; and (ii) by adding at the end the following new subparagraph: (C) Appropriate participation Not later than 1 year after the date of enactment of the Nursing Home Reform Modernization Act of 2020 , the Secretary shall ensure that the number of facilities participating in the special focus facility program is not less than 3.5 percent of all skilled nursing facilities. . (B) Conversion of the special focus facility program to the low-rated facility program and additional requirements Section 1819(f)(8) of the Social Security Act ( 42 U.S.C. 1395i–3(f)(8) ), as amended by subparagraph (A), is amended— (i) in subparagraph (B), by inserting the following before the period at the end: (or, on and after the date the Secretary makes the conversion described in subparagraph (D), at a frequency determined appropriate by the Secretary (but in no case less than once every 6 months))