Building off of program revisions originally released in October 2022, the Centers for Medicare & Medicaid Services (CMS) announced updates to the nursing home Special Focus Facility (SFF) program on January 28, 2026. Updates include new recommendations for state survey agencies to consider the prevalence of falls when selecting a nursing home from the SFF candidate list and clarification that standard health inspections will be completed in SFFs at least once every six months (no less than twice annually), while Life Safety Code and Emergency Preparedness surveys will be conducted at least annually. CMS further announced that selection for the SFF candidate list will now be based on the past two standard health inspections rather than the past three standard surveys. This change is consistent with the June 2025 adjustment to the health inspection domain rating on Nursing Home Care Compare in which the third survey cycle was dropped from Five Star Quality Rating System calculations. These changes come amid scrutiny of the Special Focus Facility program by the Department of Health & Human Services’ Office of Inspector General (OIG) that recently released reports on outcomes of SFFs as well as falls in nursing homes.
