Nursing homes in Kentucky, as elsewhere, are inspected regularly by representatives of the Centers for Medicare & Medicaid Services (CMS). Generally, a survey or inspection team visits the nursing home once a year to determine whether the facility is providing the quality of care required for participation in the Medicare and Medicaid programs.
According to CMS, the average nursing home has six to seven deficiencies on each survey. A facility is given a reasonable amount of time to correct these problems. Some nursing homes may take care of these problems by the time a follow-up inspection occurs, only to have them recur on a subsequent inspection. Some nursing homes have
- more deficiencies—about twice as many as the average nursing home;
- more serious deficiencies than the average nursing home, perhaps involving harm to residents; or
- a pattern of serious problems over an extended period of time.
CMS puts such facilities on a Special Focus Facility list.
The Special Focus Facility (SFF) Initiative
When a nursing home attains the dubious distinction of getting onto the SFF list, they are inspected about twice a year. Within 18 to 24 months, one of three things will occur:
- The nursing home will have made significant progress in addressing their deficiencies and has sustained those improvements; the facility graduates from the SFF program.
- If sufficient improvement does not occur, the nursing home’s participation in the Medicare and Medicaid programs is discontinued. Usually these facilities close soon after the funding ends, and the State Medicaid Agency helps residents move to another facility.
- The nursing home has made some progress, such as being bought by an owner with higher quality facilities, and is given additional time in the SFF program to complete its improvement plan.
SFF Lists
The CMS website maintains the following five tables, to which anyone looking for a nursing home should refer:
- New Additions. These nursing homes have been recently added to the list and have not had a survey since then.
- Not Improved. Since being added to the SFF list, these nursing homes have been given an opportunity to improve but have not, as of a subsequent survey.
- Improving. These facilities have shown significant improvement in a subsequent survey, meaning that CMS cited no deficiencies that could cause actual or systemic potential for harm to residents. These nursing homes will graduate if improvement continues through the following 12 months, or two standard surveys.
- Recently Graduated. These facilities sustained significant improvement through the following 12 months, or two standard surveys. CMS keeps them on a list of graduates for a few months so that anyone following their improvement will be aware of their success.
- No Longer in Medicare and Medicaid. These nursing homes either were terminated by CMS from participation in Medicare and Medicaid, or they voluntarily chose to withdraw. Usually these facilities close, but some later re-enter the program after making enough improvement to meet federal health and safety requirements.
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