Advocacy and Policy

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.

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.