Understanding the Special Focus Facility Program

Libby Hastings • April 21, 2025

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 Families

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.

June 24, 2025
Kansas Advocates for Better Care (KABC) hosted its first-ever community car show this month, and we’re still riding high from the energy, joy, and connections sparked at the event. Despite a little Kansas rain, 28 beautiful classic cars and over 200 attendees came out to celebrate. We were thrilled to welcome residents from both Pioneer Ridge and Presbyterian Manor, who joined alongside their families, caregivers, and community members to admire the lineup of vintage vehicles. The car show was part of our 50th anniversary celebrations, and we couldn’t think of a better way to bring generations together for fun, fresh air (a little drizzle), and conversation. We gave away over $100 through our 50/50 raffle , raffled off three gift cards and a car banner (each paired with a KABC t-shirt), and awarded four standout cars: Oldest Car – 1917 Dodge Roadster KABC’s Choice – 1937 Buick Resident’s Choice – 1955 Chevy Bel Air Best in Show – 1971 Ford Mustang Mach 1 None of this would have been possible without our outstanding planning committee , especially Max and Dalton , who helped steer every detail from concept to execution. We also want to give a heartfelt shout-out to our volunteers— Garrett, Richard, and Kurt —for helping during the show, and to our dedicated board member Barbara Braa , who stayed for the entire event to lend a hand. Special thanks to our generous event host, Rev City Church , for providing the perfect space to showcase these cars and connect with our community. We’re also deeply grateful to our event partners: O’Reilly Auto Parts and Audio-Reader Network , for setting up booths, handing out free goodies, and powering through the downpour ThisN’That-LFK , for serving up delicious food and drinks to keep spirits high Douglas County Community Foundation , whose support made this event a reality Our giveaway sponsors: Summit Racing Equipment, Stoner Car Care, Gateway Classic Cars, and EATON Detroit Spring – thank you for helping us create a memorable experience for all From the rumble of vintage engines to the smiles shared between residents and car enthusiasts alike, this car show reminded us why community connection is so vital—especially for those in long-term care. We’re already looking ahead to next year’s show. Until then, thank you for celebrating 50 years of advocacy, community, and care with us.
A close up of a person holding another person 's hand.
May 29, 2025
In a recent article published by The Beacon, reporter Blaise Mesa spotlights a heartbreaking case that exemplifies both the critical importance and serious strain facing Kansas Adult Protective Services (APS). The article, “One elder abuse investigator has 70 cases. Kansas doesn’t say how swamped other caseworkers are,” tells the story of Shirley Crow, an 85-year-old woman with Alzheimer’s whose family trusted a caretaker to manage her daily medications and appointments. That trust was broken. Despite filing a report with APS, Shirley’s family received few updates. Weeks after their report, Shirley passed away. Her case remains open—one of 10,000 APS investigations initiated in Kansas each year. The assigned APS caseworker? She has 70 other cases. This is not a story about blame. As Shirley’s daughter-in-law, Stacy Crow, told The Beacon , “We got an investigator that I truly believe has a heart… I understand they have an overwhelming demand… I don’t fault them. I just want things to change.” And so do we. Systemic Overload and the Urgent Need for Reform The Kansas Department for Children and Families (DCF), which oversees APS, has not publicly disclosed average caseloads. While DCF clarified post-publication that they do track this information, they choose not to release it, citing confidentiality. The lack of transparency and standardization prevents meaningful accountability and reform. National standards suggest 20–25 cases per worker is a manageable caseload. Kansas APS staff, in some cases, are handling double or triple that amount. With cases increasing year over year— 18,056 in fiscal year 2025 alone—the risk of delayed intervention or missed warning signs only grows. This Is a Wake-Up Call. At KABC, we continue to push for better protections for older adults, more robust support for APS investigators, and greater transparency and accountability from state agencies. In our recent blog post, “ What Happens When You Report to Adult Protective Services? ” we outline the crucial role APS plays in protecting vulnerable adults and how reporting suspected abuse can quite literally save lives. To report suspected abuse, neglect, or exploitation of a vulnerable adult in Kansas: For older adults living at home in the community or in facilities licensed by the Kansas Department of Aging and Disability Services when the perpetrator is not a resident of or staff of the facility, report to the following: Adult Protective Services (APS): 1-800-922-5330 If an emergency, call your local law enforcement agency or 911 Reporting initiates a multi-step process involving a prompt in-person visit, interviews, and, when needed, development of a service or prevention plan. The goal of APS is to protect, not to punish- to connect individuals to medical care, housing, legal services, or safety planning. But APS cannot fulfill that mission if it's underfunded, overwhelmed, and operating in the dark.  What Needs to Change: Transparency: Kansas must publicly release average caseload data and investigation timelines. Support for APS Workers: State leaders must prioritize hiring and retaining qualified APS staff and ensure manageable caseloads. Federal Investment: Continued and expanded federal funding for APS is essential—not optional. Public Awareness: Communities need to understand when and how to report suspected abuse, and how they can be part of the safety net. The APS system should be a lifeline, not a last resort.