01/29/2026

CMS Updates Special Focus Facilities Program

The Centers for Medicare & Medicaid Services (CMS) announced updates to the nursing home Special Focus Facility (SFF) program on January 28, expanding on program revisions first released in October 2022. The changes include new guidance for state survey agencies to consider the prevalence of falls when selecting facilities from the SFF candidate list, as well as clarification of survey frequency requirements. Under the updated guidance, standard health inspections must occur at least once every 6 months, while Life Safety Code and Emergency Preparedness surveys will be conducted at least annually. CMS also revised how facilities are placed on the SFF candidate list, shifting from a review of the past three standard surveys to the past two. That change mirrors a June 2025 update to Nursing Home Care Compare, which removed the third survey cycle from Five-Star Quality Rating System calculations. The updates come amid heightened scrutiny of the SFF program, following recent reports from the U.S. Department of Health & Human Services Office of Inspector General examining SFF outcomes and the prevalence of falls in nursing homes.