Opinion piece from Dave Ranney, current KABC Board Member and retired newspaper reporter: In a recent Kansas News Service story on Sen. Roger Marshall’s appearance at a town hall meeting in Oakley, Kansas, (pop. 1,982), a board member with the local nursing home said he’d hoped to hear about issues “…affecting nursing homes right now. Rural hospitals are hurting but all people wanted to do was scream at the senator.” The board member’s concerns are valid and deeply troubling. Cuts in Medicaid spending will be devastating. Medicaid is the backbone of long-term care in Kansas; 57 percent of the state’s nursing home residents rely on Medicaid for their care. These are frail elders whose estates have been depleted. They have no money. Medicaid reimbursement rates are, at best, break-even. They’re not ‘profit centers.’ Even a small reduction in rates will push many rural facilities to the brink of closure. Quality of care, too, is sure to suffer. Medicare, unfortunately, does not cover nursing home care. Rural families will be left with no choice but to move their loved ones far from home to receive the care they need and deserve. Already, eight of the state’s 105 counites are without a nursing home; at least 40 have only one. National surveys have found that a fourth of the nursing homes in Kansas are providing sub-standard care, usually due to inadequate staffing. Recruiting and retaining nurses and healthcare staff in small towns is critical. The board member would do well to consider what’ll happen when DOGE figures out that Medicaid is paying for care that often falls short of federal standard. Lawmakers on both the state and national levels have a responsibility to ensure stable Medicaid funding to keep existing facilities open while, at the same time, investing in community-based services that offer lower-cost, in-home care options that allow people to remain in their communities. Sincerely, Dave Ranney Dave Ranney is a retired newspaper reporter, he lives in Lawrence, Kansas.