Sections 1819(f)(8) and 1919(f)(10) of the Social Security Act require the U.S. Centers for Medicare and Medicaid Services (CMS) to conduct a Special Focus Facility (SFF) program which focuses on nursing homes that have a persistent record of noncompliance leading to poor quality of care. CMS’ SFF program requires the persistently poorest performing facilities selected in each state to be inspected no less than once every six months and that increasingly severe (progressive) enforcement actions …

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