CMS's shortlist of nursing homes flagged for repeat serious deficiencies — and the 64% who slip back after graduating.
The Special Focus Facility (SFF) program is the most-actionable consumer-facing quality signal in the CMS nursing-home dataset — 85 active SFFs + 441 candidates in the 2026-05-07 snapshot, across 49states. Facilities cycle through enrollment → graduation → and, per the OIG's October 2025 review, 64% relapse to substandard quality. CMS QSO-23-01-NH REVISED (January 2026) replaced staffing with falls prevalence as a selection criterion; CMS rejected the OIG ownership-disclosure recommendation.
See the Audit Pack →Active Special Focus Facilities
Facilities currently under heightened CMS oversight for repeat serious deficiencies. CMS publishes the SFF list quarterly with rotation guidance and graduation criteria.
SFF Candidates
Facilities flagged for SFF program eligibility but not yet enrolled. CMS QSO-23-01-NH REVISED (January 2026) replaced staffing with falls prevalence as a candidate selection criterion.
Substandard-Quality Recurrence
OIG-25-00163 (October 2025): 64% of SFF graduates relapse to substandard quality. CMS rejected the OIG ownership-disclosure recommendation that would have tied SFF flag to ownership-percentage transparency.
47 states with active SFFs · 49 with candidates
State-level pages and per-facility profiles ship in follow-on state-pages waves.
SFF Relapse Analysis — Sprint 2 flagship study
Forthcoming flagship study mining the SFF graduation cohort + post-graduation deficiency citation history for the 64% relapse story plus the CMS-vs-OIG ownership-disclosure rejection. Source material drafted; publication queued for Sprint 2.