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.

Dan Goodman testifies before legislative committee
By Libby Hastings October 16, 2025
On Monday, October 13th, Dan Goodman, Executive Director of Kansas Advocates for Better Care (KABC), delivered testimony before the Robert G. Bethell Joint Committee on Home & Community Based Services & KanCare Oversight. His remarks focused on the urgent need to strengthen Kansas’ long-term care system through sustainable funding and workforce investments. Goodman urged legislators to provide additional funding for the Home and Community-Based Services (HCBS) Frail Elderly waiver , noting projected shortfalls of $27 million in FY26 and $70 million in FY27. Without intervention, hundreds of older Kansans could face placement on a waitlist as early as this fall—delaying access to critical in-home services and increasing the risk of premature institutionalization. He also highlighted the need to support and stabilize the state’s long-term care workforce by exploring innovative approaches used in other states. For example, New Mexico’s Competitive Pay for Professionals program has helped attract and retain workers by linking higher wages to improved reimbursement rates and accountability measures. Goodman suggested Kansas consider similar models to strengthen its caregiving workforce and ensure providers can offer competitive pay. KABC remains committed to advocating for policies that promote quality care, protect older adults, and sustain a strong, well-supported caregiving system across Kansas. Read KABC’s full testimony here: View Testimony (PDF) Watch a full recording of the committee here: YouTube Link
By Libby Hastings October 6, 2025
On October 1st and 2nd, the 2025 Special Committee on Health and Social Services met, with the first day devoted to nursing home surveying and credentialing. The joint committee of both House and Senate members heard from the Kansas Department for Aging and Disability Services (KDADS), the Long-Term Care Ombudsman, industry representatives from Kansas and out of state, administrators, and contractors. Notably absent were the voices of consumers, their family members, and facility staff , the people most affected by long-term care policy. The committee heard information about: Survey Backlogs and Staffing Challenges KDADS contracts with the federal government to inspect adult care homes for health and safety compliance. KDADS has struggled for years to meet federal requirements, due in large part to recruiting and retaining nurse surveyor positions. More than half of the 60 approved positions were vacant earlier this year. As a result, Kansas currently averages 19.9 months between nursing home inspections , far beyond the federal requirement of 12-15.9 months. With just over 300 federally licensed facilities in the state, timely inspections are critical to protecting residents. To address this, KDADS eliminated 15 vacant positions and raised starting pay: up to $60,000 for multidisciplinary surveyors and $67,000 for RNs . The agency is also considering incentives to encourage more RNs to work as surveyors. Kansas has one of the highest rates of the most serious deficiencies, known as Immediate Jeopardy (IJ) deficiencies, in the nation , citations for situations where resident health and safety are at serious risk. The committee explored the possibility of privatizing the survey process. Resident Rights at Risk Testimony also revealed troubling practices in some nursing homes, including charging residents $200–$300 per month in “pharmacy provider” or “medication set-up” fees if they choose to use an outside pharmacy. This practice undermines residents’ right to choose their own providers and unfairly penalizes private-pay residents, already shouldering an average of $7,000–$8,000 per month in nursing home costs. Involuntary Discharges and the Ombudsman’s Recommendation The Long-Term Care Ombudsman urged lawmakers to expand discharge reporting requirements. As she noted: “Federal regulations require a notice to be sent to our office for a facility-initiated transfer (involuntary discharge) in federally licensed nursing homes, but that is not the case for state licensed homes, assisted livings, home pluses and residential health care facilities. With the help of our office, we can often help resolve the reason for the discharge notice to prevent a resident transfer or support the resident to ensure a transition occurs safely.” The committee heard concerns from representatives of the nursing home industry and decided to delay making a recommendation on this issue, noting that additional information is needed. KABC has advocated for not only strengthening the reporting requirements but also giving residents of assisted living facilities the same right to appeal an involuntary discharge that nursing home residents enjoy. Raising the Personal Needs Allowance The Personal Needs Allowance (PNA) for nursing home residents is a monthly stipend that Medicaid recipients can use for personal expenses. In Kansas, the PNA is just $62 per month. Many residents express concern that this amount is insufficient to cover basic personal expenses such as haircuts or undergarments. An immediate increase to the allowance is needed, along with an ongoing adjustment to keep pace with rising costs. The Long-Term Care Ombudsman recommended a PNA increase to the national average of $72 with an additional annual Cost of Living Adjustment. KABC’s Position KABC will continue to advocate for: • Strong oversight of nursing homes. • Resident rights protections, including freedom of choice in providers. • Central inclusion of residents and staff voices in all policy discussions. You can watch the hearing on the Kansas Legislature’s YouTube channel here . KABC will continue to monitor these conversations closely as the 2026 legislative session approaches.