What is particularly disturbing about these three cases is that the Federal Government has designated all these three facilities as Special Focus Facilities (SFF). The Centers for Medicare & Medicaid Services (CMS) has defined a Special Focus Facility (SFF), as having
1. More problems than other nursing homes (about twice the average number of deficiencies),
2. More serious problems than most other nursing homes (including harm or injury experienced by residents), and
3. A pattern of serious problems that has persisted over a long period of time (as measured over the three years before the date the nursing home was first put on the SFF list).
Although such nursing homes would periodically institute enough improvements in the presenting problems that they would be in substantial compliance on one survey, significant problems would often re-surface by the time of the next survey. Such facilities with a “yo-yo” or “in and out” compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies. To address this problem CMS created the “Special Focus Facility” (SFF) initiative.
- Total money the Federal Government spends on the SFF Program for the whole country.
–SFF Money spent per U.S. Nursing Home
$ .66 (Cents)
- SFF Money spent per Nursing Home Resident in U.S.
- SFF Money spent on 2 residents (that we know about) who have died as a result of being in an SFF facility.
- Facilities now in SFF program.
- Facilities that the GAO claims should be in the SFF program and who qualify under Federal Guidelines for an SFF. Lack of funds is the reason that more facilities are not in the program.
- Average number of years, a SFF stays in the SFF Program.
- Months on the SFF program for worst facility.
In a General Accounting Office (GAO) report to Congress, prepared in August 2009, it was concluded that
“CMS’s Special Focus Facility Methodology Should Better Target the Most Poorly Performing Homes, Which Tended to Be Chain Affiliated and For-Profit”.
According to GAO’s estimate, almost 4 percent (580) of the roughly 16,000 nursing homes in the United States could be considered the most poorly performing. These 580 homes overlap somewhat with the 755 SFF Program candidates—the 15 worst homes in each state—and the 136 homes actually selected by states as SFFs. For example, GAO’s estimate includes 40 percent of SFF Program candidates and about half of the active SFFs as of December 2008 and February 2009, respectively. Under GAO’s estimate, however, the most poorly performing homes are distributed unevenly across states, with 8 states having no such homes and 10 others having from 21 to 52 such homes.
GAO found that the most poorly performing nursing homes had notably more deficiencies with the potential for more than minimal harm or higher and more revisits than all other nursing homes. For example, the most poorly performing nursing homes averaged about 56 such deficiencies and 2 revisits, compared to about 20 such deficiencies and less than 1 revisit for all other homes. In addition, the most poorly performing homes tended to be chain affiliated and for-profit and have more beds and residents.
How did the three Nursing Homes in the stories fare in their inspections? DEATHLY POOR.