Medicare Medicaid CMS Special Focus Facility Nursing Home Deficiency List
Medicare Medicaid CMS Special Focus Facility Nursing Home Deficiency List

Special Focus Facility Initiative

The Centers for Medicare and Medicaid CMS creates a Special Focus Facility “SFF” list of nursing homes that have a history of serious quality issues and are included in a program designed to seek improvement in care.  The list is updated regularly with new facilities being added as needed and other falling off due to significant improvement in the quality of care or from being terminated from Medicare.

The Special Focus Facility list is generated from data received through the CMS inspections or surveys which are focused on looking for deficiencies in care based on federal nursing home regulations.  According to the CMS website, Most nursing homes have some deficiencies, with the average being 6-7 deficiencies per survey. Most nursing homes correct their problems within a reasonable period of time. However, we have found that a minority of nursing homes have:

  • More problems than other nursing homes (about twice the average number of
  • More serious problems than most other nursing homes (including harm or injury experienced by residents); and
  • A pattern of serious problems that has persisted over a long period of time (as measured over the three years before the date the nursing home was first put on the SFF list).

Effect of Being on Special Focus Facility List

According to Medicare CMS, there are more frequent surveys and inspections to facilities on the SFF list usually about twice per year.  The longer the problems and deficiencies exist the more stringent the response from CMS, with penalties ranging from civil fines to being terminated from CMS from Medicare and Medicaid payments.

Within about 18-24 months the nursing home is expected to have one of three possible outcomes:

  • The ideal outcome is the facility shows improvement and the facility graduates from SFF due to significant improvements in the quality of care which has continued over time;
  • The facility is terminated from Medicare after failing to make significant and lasting improvements; and
  • There can also be an extension of time given when there are signs of very promising improvements.

Information on the most recent Minnesota Special Focus Facility nursing homes can be found on my website located at the Information About Facilities.

Click the following links for more information about the Medicare & Medicaid CMS survey process and information on filing a complaint with the Minnesota Department of Health for concerns about the quality of care or abuse and neglect suffered by a Minnesota nursing home resident.

If you have concerns about  Special Focus Facilities or questions about elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at


Special Focus Facility Process