Ask the care expert: how to understand state deficiency scores

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
I am a new charge nurse and don't understand the way the state scored our deficiencies. Can you give me a Web site I can check to better understand how this was done?

Your facility should have a copy of your state regulations available. Ask your director of nursing for this. You also should consult the Centers for Medicare & Medicaid Services Web site.

It is quite vast but will answer almost any question you have on scoring, scope or severity, along with the scope and severity grid.

The scoring methodology for the Special Focus Facility (SFF) comprises two scores: the deficiency score and the revisit score. Results from the most recent surveys are weighted more heavily than results from earlier surveys. The SFF selection methodology can be understood as a five-step process:

(1) Health deficiencies: Health deficiencies are scored and weighted.

(2) Revisits: If the facility required more than one revisit to demonstrate substantial compliance, additional points are added to the SFF score.

(3) Weighting by year: Results are totaled and weights are assigned to each period, with more recent results weighted more heavily.

(4) List per state: The facilities are grouped within each state and the 15 facilities with the highest SFF scores (i.e. most serious and persistent healthcare deficiency histories) are presented to the state for consideration as SFF facilities.

(5) State recommendation and selection: Each state reviews the candidate list, brings its state-specific knowledge and information to bear (e.g., results of State licensure surveys), and recommends a final selection to CMS.