and
- Number of re-visits needed to ensure correction of identified deficiencies.
For each available SFF slot in a state, five potential candidates are provided. The SFF list has three spots for nursing homes in New York state. Inclusion on this list means that the nursing home will have more inspections, higher penalties, and is at greater risk of losing its Medicaid/Medicare funding if care is not improved.
The nursing home in question has had previous complaints that continue to accumulate. Over the past four years, the facility has been sited 172 times for health and safety violations by inspectors from the New York State Department of Health (NYSDOH). The statewide average is 32.
A new ownership group has been brought in to correct the issues and improve compliance.
The facility’s new administrator told reporters that the facility serves a population of residents many other nursing homes don’t want—persons with mental health, substance abuse, or poverty issues. Most of the residents are covered under Medicaid which results in minimal profit margins.
Compliance Perspective
Failure to investigate and correct complaints and citations issued by state inspectors for violations of patient care and safety regulations may result in a nursing home losing its Medicare/Medicaid funding status.
Discussion Points:
- Review policies and procedures for compliance with nursing home regulations and QAPI/QAA responsibilities for maintaining improvement of previously cited deficiencies and plans of correction.
- Train staff on the nursing home’s policies and procedures for complying with regulations and their role for maintaining correction of previously cited deficiencies.
- Periodically audit to determine if correction of previously cited deficiencies is being maintained.
