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Fonteum · Special Focus Facilities

CMS's shortlist of nursing homes flagged for repeat serious deficiencies — and the 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 49 states. Facilities cycle through enrollment → graduation → and, per the OIG's October 2025 review,

64%Source: https://data.cms.gov/provider-data/dataset/r9s8-i3pj · Dataset: cms-care-compare-nh-deficiencies/v1 · Snapshot: 2026-05-01
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.

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Snapshot May 7, 2026·526 85 active SFFs + 441 candidates (snapshot 2026-05-07)·CMS Special Focus Facility Program List + OIG October 2025 SFF Report·Methodology →·Audit Pack →·Verify at CMS → ↗
CMS publishes the SFF list quarterly; source-modified 2026-04-01. OIG-25-00163 (October 2025) documents 64% post-graduation relapse to substandard quality. CMS rejected the OIG ownership-disclosure recommendation.
Active enrollment

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.

85
Pipeline

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.

441
Post-graduation relapse

Substandard-Quality Recurrence

OIG-25-00163 (October 2025):

64%Source: https://data.cms.gov/provider-data/dataset/r9s8-i3pj · Dataset: cms-care-compare-nh-deficiencies/v1 · Snapshot: 2026-05-01
of SFF graduates relapse to substandard quality. CMS rejected the OIG ownership-disclosure recommendation that would have tied SFF flag to ownership-percentage transparency.

64%
State coverage — top 10 by total flagged

47 states with active SFFs · 49 with candidates

State-level pages and per-facility profiles ship in follow-on state-pages waves.

StateActive SFFsCandidatesTotal flagged
TX63137
CA63036
OH52530
IL42024
PA42024
FL31518
MO31518
NY31518
IN21517
GA21012
Research — coming soon

SFF Relapse Analysis — Sprint 2 flagship study

Forthcoming flagship study mining the SFF graduation cohort + post-graduation deficiency citation history for the

64%Source: https://data.cms.gov/provider-data/dataset/r9s8-i3pj · Dataset: cms-care-compare-nh-deficiencies/v1 · Snapshot: 2026-05-01
relapse story plus the CMS-vs-OIG ownership-disclosure rejection. Source material drafted; publication queued for Sprint 2.

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Methodology · Corrections log · Editorial policy

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Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

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The substrate, by the numbers

44federal source familiesDistinct CMS, OIG, HRSA, FDA and peer datasets
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61reproducible studiesEach shipping the SQL behind its figures