Advocacy in Action (July 2024): Problem Facilities
Libby Hastings • July 5, 2024
The Long-Term Care Community Coalition (LTCCC) recently released alarming data on the state of nursing facilities across the United States, revealing that nearly one in four nursing homes (24.6%) qualify as "problem facilities." This term encompasses nursing homes that have received a one-star rating on the federal Five-Star Quality Rating System, are part of the Special Focus Facility (SFF) Program or are SFF candidates. These facilities are notable for their substandard care and persistent compliance issues.
National and Kansas-Specific Findings
The data paints a concerning picture of nursing facility care quality nationwide, and Kansas is notably worse than the national average. According to LTCCC's data, out of the 306 nursing facilities in Kansas, 25.2% are classified as "problem facilities", 59.8% of nursing facilities in Kansas are for-profit, and 75% of "problem facilities" in Kansas are for-profit.
The Five-Star Quality Rating System
The Centers for Medicare & Medicaid Services (CMS) utilizes the Five-Star Quality Rating System to aid consumers in comparing nursing homes. This system rates facilities on a scale from one to five stars, with five-star ratings indicating superior care and one-star ratings flagging the poorest quality. The effectiveness and accuracy of the CMS Five-Star Quality Rating System has been debated among long-term care advocates, residents, and their families. A star rating is composed of three parts: outcomes from the state inspection report, staffing, and quality measures.
For-Profit Facilities and Quality Concerns
The LTCCC report highlights a troubling correlation between for-profit status and lower-quality care. A federal government study, released in November 2023, concluded that for-profit nursing facilities tend to have lower quality ratings, fewer registered nurses, and more safety violations, prompting one to wonder if for-profit facilities prioritize financial returns over patient care. A February 2021 study from the National Bureau of Economic Research found that going to a facility owned by a private equity firm increased the chance that a resident would die by 10%, compared with living in another type of facility.
The Special Focus Facility Program
The SFF Program targets nursing facilities with a history of serious quality issues. Facilities are identified based on their performance over the last three standard health survey cycles and three years of complaint surveys. Points are assigned for deficiencies cited during inspections, with higher points given for more severe violations. Those facilities with the highest points become SFF candidates, marking them as requiring significant improvement. The methodology behind the SFF Program is the same as that used for health inspections within the Five-Star Quality Rating System. This rigorous approach ensures that only those facilities with the most concerning track records are selected for intensified oversight.
Implications for Consumers
The LTCCC's findings and data serve as a crucial reminder for consumers to be vigilant when selecting nursing facilities. The prevalence of "problem facilities", especially among for-profit institutions, underscores the importance of thorough research and consideration of a facility's rating and compliance history.
As always, if you would like Consumer Information Reports about any licensed long-term care facility in Kansas, feel free to call or email. There is never a charge for any of our materials.
At KABC, we will continue to advocate for increased staffing, quality care, and financial transparency within for-profit nursing facilities.
Understanding the Special Focus Facility (SFF) Program: What Families Need to Know When Choosing a Nursing Home in Kansas When searching for a nursing home for a loved one, families often look for a place that will offer safe, reliable, and compassionate care. One important—but often overlooked—resource that can help inform that decision is the Special Focus Facility (SFF) Program , managed by the Centers for Medicare & Medicaid Services (CMS). What Is the Special Focus Facility (SFF) Program? The SFF Program was created by CMS to address the most persistent quality problems in nursing homes across the country. Every nursing home that accepts Medicare or Medicaid is regularly inspected to ensure it meets health and safety standards. Most nursing homes will have a few issues identified during these inspections—typically six to seven deficiencies on average—but some facilities consistently fall far below acceptable standards. These nursing homes: Have twice as many deficiencies as the average facility, Have more serious issues , including those that cause actual harm to residents, And show a long-term pattern of poor performance over a span of about three years. Facilities like these may fix issues temporarily, but often fail to address the root causes—resulting in a harmful cycle of repeated violations. That’s where the SFF program comes in. How the SFF Program Works CMS uses inspection data to score nursing homes based on both the number and severity of their deficiencies. Facilities with the highest scores (i.e., the most and most serious problems) are added to a list of SFF candidates . Each state is allowed only a limited number of active SFFs at a time—currently, only 88 facilities nationwide can be enrolled in the program. However, CMS maintains a much longer list of SFF candidates that also meet the criteria but haven't yet been selected for the program due to space limits. Once a facility is chosen as an active SFF: It is inspected every six months instead of the usual once a year. It may face progressive enforcement , such as financial penalties or losing eligibility for Medicare and Medicaid. It must show real, lasting improvements to graduate from the program. A facility "graduates" from the SFF program only after it has two consecutive inspections (after being named an SFF) with no more than 12 relatively minor deficiencies and none at a higher severity level. If a facility continues to have serious violations, CMS may consider terminating its participation in Medicare and/or Medicaid. Why This Matters to Kansas Familie s Being informed about a nursing home’s history can help protect your loved ones. Facilities in the SFF program—or on the candidate list—have serious quality concerns. While some may be working hard to improve, others may continue to struggle with systemic issues that put residents at risk. As of March 2025, the following nursing homes in Kansas are included in the Special Focus Facility (SFF) program: Excel Healthcare and Rehab Topeka (recently closed) Access Mental Health (Peabody) The following facilities in Kansas are currently on the SFF candidate list : Clearwater Nursing and Rehabilitation Center Good Samaritan Society- Liberal Kearny County Hospital Long-Term Care Unit Legacy at College Hill (Wichita) Legacy on 10th Avenue (Topeka) Medicalodges Jackson County Medicalodges Post Acute Care Center (Kansas City) Meridian Rehabilitation and Health Care Center (Wichita) Riverbend Post Acute Rehabilitation (Kansas City) Tanglewood Nursing and Rehabilitation (Topeka) The following facilities graduated from the SFF program: Advena Living of Cherryvale Life Care Center of Osawatomie Anew Healthcare Oxford is a facility that is no longer participating in the Medicare and Medicaid Program. We encourage families to take time to research and ask questions when considering a nursing home. You can access the full national SFF and candidate list on the CMS website here . KABC offers free unbiased Consumer Information Reports on all licensed adult care facilities in Kansas, helping you make an informed choice when deciding between long-term care options. Final Thoughts The Special Focus Facility Program exists to push underperforming nursing homes to do better—but it’s also a signal to the public. When selecting long-term care, knowing whether a facility is on this list can be an important part of making the best choice for your loved one. If you have questions about how to find quality nursing home care in Kansas or want help understanding a facility’s inspection history, don’t hesitate to reach out to our team.
As we move further into 2025, we want to share an update on our legislative advocacy efforts this session. KABC remains committed to championing policies that protect and support older adults and individuals in long-term care. Here’s a look at key legislative developments and where things stand: