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ARTICLE

Date ArticleType
3/6/2017 Regulatory
CMS Update on the 2017 Special Focus Facility Program

In memorandum S&C: 17-20-NH (March 2, 2017), the Centers for Medicare and Medicaid Services (CMS) provides an update on the 2017 Special Focus Facility (SFF) Program. The memo describes the SFF program background, process for initial selection and notification of SFF, progressive enforcement, graduation from the SFF program, authority to terminate, and operational procedures. The memo notes the following:
 
The State Survey Agency (SA) must notify the provider in writing of their SFF selection and conduct a meeting with the provider's accountable parties and the CMS regional office (RO) - if the RO wants to be included.

• The memorandum specifies that the SA must send a letter (see Appendix B) to the facility and all accountable parties about its SFF selection.
• All communications to SFF facilities should include copies to the following accountable parties: administrator, Chairperson of the Governing Body, holder of the provider agreement, any party who owns more than a 5 percent interest in the facility, the management company (if applicable), the facility landlord(s), the mortgage holder, and corporate owner(s) for chain-operated nursing centers.

Once a SFF has completed two consecutive standard surveys with no deficiencies cited at a scope and severity of "F" or greater (or "G" or greater for Life Safety Code deficiencies), and has had no complaint surveys with deficiencies at "F" or greater (or "G" or greater for Life Safety Code deficiencies) in between those two standard surveys, the facility will graduate from the SFF program.

• However, if the only deficiency preventing graduation is an "F" level deficiency for food safety requirements (42 CFR §483.60(i) Tag F371), the RO has discretion to allow the facility to graduate from the SFF program. F371 deficiencies at a "G" level or greater will prevent the facility from graduating from the SFF program.

Consistent with longstanding authority, the CMS ROs may use discretionary termination for SFFs (or any facility) if necessary to protect resident health and safety.
 
In addition:

• Under Section III: Progressive Enforcement, CMS incorporates provisions of S&C: 16-31-NH on the immediate imposition of remedies with no opportunity to correct. 
• Under Section VI: Operational Procedures, CMS specifies other operational procedures that must be completed by the SA and CMS RO for facilities that have not graduated after two standards surveys.

Contact the CMS SFF mailbox with questions about the program.