Special Focus Facilities: the CMS watch list
According to the federal Centers for Medicare & Medicaid Services, the Special Focus Facility (SFF) program is how the government tracks the nursing homes with the most persistent, serious quality problems. SFFs are inspected about twice as often as other homes, roughly every six months instead of annually, and face escalating enforcement until they improve, graduate from the program, or are terminated from Medicare and Medicaid. This page lists every facility the CMS Nursing Home Compare dataset currently flags as an active SFF, current to August 2026; see our methodology for how this data is compiled.
What the watch list shows
CMS currently designates 84 nursing homes across 48 states as active Special Focus Facilities, with a further 441 flagged as SFF candidates, homes that qualify for the program but have not yet been selected for a limited slot.
- 84
- Active Special Focus Facilities
- 441
- SFF candidates (qualify, not yet selected)
- 48
- States with an active SFF
An SFF designation is one of the strongest warning signs in the CMS data, it reflects a documented pattern, not a single bad inspection. Candidates are not yet in the program but warrant the same scrutiny.
Active Special Focus Facilities (84)
Citing this list
The Special Focus Facility designation is published by CMS and is free to cite. Suggested attribution: "CMS Special Focus Facility list, August 2026." The list changes as homes enter, graduate, or are terminated; verify a facility's current standing on its state page or the official Medicare Care Compare tool before drawing conclusions.