Report Card: Wisconsin and New Mexico Special Focus Facilities

The Centers for Medicare and Medicaid Services (CMS) reports most nursing homes today may have between six or more deficiencies. Keeping this in mind, how many deficiencies may result in a nursing home being classified as a Special Focus Facility (SFF)? What happens after they are placed on this list?

PKSD shares some insights about what an SFF is and looks at the progress of previously SFF-classified nursing homes in Wisconsin and New Mexico.

If you are concerned about the care your loved one is receiving in his or her nursing home and believe there are severe issues with the overall quality of care, we urge you to notify facility administrators before reaching out to our firm for legal assistance. There is no cost for an initial consultation with one of our knowledgeable Wisconsin nursing home attorneys, and you can learn more about your legal options.

What is a Special Focus Facility?

CMS inspects nursing homes regularly to help to ensure nursing home residents are receiving the quality of care that adheres to both state and federal standards. While you can read more specific details about the SFF program, here are some quick facts to help you understand more about SFF facilities.

When considering candidates for the SFF program, CMS site inspectors are looking for:

• Specific patterns of serious issues occurring over a long period of time
• Serious incidents occurring more often than in the average facility
• A higher number of issues when compared to the average facility

The SFF program also utilizes a five-star quality rating system resulting from inspections over an extended period – typically three years. These results are then converted into a point system, based on the severity of the issues and deficiencies cited. Facilities that receive the highest scoring have more serious quality and deficiency issues. No more than 30 of the candidates inspected and scored in each state will make the list.

How Often Are SFF Nursing Homes Reevaluated?

The purpose of placing a nursing home on the SFF list is to let the public know about the quality, safety and other care concerns, but also to enforce a plan for improvement. To help accomplish this, these SFF facilities undergo a full onsite inspection every six months for as long as they are in the program. Progressive enforcement also continues, which may include denial of Medicare payments, fines or other penalties, until the facility improves enough to graduate from the program or until they are terminated from the Medicare and Medicaid programs.

Scope of Deficiency

When a nursing home is found to have deficiencies, it is examined both by category (isolated incident, ongoing pattern, widespread occurrences) and severity:

• Level 1: No actual harm has happened, but there is minimal potential for harm to occur
• Level 2: No actual harm, however there is potential for more than minimal harm – no immediate jeopardy
• Level 3: Actual harm has occurred, but there is no immediate jeopardy
• Level 4: Not only has harm occurred, but there are also immediate concerns for danger to residents’ health and safety

When researching potential nursing homes for your loved one, learning more about the Special Focus Facilities list, along with other useful resources, such as Medicare’s Nursing Home Compare tool, can help you make an informed decision.

Special Focus Facilities in Wisconsin and New Mexico

Looking at the current SFF list, we want to keep you informed about the status of facilities that are closer to home, specifically in Wisconsin and New Mexico. CMS classifies SFF facilities in three categories. We have provided the CMS updates for each category:

Table A: Facilities Newly Add to the SFF Program

• Wisconsin: Pine View Care Center in Black River Falls – eight months as an SFF
• New Mexico: There are no newly added facilities from New Mexico

Table B: Facilities That Have Failed to Improve

• No facilities from Wisconsin or New Mexico were added to this list.

Table C: Facilities That Have Significantly Improved

• Wisconsin: Bay at Colonial Manor Health and Rehab in Wausau – 20 months as an SFF; the latest inspection occurred on January 8, 2020
• New Mexico: Mission Arch Center in Roswell – 10 months as an SFF; the most recent inspection was on November 21, 2019

Speak with an Experienced Attorney for Legal Help

If your loved one has suffered injuries or an illness due to negligence or abuse at his or her nursing home, we are prepared to help.

It is important that you notify the State about your suspicions and concerns, but we also strongly recommend that you seek legal help as soon as possible.

At PKSD, we are deeply committed to advocating on behalf of the injured in nursing homes. We have recovered millions in compensation for the damages they and their loved ones have suffered. Our initial consultations are completely free, and there is no risk or obligation for discussing your potential legal options. If we take your case, there are no upfront fees. We do not get paid unless you do.

PKSD Law. Trusted legal help fighting for you. 414-333-3333