CMS Adjusts Special Focus Facilities Program, Includes State Minimums

Effective April 2014, the Centers for Medicare & Medicaid Services (CMS) has adjusted the number of required slots and candidates for the Special Focus Facilities program. Due to sequestration issues, CMS had required that State Agencies (SAs) schedule a final “last chance” onsite survey with nursing homes that were designated SFFs for more than 18 months and failed to show improvement. In an S&C letter dated April 18, 2014, “Fiscal Year (FY) 2014 Post Sequester Adjustment for Special Focus Facility (SFF) Nursing Homes” CMS noted that States can now resume selecting and replacing nursing homes to be placed on the SFF list.

CMS also expects that “States will continue the process of to speed up final resolution of the issues with these nursing homes,” including these changes:

  • An 18 month “last chance” on-site survey, where if the on-site survey reveals continuing issues, the facility will continue in the SFF program with more emphasis being placed on its quality improvement program, or the provider agreement would be terminated
  • Review of the progress of all facilities that have been on the SFF list for more than 12 months

The Agency has created a list of the number of SFF slots available for each State as well as a list of potential candidates. Most States have not yet met their minimum required number of slots, and have the option of phasing in new facilities by July 31, 2014 or they can designate new facilities as SFFs immediately. States such as Illinois, New York, Ohio, Pennsylvania and Texas have large numbers of potential candidates that could be selected due to their poor performance on survey.


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