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In a recent podcast episode and article with the Kansas Reflector, Dan Goodman, Executive Director, and Libby Hastings, Communication and Public Relations Coordinator, shed light on the critical issues facing nursing facilities in Kansas. Interviewed by Tim Carpenter, they discussed the alarming findings from the Long Term Care Community Coalition's latest data regarding "problem facilities" and the federal staffing mandate from U.S. Centers for Medicare & Medicaid Services. This conversation was based on the insights shared in our July e-newsletter Advocacy in Action article and has garnered significant attention. Media outlets and local newspapers in Hays, Dodge City, Ottawa, and Wichita have picked up the Kansas Reflector story, amplifying the urgent need for reform in long-term care. At KABC, we remain steadfast in our mission to ensure quality long-term care for all Kansas residents. We invite you to read our article with Tim Carpenter and listen to the podcast episode. Your support and engagement are crucial as we continue to fight for improved care standards. We extend our heartfelt thanks to our supporters and the media for helping us share the harsh realities of nursing homes. Together, we can drive the change needed to ensure safe, dignified, and quality care for all residents in Kansas.

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.

June 15th is recognized globally as World Elder Abuse Awareness Day , a crucial time to shed light on the often-hidden issue of elder abuse. Alarming statistics reveal that 1 in 10 older adults experience some form of abuse, neglect, or exploitation each year. As a community dedicated to advocating for the rights and well-being of older adults, it's essential to highlight the work being done and the ongoing challenges we face. From July 1, 2022, to June 30, 2023, the Abuse, Neglect, and Exploitation (ANE) Unit tracked over 6,800 referrals to law enforcement agencies statewide—a significant 16 percent increase from the previous fiscal year. These referrals, originating from the Department for Children and Families (DCF), Adult Protective Services (APS), the Kansas Department for Aging and Disability Services (KDADS), and the Kansas Department of Health and Environment (KDHE), highlight the severity and prevalence of abuse in our communities. "Financial exploitation" remains the most reported allegation. The Economic Crimes Unit, previously known as the Fraud and Abuse Litigation Division, played a pivotal role in addressing these issues. In the past fiscal year, they litigated 15 cases of elder and dependent adult abuse, resulting in over $625,000 in restitution. Additionally, they investigated 40 cases, reflecting their commitment to combating financial exploitation and securing justice for victims. The Kansas Long-Term Care Ombudsman's annual report paints a troubling picture. Ombudsmen documented 120 complaints of abuse, neglect, and exploitation, including physical assaults, verbal abuse, and financial misappropriation. The report criticized the current reporting system, noting that calls to the ANE hotline often lack sufficient detail, and residents are seldom interviewed adequately. Moreover, facility staff frequently face intimidation or job loss when reporting abuse, creating a significant barrier to justice. The report strongly recommends enhancing access to justice for older adults and addressing systemic issues within care facilities. As part of this effort, our Public Policy Coordinator, Barb Conant, serves on the Elder and Dependent Adult Abuse Prevention Council, working tirelessly to advise and make recommendations to the ANE Unit. At KABC, we take the issues of abuse, neglect, and exploitation very seriously. We are committed to working alongside the State Long-Term Care Ombudsman and other community partners to ensure that justice is served and protections for older adults are strengthened. Additionally, KABC offers an elder abuse toolkit booklet, providing comprehensive information and resources on recognizing and addressing elder abuse. This valuable resource is available for free on our website. Let us use World Elder Abuse Awareness Day as a catalyst to continue our advocacy, support our community, and work towards a future where every older adult can live with dignity and safety.

When it comes to finding the right in-home services for yourself or a loved one, navigating the myriad of options can be daunting. Fortunately, in Kansas, there are comprehensive resources available that extend beyond private pay companies, ensuring that individuals of all ages, abilities, and income levels can access the support they need. Here’s a closer look at some of these invaluable resources. The Kansas Aging and Disability Resource Center (ADRC) The Kansas Aging and Disability Resource Center (ADRC) serves as a one-stop shop for individuals seeking long-term service and support. Whether you are an older adult, a person with a disability, or a caregiver, the ADRC offers objective information and personalized counseling to help you make informed decisions about your care options. Operated by the eleven Area Agencies on Aging (AAA) across the state, the ADRC provides: Coverage Across Kansas: No matter where you live in Kansas, ADRC ensures you have access to a wide array of support options tailored to your individual preferences, strengths, and values. Statewide Call Center: Reach out to knowledgeable staff for information, referrals, and assistance with community services via the statewide call center at 855-200-2372. Functional Assessments: The ADRC conducts assessments to determine eligibility for Home and Community-Based Service (HCBS) programs and nursing facility placements. Senior Care Act Program The Kansas Legislature established the Senior Care Act program to support older Kansans who can live in the community with some assistance. This program is designed for residents aged 60 or older who have functional limitations in self-care and independent living. Services vary by county but typically include: Attendant care Respite care Homemaker support Chore services Adult daycare Participants contribute to the cost of services based on their ability to pay. The program is administered by the Kansas Department for Aging and Disability Services (KDADS) through the AAAs. Older Americans Act (OAA) Programs Enacted by Congress in 1965, the Older Americans Act (OAA) addresses the lack of social services for older adults in the community. The OAA offers: Legal assistance Caregiver support In-home services Transportation Nutrition programs These services are typically free or available on a contribution basis. Like the Senior Care Act, the OAA programs are administered by KDADS through the AAAs. Medicare and Medicaid In-Home Services If you are under a physician’s care and require home health care services, Medicare or Medicaid might cover these services for short-term needs, provided there is an established care plan. Coverage requires using a home health agency certified for Medicare and Medicaid services. Additional financial support may come from: Private insurance Medicare supplements Long-term care insurance Many home health agencies also offer private pay options for those needing additional or non-covered services. Home and Community-Based Services (HCBS) Programs For those needing more extensive support, the HCBS programs may be an option. To participate, you must: Be approved for Medicaid (KanCare) Meet the functional eligibility criteria The initial assessment is carried out by the AAAs, such as the Jayhawk Area Agency on Aging for residents in Douglas County. HCBS programs are coordinated by Managed Care Organizations (MCOs) under KanCare, and care plans might include: Adult Day Care Personal Care Services Personal Emergency Response Home Telehealth Medication Reminders Enhanced Care Services, and more The HCBS Frail Elderly (FE) Waiver is aimed at adults aged 65+ who meet the criteria for nursing home placement, are Medicaid eligible, and require assistance with activities of daily living.

Choosing a long-term care facility can be a daunting experience. Most people have no idea where to begin. There are so many things to consider! So many questions! KABC has compiled a list of eight important questions to ask and have answered, to help make your decision a bit easier. For more information and additional tips, please check out our resources, “ Is This the Nursing Home to Choose? ” or “ Planning for Better Care. ” 1) What is the resident to staff ratio? During your tour, inquire about the number of staff in the facility vs number of residents. A higher staff ratio often means residents receive more personalized care and attention. It can also lead to better outcomes for residents including reduced rates of infection, fewer falls and improved quality of life. 2) How do you handle medical emergencies and provide ongoing care? Medical emergencies can happen at any time. What procedure does the facility have in place for handling emergencies while still providing ongoing care to other residents? Delays or inadequate response can have serious consequences for resident health and well-being. Don’t hesitate to ask! Your loved- one’s safety depends on it! 3) What types of recreational activities and social events do you offer? Quality of life extends beyond medical care. Ask about the activities and other events offered. Social isolation can have a negative impact on a person’s mental and physical health, so it’s important for residents to have opportunities for social engagement and connection. A vibrant community enhances residents’ well-being. 4) What safety measures are in place to prevent falls and accidents? Ensuring safety is paramount for residents in long-term care facilities. Falls are a serious concern, especially if call lights go unanswered. When touring, ask about staff response times to call lights, and what protocols are in place to prevent falls. If a fall occurs, does staff call 911? Do they attempt to pick up the resident or wait for help? Is the fall reported to the Kansas Dept. for Aging & Disability Services? (FYI - reporting is mandatory.) 5) How do you ensure that residents receive personalized care plans tailored to their needs? During your tour, always ask about the process for creating individualized care plans. Advocate for person-centered care. How does the facility assess resident needs and preferences to make sure they receive the care they require and deserve in a dignified fashion? 6) What is the protocol for administering medications to residents? How do you assure accuracy and compliance? Accurate medication administration/management is vital for the health and safety of residents. Ask how the facility maintains accuracy in dosage and documentation. Understanding these processes can help assure your loved-one receives the right medication at the right time. 7) What are your dining options and meal plans offered, including any special/restricted dietary accommodations? Nutrition tailored to individual need, including religious/cultural belief, food preferences or medically-restricted diets is crucial for the well-being of any resident. Ask how these needs are met. Knowing your loved-one is getting the proper nutrition can provide peace of mind. 8) What types of therapies and rehabilitation services are available on-site for residents who require them? Fostering holistic well-being means addressing both physical and mental health needs in long-term care settings. Ask about the availability of physical, speech and occupational therapy services. Are they available in-house? Do you offer mental health support? Understanding these services can ensure the facility offers multidisciplinary care.

Recently, we have been disheartened by legislative actions that undermine efforts to improve staffing standards in nursing homes, particularly in Kansas. H.R. 5796 , co-sponsored by Representatives Tracey Mann, Jake LaTurner, and Ron Estes, seeks to disapprove a federal staffing standard minimum rule that would greatly benefit residents of nursing facilities. Similarly, S.3410 , co-sponsored by Senators Roger Marshall and Jerry Moran, aims to address the same issue in the Senate. If passed, these legislations would prohibit the Secretary of Health and Human Services from implementing the final settings rule for minimum staffing in nursing facilities. The Nursing Home Minimum Staffing Rule finalized on April 22nd will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day (hprd) of total staffing, including a defined number from both registered nurses (0.55 hprd) and nurse aides (2.45 hprd). It will also require facilities to have a registered nurse onsite 24 hours a day, seven days a week. At the heart of this issue is the need for adequate staffing levels in nursing homes. Research consistently shows that higher staff-to-resident ratios lead to better outcomes for residents, including reduced rates of infections, fewer falls, and improved overall quality of life. By opposing the implementation of a federal staffing standard minimum rule, these legislators are failing to prioritize the well-being of vulnerable older adults in Kansas and across the nation. Additionally, it's disappointing to see the nursing home industry diverting attention away from the real issue at hand. Instead of lobbying against essential staffing regulations, they should be directing their efforts towards hiring and retaining qualified staff, ensuring fair wages, and creating supportive work environments. Working in a nursing facility is a skilled job that deserves respect, and addressing the staff shortage requires dedicated time and attention. However, amidst these challenges, we find hope in the actions of the Biden administration and advocacy organizations who have pushed for measures to improve staffing standards in nursing homes. We applaud their commitment to addressing this critical issue and urge them to continue their efforts. In Kansas, the Medicaid program spends $95,000-$108,000 annually per resident for often sub-standard care. The state allocates approximately $862 million to long-term care facilities, yet Kansas ranks 46th in addressing the shortage of nurses and nurse aides. Taxpayers deserve greater value for their money, and older Kansans deserve improved long-term care options given the consistently poor performance of many in this industry. We cannot afford to ignore this problem any longer. To effectively address the staffing shortage problem in Kansas, we must also look to other states for guidance and best practices. By learning from successful initiatives implemented elsewhere, we can tailor solutions to suit the unique needs of our state's long-term care facilities. Furthermore, it's crucial to foster a collaborative effort that includes the voices of long-term care residents and staff in these discussions. By actively involving those directly impacted by staffing challenges, we can develop more comprehensive and effective strategies to ensure quality care for all individuals in nursing homes. We encourage our readers to act. Contact your Kansas Congressional delegates and share your stories about why staffing is critical to improving quality metrics across the board. Your voices matter, and together, we can make a difference in the lives of countless individuals in long-term care facilities.

When considering long-term care options for yourself or a loved one, it's essential to understand the differences between nursing facilities and assisted living facilities. While both offer supportive environments for individuals needing assistance with daily activities, they serve distinct purposes and cater to varying levels of care needs. Let's delve into the comparative aspects of these two types of facilities to help you make an informed decision. Medical Services: Assisted Living: Assisted living facilities primarily focus on providing assistance with daily activities while offering varying levels of medical attention. Residents may receive support such as transportation to medical appointments and assistance with medication management. Additionally, specialized care areas may be available for individuals with conditions like dementia. Assisted living facilities are not regulated by the federal government but, in Kansas, are licensed by the Kansas Department for Aging and Disability Services. Nursing Home: In contrast, nursing homes, also known as skilled nursing facilities, offer round-the-clock, 24-hour medical care, typically with more staff than an assisted living facility. A nursing home setting may be appropriate for individuals who need extended post-operative care, complex medical monitoring, nursing, medical, social, and rehabilitative care. Moreover, nursing homes provide rehabilitative services such as physical, occupational, respiratory, and speech therapy for residents in need. Nursing homes are subject to more government oversight by both the state and federal governments. Living Space: Assisted Living: Residents of assisted living facilities typically reside in individual or shared apartments equipped with kitchenettes, bedrooms, and living areas. Common spaces encourage social interaction and participation in communal activities, including dining areas, activity rooms, salons, and gardens or outdoor walkways . There may be accommodations for pets. Nursing Home: Nursing homes typically provide individual or shared (semi-private) rooms with en-suite bathrooms. While the living arrangements may be more compact, residents still have access to common areas for meals and activities. Assistance with Daily Activities: Assisted Living: Assisted living facilities offer light support with daily tasks like bathing, dressing, and meal preparation, tailored to the residents' needs. Laundry, housekeeping, and meal services are also available. Nursing Home: Residents of nursing homes often require more extensive assistance with daily activities. Staff members should assist with personal care tasks, medication management, meal preparation, and housekeeping. Recreational Activities: Assisted Living: Assisted living facilities prioritize providing a wide range of activities to promote physical and social engagement among residents. From exercise programs to creative expression and volunteering opportunities, these facilities foster a vibrant community atmosphere. Nursing Home: While recreational activities are also offered in nursing homes, they may be more limited in scope. However, supervised exercise sessions and various enrichment activities contribute to residents' overall well-being. Meals: Assisted Living: Residents in assisted living facilities may have the option to cook in their own kitchenettes or dine in communal dining rooms. Meal delivery services may also be available for added convenience and may require an additional cost. Nursing Home: In nursing homes, dieticians prepare meals for residents, considering their dietary preferences and restrictions. Residents can choose to dine in communal spaces or have meals served in their rooms. Cost and Insurance Coverage:  In 2023, the average cost for a semi-private nursing facility room in Kansas was $7,483. For an assisted living room, the median cost was $5,850. Nursing home care tends to be more expensive than assisted living, with costs varying based on factors like location and level of care required. Medicare may cover some expenses for nursing home care (up to 100 days) under certain conditions, whereas assisted living is typically not covered by Medicare. Because Medicaid is a joint federal and state public health insurance program administered by individual states, coverage for assisted living services varies. Medicaid is available for those who need nursing home care but can't afford it or have a restricted income. Medicaid will pay for nursing home care for persons who require that level of care and meet the program's financial eligibility requirements. A person can have no more than $2,000 of "countable" assets in Kansas to qualify for Medicaid. Overall, understanding the distinctions between nursing facilities and assisted living facilities is crucial for selecting the most suitable option based on individual needs and preferences. Whether prioritizing medical care, independence, social engagement, or cost, there's a long-term care solution tailored to meet diverse needs. It's advisable to explore available resources, consult with healthcare professionals and KABC, and carefully evaluate each facility's offerings before deciding. KABC is here to help! We offer free Consumer Information Reports on all licensed adult care facilities to help you make an informed decision.

The latest data from the Long-Term Care Community Coalition paints a troubling picture of the prevalence of antipsychotic drug use among nursing home residents nationwide. Shockingly, over 250,000 residents are being administered these dangerous drugs, often without clinical justification. Antipsychotic drugs are too frequently used as chemical restraints, particularly among individuals with dementia or dementia-related diagnoses. Instead of receiving the services they are entitled to under federal law to live comfortably, residents are being sedated, robbing them of their autonomy and quality of life. Antipsychotics are drugs that are used to treat symptoms of psychosis such as delusions (for example, hearing voices), hallucinations, paranoia, or confused thoughts. They are used in the treatment of schizophrenia , severe depression and severe anxiety . In Kansas, the situation is no less alarming. Approximately 117 nursing facilities out of 300 in our state have 20% or more of their residents on antipsychotic medication. CMS Region 7 (serves Iowa, Nebraska, Missouri, and Kansas) had the highest regional rate (24.7%). This misuse of medication not only violates the rights of residents but also puts their health and well-being at risk with potentially severe consequences. Antipsychotic drugs are associated with a host of adverse outcomes in older adults, including heart attacks, strokes, Parkinsonism, falls, and even death. It is clear that the overuse of these drugs constitutes a serious threat to the safety and dignity of nursing home residents. Furthermore, the data from the Long-Term Care Community Coalition underscores the need for increased oversight and accountability within the long-term care industry. The fact that non-risk-adjusted data show such a high prevalence of antipsychotic drug use, coupled with a significant increase in potentially fraudulent schizophrenia diagnoses ( 194% increase between 2015 and 2019 ), is deeply concerning. In the " Final Report of the Kansas Senior Care Task Force to the 2023 Kansas Legislature ", the Kansas Senior Care Task Force, consisting of legislative and non-legislative members, recommended leveraging technology to connect highly specialized geriatric psychiatric prescribers across the state for consultation. The task force also recommended improving upon existing standard training and education by providing targeted education for surveyors, direct care workers, providers, prescribers, long-term care providers and caregivers on the use of prescribed psychotropic medication for older adults with dementia or geriatric behavior health conditions. We encourage all individuals to utilize the data provided by the Long-Term Care Community Coalition. In the data spreadsheet, you can filter by state and county. Thank you for your ongoing support in our mission to advocate for the rights and well-being of those in long-term care. Alarming Rate of Antipsychotic Drugging in US Nursing Homes

Spearheaded by the activism of Anna "Petey" Cerf, a "band of six" women from the Lawrence and Topeka communities came together with a shared vision: to improve the quality of long-term care for older adults and adults with disabilities in Kansas nursing homes. They were appalled by the poor conditions and mistreatment that they witnessed in many of these facilities and knew that something had to be done. These women, Jessie Branson, Anna "Petey" Cerf, Lesley (Lee) Ketzel, Harriet Nehring, Katie Pyle, and Bryona Wiley, were not content to simply accept the status quo. They refused to turn a blind eye to the suffering of those who were most vulnerable and were determined to make a change. Together, they founded Kansans for Improvement of Nursing Homes in 1975 and launched a reform movement through political advocacy, lobbying for changes to the laws and regulations that governed nursing homes. Their efforts were not always easy. They faced opposition and hostility from those who were resistant to change and had to fight tirelessly to make their voices heard. But they persevered, driven by a deep sense of compassion and a commitment to making a difference. The organization has evolved over the years (even changing their name to Kansas Advocates for Better Care), but the significant impact on the lives of countless individuals in Kansas remains. KABC continues to advocate for policies and regulations that improve the quality of care in all long-term care settings and provide support and resources to individuals and families who are navigating the complex world of long-term care. The legacy of these six women is a testament to the power of advocacy and the impact that dedicated individuals can have on their communities. They refused to accept things as they were and fought for change, making a profound difference in the lives of so many while emphasizing the fundamental right to be treated with dignity and respect. As we celebrate Women's History Month this March, let us remember the courage and determination of these trailblazing women, and let us recommit ourselves to the fight for better care for all. Their legacy continues to inspire us today.