Nursing homes are beset by pervasive, longstanding
quality and safety issues. A little-known federal
program that targets the worst of the worst is
failing to foster lasting improvement.
Congress and President Bill Clinton created the Special
Focus Facility program, or SFF, in 1998 to rehabilitate the
most troubled nursing homes. The program identifies the
skilled nursing facilities with the most severe problems
and subjects them to more frequent inspections and
enforcement actions until deficiencies are corrected — or
not, in which case they can be banned from Medicare and
Medicaid.