[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6427315,"mediaKeyId","5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc","parentId",5893224,"title","Committee hears examples of immediate jeopardy citations and multiday civil monetary penalties","audioSeconds",715,"startMs",2572000,"endMs",3287000,"viewUrl","/Search/View?dp=1&key=5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc&start=2572&end=3287","thumbnailUrl","https://assets.pipeline.soar.com/5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc/thumbnail_2572000.jpg","articleUrl","/articles/6427315/Kansas/Committee-hears-examples-of-immediate-jeopardy-citations-and-multiday-civil-monetary-penalties","mediaUrl","https://secure.pipeline.soar.com/6427315-8ab184c9273e1109a0b5168ee57a9623/orig.mp4?Expires=1775206042&Signature=S0x7fCnp4xN~YxB~6vCluDC41572qppSYo1qMh1Leh42NZRuIpYg0QvUtxp4huNYPjlHLFTw3Vr~17eSPpsIwYAvEd06FU3RYYbEtS3yuUEk~OtM-HvZD1Mab7lpWpPD5tDokjmU6o5YI2Nh8073JQCjzXXeuAnFJR6V1hWzEMjC9X9VY9sZAZ~KlQr2lBDl7-RVI2G8Yp1XwOiUMFvwPVa7sM4tP1c9qd7l~xbec0XTZ-0pCstFlnP4EsWYDWsH9Gpcqor98q~EEAB4-JMewM6oWAU6y4032XUfK~CtSse84IqjPQiDGqZiUdzmRKB7GKbUULQZ28NykzMgn8mVQA__&Key-Pair-Id=KUT5TJCACFTXG","author","Special Committee on State Employee Compensation","date","2025-10-01T21:54:34Z","article","Kansas Department for Aging and Disability Services staff and nursing-home operators discussed how enforcement works when surveys identify harm or immediate-jeopardy conditions, including CMPs and the appeals timeline.

Lacey Hunter, commissioner of survey certification and credentialing for KDADS, reviewed how CMS and the state categorize deficiencies and allocate enforcement remedies. KDADS follows CMS guidance that groups enforcement into remedy categories; the most severe enforcement (including temporary management, termination or denial of payment) is required when immediate jeopardy to resident health or safety is found. A civil monetary penalty can be imposed as a per-instance or a per-day amount. Hunter said CMS imposes CMPs in practice for immediate jeopardy at high per-day rates — she cited examples where CMS used per-day amounts in the thousands to tens of thousands of dollars during immediate-jeopardy periods.

Hunter described the timeline for enforcement and appeals: KDADS issues a statement of deficiencies up to 10 days after a survey exit; a facility has 10 days after receipt to request an informal dispute resolution (IDR); if CMS issues a CMP, the facility has 10 days to request an independent informal dispute resolution (IIDR). KDADS staff noted CMPs run concurrently with IDR/IIDR processes and can be held in escrow while appeals are pending.

Operators told the committee their experience includes cases where facilities self-reported incidents and immediately worked to abate potential threats to residents, but still received IJ citations and substantial CMPs. Ricky Turley, director of health services for Lakeview Village in Lenexa, described two incidents at his not-for-profit community that were similar in nature (elopements or door/badge failures) but resulted in different enforcement outcomes in nearby states; for one Kansas incident his facility received an IJ citation despite no resident harm and rapid response. He said his later appeal (IDR) was effectively decided by KDADS staff and did not lead to a different outcome.

KDADS and providers said the CMP reinvestment fund (federal CMP monies split with the state) can be used for training and quality improvement projects; Hunter noted that some funds are held as reserves for emergency use such as receiverships. KDADS reported approximately $10 million in the CMP reinvestment fund, part of which is reserved for emergency receivership responses.

Ending: Committee members asked KDADS to provide information on the structure and timing of CMP notices and the state's use of civil monetary reinvestment funds; providers pushed for clearer, more consistent approaches to severity and scope determinations and independent appeal mechanisms.","mediaType","Video","parentTitle","Special Committee on Health and Social Services 10/01/2025","oneSentenceSummary","Officials and providers described how immediate-jeopardy (IJ) findings and civil monetary penalties (CMPs) are assessed, the potential size of fines, and how penalties can be held in escrow while facilities pursue dispute processes. Providers said they sometimes self-report incidents yet still receive high-level enforcement actions.","taxTitle","Special Committee on State Employee Compensation, Special & Select, Committees, Legislative, Kansas","taxId",77719,"location","Kansas","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6427322,"KDADS outlines staffing, training shortfalls as survey workload grows",1092,63000,1155000,"/Search/View?dp=1&key=5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc&start=63&end=1155","https://assets.pipeline.soar.com/5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc/thumbnail_63000.jpg","/articles/6427322/Kansas/KDADS-outlines-staffing-training-shortfalls-as-survey-workload-grows","https://secure.pipeline.soar.com/6427322-6c4660ce3683c135508c413275c284eb/orig.mp4?Expires=1775206042&Signature=Abt-hZKS~j9l8XiRXrc8MEcq2z~iVYTgz-WCO1q6toKq2keXKfNc3DR3bWooiyQBNebI13Fp3rHCiajjeCrjCQ39SCtEwQoICt1DQRHBXzNJfSLRiPmNOaso-GJgb3Rk49hiTfwkDW3Qjjfd9Vsaui56dtvDdb73HFT3FIIDav8m3~lCP-qaYIZu80-r8Bh1B2lroy~7hP04Onmd20oOh07ycNtKyNCnhiyETpRbo5DdNta13URwlQndXyA25WdltnKFWafn3ClS28uM-tMChN8IIz5xHYoOOKt5E1ryJkNevM6ub-F0Rk0A3ot~fEKKcx-ZZULSq7GUWm7YBxpIaw__&Key-Pair-Id=KUT5TJCACFTXG","Lacey Hunter, commissioner of survey certification and credentialing for the Kansas Department for Aging and Disability Services, told the Special Committee on State Employee Compensation that the state is behind federal survey requirements because of staff shortages and the length of training required to certify new surveyors. Hunter said Kansas currently certifies about 303 federally certified nursing facilities and about 525 state-licensed-only adult care homes, and that federal rules call for a recertification survey “no greater than every 15.9” months. “We are currently as a state sitting at an average of 19.9,” Hunter said.

Hunter outlined the surveyor training pipeline: state onboarding plus approximately 1,500 pages of federal reading and a sequence of online tests and observation surveys. She said most recruits take about six months from hire to independent surveyor. “Most of our staff are getting all this done, getting all their tests passed in about six months from the date of hire,” Hunter said, adding that the Centers for Medicare and Medicaid Services (CMS) expects a shorter ramp-up.

To address vacancies, Hunter described a recent regrade and salary negotiation with the Department of Administration. The licensure unit’s approved headcount was reduced from about 51.5 positions to a smaller number; Hunter said 28 of the original 51.5 positions were vacant earlier and the department eliminated 15 positions in the reclassification, leaving 13 vacancies at the higher starting salary. Hunter said the new salary framework allows non-RN hires to be offered a starting pay about $60,000 and registered nurses about $67,000, with a roughly $2,000 training completion bonus (raising those levels to $62,000 and $69,000 after passing required training).

Hunter said CMS permits states to use a broader pool of professionals as surveyors—social workers, dietitians, sanitarians and others commonly called “generalists” in other states—but Kansas has been cautious. She said a key barrier is the difference between exempt and nonexempt pay status: many potential non-RN hires would be nonexempt and eligible for overtime, while RNs in Kansas are currently treated as exempt salaried employees. Hunter explained that overtime exposure would substantially increase budget needs and complicate team dynamics on multi-day surveys: “It is often not right next door…when we are looking at staff who are not exempt and held to 40 hours a week or we’re paying overtime…that part will make a little more sense in my next presentation actually.”

Committee members asked about alternatives Hunter said the agency is pursuing: targeted recruitment at career fairs, state fleet vehicles for surveyors, and revised pay offers intended to make state jobs more competitive with local employers. Hunter and other KDADS staff said they are also discussing flexibility about who may serve on survey teams, but emphasized any change requires coordination with the Department of Administration and attention to state pay rules and federal CMS requirements.

Hunter framed the problem as operational and legal: surveyors must be experienced and trained, the federal standard for the recertification frequency is fixed, and CMS has minimum expectations for who may act as a surveyor and how long training should take. She recommended a combination of strategies—higher starting pay, more recruitment, and careful consideration of generalist hires—to decrease Kansas’ average recertification interval toward the 15.9-month target.

Ending: KDADS officials said they will return to the committee with updated vacancy and hiring outcomes and asked for legislative flexibility where state rules constrain recruitment options.","Kansas Department for Aging and Disability Services officials told a legislative committee they face persistent vacancies and a lengthy training pipeline for nursing-facility surveyors, and they described a narrow set of options—higher pay, reclassification, or use of non-RN 'generalists'—to meet federally-required recertification timelines.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6427309,"Independent review vendors, expanded IDR options offered as path to fairness and speed",2847,16167000,19014000,"/Search/View?dp=1&key=5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc&start=16167&end=19014","https://assets.pipeline.soar.com/5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc/thumbnail_16167000.jpg","/articles/6427309/Kansas/Independent-review-vendors-expanded-IDR-options-offered-as-path-to-fairness-and-speed","https://secure.pipeline.soar.com/6427309-7d57349e3583d4cdf5a92de1db6da7b5/orig.mp4?Expires=1775206042&Signature=lGn0GJTGvnYvBMof~lF14VrM~~c85pQpST0G6p6woAcjXE5gLSxJyvlpbdOWSKXPv2WSNaSh9fiAntZ7Lpx-B0Uq3VIXjfNrojVGj--lxwEbrpZQs6wvkfglqKWLjfJLDZHrpyMdqwi1lSvGFilcrAzWzRnvS9sfvF~11PlTMAPbcwV5s1Sb03earrqvGlWGcocaxm6PR2BwyUZBy2d91uNwwP0MJdbQYvQqIhwIOMEAL-p4Ux4UxtZWfk8CP1aJLVGAT5CER9tW9whjFqLCpiogCX6Xrz9pp642xM2BEkPksEO8jKKHuHLQkkUY71cmQbEyuZjms6Xq7~4NHQV6Sw__&Key-Pair-Id=KUT5TJCACFTXG","Consultants and vendors who run independent review or survey contracts told the committee Kansas can reduce backlog and improve perceived fairness by adopting independent IDR/IIDR vendors and, where needed, contracting outside survey teams.

Bailey Brockmeier, managing director of IDR/IIDR at Improve Health, described the purpose of IDR and IIDR processes: IDR is a nonlegal, state-run informal review that lets facilities challenge survey findings; IIDR (created under the Affordable Care Act) is a separate independent review available when civil monetary penalties are imposed. Brockmeier said federal rules in the State Operations Manual (chapter 7) set minimum requirements for IDR and require independence for IIDR reviewers. She told the committee Improve Health holds URAC accreditation and follows conflict-of-interest and data-security standards; the company typically returns recommendations to states within about 16–18 calendar days after assignment.

Charlene Pachek Belitsky and Charlene Bea (Improve Health reviewers) described how an IIDR reviewer examines the written survey record and facility rebuttal and issues a recommendation to uphold, delete, or amend deficiencies. Improve Health and other accredited independent organizations provide standardized written rationale for recommendations that states may accept or forward to CMS, which has final authority.

Private survey contractor CertiServe told the committee it provides turnkey or supplemental survey services and can be mobilized quickly once a state contract is executed. Bob Foyer, CertiServe founder and CEO, said the procurement step and budget authorization are the main constraints: once the contract exists, CertiServe can start surveys within 30–60 days and often in a week for emergency assignments. He said pricing models vary (flat fee per survey, per-tag fees, or blended rates) and states often use multi-year contracts and purchase orders to control budgets.

Vendors and consultants identified practical considerations for Kansas: requirements to secure CMS approval for an IIDR approach; the need to ensure reviewers have clinical and regulatory expertise; and the ability to stand up portals and secure data exchange (the vendors highlighted URAC accreditation as a sign of systems maturity). Vendors suggested states could pilot independent IIDR for a year or sign a standing contract so the state can call on outside capacity during staffing shortfalls.

Ending: Committee members asked KDADS to explore contracting options, to provide a list of prospective costs for turnkey or supplemental survey services, and to consider an independent IIDR panel or vendor as a short-term measure while KDADS implements pay and recruitment changes.","Experts from Improve Health and private vendors told the committee Kansas could adopt independent IDR/IIDR vendors or outsource surveys to catch up with backlogs. They outlined accreditation, timelines and cost models and said states can contract quickly if statutes and procurement rules allow it.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6427302,"Ombudsman urges discharge notification expansion; residents report pharmacy fees and low personal-needs allowance",4441,17325000,21766000,"/Search/View?dp=1&key=5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc&start=17325&end=21766","https://assets.pipeline.soar.com/5893224-0cfcd3eff2ff5554a8480b5fdb52cbbc/thumbnail_17325000.jpg","/articles/6427302/Kansas/Ombudsman-urges-discharge-notification-expansion-residents-report-pharmacy-fees-and-low-personal-needs-allowance","https://secure.pipeline.soar.com/6427302-24f379ff4a6a125e80e8585e51ac68d7/orig.mp4?Expires=1775206042&Signature=J0~NzrvPKCTyJJUeJqwR6OsRaTeR0iKuM6m20CnLYrfUFdpFnTgNTNpjbXcdluZXmT9s5QkJGn-P8UzpWd1s1jxc99v-REuVafJwl6D5hm1oyaw4gDXnY5T69GsIFpogGClFB67G1KWzOjJ0aIZRGtQRzr29S3apClXrYtQ8yCJHCq3eZfeKfbL7JcZM7y-pOrRRHDPEPRsaATdRcaTvKJbE~PCe7iOB1ylT8jfzwzkQCWPZwxrqE3tGcdkEWc7j9N3GshV6~wo-8cL77A~VwyVEFLtsSjLie-Ln0tGA3xO4H7Ydfjdm9SNhYaWTc0V5DiGB-BdicBe--WtyDBDOhQ__&Key-Pair-Id=KUT5TJCACFTXG","Haley Ordoyne, Kansas State Long-Term Care Ombudsman, told the committee her office reviews complaints and advocates for nursing home and adult care residents and recommended expanding the state’s notification rules so the ombudsman is notified of facility-initiated involuntary discharges for all adult care home types, not only federally-certified nursing facilities.

Ordoyne said her office made roughly 2,300 facility visits in the latest reporting year and handled a variety of complaints—resident rights, abuse/neglect reports, involuntary discharges, care shortcomings, and facility environment issues. She described how some complaints start as low-level concerns but grow into larger investigations and that when residents die before a complaint is completed, the case closes and may appear as “not resolved” even though it was not addressed to the resident’s preference.

Ordoyne asked the Legislature to require that all adult care homes notify the ombudsman about facility-initiated involuntary discharges. She said doing so would allow the ombudsman to intervene more often and to work with residents and facilities to pursue options that keep residents in place where appropriate.

Ordoyne also said residents report being charged monthly pharmacy ‘service’ fees—ranging from about $100 to $300—if they use a pharmacy not contracted by the facility. She said residents and families view these charges as penalties that limit consumer pharmacy choice. The ombudsman asked for a statutory or regulatory review of that practice.

On benefits, Ordoyne recommended increasing the Medicaid personal-needs allowance (PNA) for nursing-home residents. She said Kansas’ current PNA is low (about $62 per month) and that a national advocacy group’s data show a national average near $73; she urged raising Kansas’ allowance and tying it to a cost-of-living adjustment.

Ending: Ordoyne asked the committee to consider requiring universal discharge notification to the ombudsman, to review pharmacy fee practices that restrict consumer choice, and to consider increasing and indexing the personal-needs allowance for Medicaid nursing-home residents.","The Kansas long-term care ombudsman urged requiring notice for facility-initiated involuntary discharges across all adult care home types, described complaints volume and case outcomes, and raised resident concerns about pharmacy surcharges and a low personal-needs allowance tied to Medicaid.","actionData","errors"]

Article not found

Committee hears examples of immediate jeopardy citations and multiday civil monetary penalties

KDADS outlines staffing, training shortfalls as survey workload grows

Independent review vendors, expanded IDR options offered as path to fairness and speed

Ombudsman urges discharge notification expansion; residents report pharmacy fees and low personal-needs allowance