The Special Focus Facility (SFF) Program

The Special Focus Facility program is CMS's watch list for the nation's most persistently poor-performing nursing homes. CMS scores every certified facility's last three survey cycles — weighted heavily toward actual-harm and Immediate Jeopardy citations plus revisit failures — and the worst-scoring facilities in each state become SFF candidates. Roughly 88 active SFF slots exist nationally.

What Happens Inside the Program

For Families

An SFF designation is the strongest public warning CMS issues about a nursing home, and SFF candidates deserve nearly the same caution. Recent surveys matter more than old ones — review the facility's most recent inspection results, compare nearby alternatives, and read the nursing home red flags guide.

For Facility Teams

The path off the list is the same as the path to never joining it: fewer citations, lower severity, and clean revisits — driven by root-cause-based Plans of Correction and prevention of repeat citations.

Current Special Focus Facilities (88)

Current SFF Candidates (440)

Explore POCDesk — Free Nursing Home Compliance Tools

Official Sources

POCDesk analyzes official government data. Verify any facility's record or read the underlying regulations at these primary sources: