The impact of special focus facility nursing homes on market quality

Special Focus Facilities (SFFs) are nursing facilities designated by the Centers for Medicare & Medicaid Services to be of chronic poor quality. Relatively few nursing facilities are included in this initiative. The purpose of this research was to examine whether nursing facilities included in the 2007 SFF initiative subsequently influenced the quality of other facilities in their market.

The 2007 On-line Survey, Certification and Reporting data and 2007 through 2008 Nursing Home Compare data were used. Multivariate analyses examining the quality indicators at the county level were used to examine the market influence of SFFs.

Of the 135 nursing facilities included in the 2007 SFF initiative, 58 (i.e., 42%) have shown significant improvement in quality. When examining all nursing facilities, of the 22 multivariate models 6 showed that the quality indicators of non-SFFs were significantly different in counties with SFFs. When examining nursing facilities with the lowest quality, of the 22 multivariate models 10 showed that the quality indicators of non-SFFs were significantly different in counties with SFFs.

The use of the SFF initiative may have influenced aggregate market level nursing facility quality.