How does a nursing home end up on Medicare’s Special Focus Facility List?

Get Help Now

Nursing homes that accept Medicare and Medicaid payments are required to be inspected regularly by representatives of the Centers for Medicare & Medicaid Services (CMS). If you believe your elderly loved one has suffered harm due to nursing home abuse or neglect, the results of these inspections may be valuable evidence in your case. A nursing home that is on the Special Focus Facility (SFF) List may have deficiencies that placed your loved one in unacceptable danger. Special Focus Facility Lists

About the Special Focus Facility List

Typically, inspections are conducted yearly to determine if a nursing home is providing the quality of care legally required for continued participation in the Medicare and Medicaid programs.

These inspections are very thorough. It is normal for a nursing home to have six to seven deficiencies on each survey. Nursing homes are allowed to take care of their issues within a reasonable timeframe, which is then verified by a follow-up inspection.

Nursing homes can be placed on the SFF List if they have:

  • Significantly more deficiencies than average
  • More serious deficiencies than average, especially if these deficiencies involve harm caused to residents
  • An ongoing pattern of serious problems providing quality care

What it Means to Be a Special Focus Facility

If a nursing home is placed on the SFF List, it will be inspected twice a year. Within 18 to 24 months, its position will be reevaluated. At this time, one of three things will occur:

  • The nursing home will be shown to have made significant and sustained improvements. As a result, the facility will graduate from the SFF program.
  • The nursing home is determined to have made progress but is granted additional time to continue with its improvement program.
  • The nursing home’s participation in the Medicare and Medicaid programs will be discontinued due to its continued failure to provide quality care. When this happens, the facility often closes shortly after, and residents receive assistance from the State Medicaid Agency to move to another facility.

Facilities are grouped into five categories in tables that are available on the CMS website:

  • New Additions - Nursing homes that were recently added to the list, but haven't had follow-up inspections to check their progress
  • Not Improved - Nursing homes that have shown no improvement in a follow-up inspection
  • Improving - Nursing homes showing significant improvement and labeled as on track to graduate from the program in a timely fashion
  • Recently Graduated - Nursing homes that have recently graduated from the SFF program after showing they now meet quality of care guidelines
  • No Longer in Medicare and Medicaid - Nursing homes that have had their funding pulled due to ongoing failure to improve

How the SFF List Affects Your Nursing Home Abuse Claim

If your loved one has been a victim of nursing home abuse, the SFF List may be used as evidence in your case. Reviewing the results of surveys can establish that the nursing home knew of a violation and failed to correct it within a specific time frame. The survey can also help determine if the facility had a history of “wishy-washy” compliance—making the bare minimum improvements to pass a follow-up inspection and then failing the subsequent inspections.

Other evidence that may be used in your claim includes:

  • Statements from the nursing home resident
  • Testimony from family and friends who directly observed mistreatment
  • Testimony from workers in the facility
  • Medical records and statements from the resident's healthcare provider
  • Photos of unsafe conditions in the facility or injuries the resident received
  • Additional fines or citations the facility has received

The Value of Legal Representation

Hiring an experienced attorney is the best way to protect your legal rights in a nursing home abuse case. Your attorney can document damages, establish liability, and negotiate on your behalf, so you are free to focus on providing your loved one with the necessary care and support.

Neblett, Beard & Arsenault has extensive experience helping Louisiana residents obtain justice for their elderly loved ones who have been victims of nursing home abuse. Contact us online or call our office directly 318.541.8188 to schedule a no-fee consultation.

 

Richard J. Arsenault
Connect with me
Recognized by several legal associations, Richard Arsenault has vast experience in complex litigation cases.