Falls to be considered in SFF decision

• By: Maureen Carland
• On: 01/29/2026 11:44:26
• In: Quality/Regulatory

CMS announced a change to how states select candidates for the Special Focus Facility (SFF) Program, placing greater emphasis on resident fall rates. In  QSO-23-01-NH REVISED, CMS directed states to begin considering fall prevalence in addition to survey performance when identifying facilities for SFF designation. The revised guidance removes prior language that instructed state survey agencies to consider staffing ratings or staffing ratios as part of the selection process.

The QSO explains that this change follows findings from an Office of Inspector General report, which highlighted the seriousness of nursing home resident falls and the need to strengthen fall-prevention efforts. The memo notes that when state agencies are evaluating two potential SFF candidates with similar compliance histories, CMS recommends selecting the facility with the higher prevalence of falls.
 
Staff contact: mcarland[at]mehca.org