The Special Focus Facility program, a federal initiative that targets very low-performing nursing homes for additional oversight and improvements, would be expanded and renamed under a new legislation proposed by two federal lawmakers this week.

The Nursing Home Reform Modernization Act of 2020 was unveiled Tuesday by Pennsylvania Sens. Pat Toomey (R) and Bob Casey (D), and seeks to “improve and expand” the SFF program to include facilities that currently qualify for the program. 

Changes to SFF program 

The senators noted that a maximum of 88 facilities are chosen to participate in the program, despite there being more than 500 facilities nationwide that have “consistently failed to meet federal safety and care requirements.”

The law would mandate that no fewer than 3.5% of the lowest-rated facilities participate in the program and that on-site consultation and educational programming be established for those facilities. 

The program would also be renamed the “Low-Rated Facility Program” under the legislation. Other improvements to the program would include: codifying core enforcement elements, such as the use of progressive enforcement actions and the requirement that a facility must improve in order to graduate from the program; and reinvesting Civil Monetary Penalties (CMPs) to bolster improvement among program participants. 

More icons, advisory council 

The legislation also calls for the establishment of an icon that identifies high-rated facilities on the Care Compare site for nursing homes — similar to the consumer alert icon that was implemented in late 2019.

An Advisory Council would also be created to manage skilled nursing facility rankings under the Medicare and Medicaid programs under the program. 

The Department of Health and Human Services would also be mandated to establish a “data-driven process, drawing on the recommendations of the Advisory Council” to rank nursing homes based on their performance, from high to low. 

“We have an imperative to help nursing homes residents and workers amid this public health crisis, and we must also improve care quality in nursing facilities—especially those that have a consistent pattern of failing safety and care standards,” Casey said in a statement.