The publicity surrounding the Centers for Medicare & Medicaid Services’ “worst performers” list this week has wrongly painted some providers into a bleak corner, defenders say.

An operation with a Special Focus Facilities designation isn’t necessarily a non-starter for savvy providers, and the SFF label might misrepresent what’s actually happening on the ground.

Several operators this week said they became involved in SFF buildings as investment opportunities and have been pumping in better staffing practices, clinical support and quality of care strategies that have proven successful elsewhere. Those facilities, however, may still carry the stigma of being on the list.

But the vast majority of SFF participants — 90% since 2005 according to one CMS official — eventually get the green light to operate under normal conditions again.

Three facilities owned by the co-located Boulder Healthcare and Hillstone Healthcare are in the SFF program. All together, Ohio has five participants — and an additional 18 candidates, as indicated by the Senators’ disclosure of about 400 additional weak facilities on Monday.

While the Columbus Dispatch questioned the quality of care provided at the company’s 39 skilled nursing sites, Hillstone Chief Operating Officer Matt Dapore told the newspaper the companies’ strategy has been to pick buildings they can revamp.

The Uptown Westerville location, for instance, was purchased just 30 days prior to its selection for SFF. Hillstone took over 17 former HCR ManorCare facilities when that company filed for bankruptcy last year.

“We take challenging buildings,” Dapore told the newspaper. “That’s what we do because we can turn them around, and we can fix them … To classify the company as a whole poorly because of the facilities we choose to take, I think is a bad assessment.”

Dapore did not return calls from McKnight’s seeking additional comment.

Some facilities are able to move off the candidate list before moving to “participant” status by improving independently, without additional surveying requirements, CMS Chief Medical Officer Kate Goodrich said Wednesday.

And, she added, most participating facilities exit the program by passing two consecutive surveys at least six months apart, showing they were able to “overcome systemics issues.”

Since 2005, 90% of selected facilities had been released, while 10% were terminated from Medicare.

The only way a new site enters the program is when another “graduates” or closes its doors.

Montana’s Heritage Place made the candidates’ list.

In a statement to local media, company officials acknowledged previous struggles and efforts to improve staffing and education.

“Turnaround situations are never easy,” the company said, noting that new administrative and clinical leadership had been appointed since a rapid transition following the “eminent bankruptcy of the prior operating company.”

Nursing Home Compare does specify that the facility changed ownership within the last year, but it’s unclear whether that was before or after a survey resulting in $107,955 in fines.

Since being placed on the candidates list, Heritage Place officials said they have submitted plans for correction for which the facility is in “substantial compliance.”