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Nursing home and long‑term care groups urge permanent Medicaid add‑ons, rate reform and stronger state survey capacity
Summary
Hospitals, long‑term care associations and the state long‑term care ombudsman told KDADS that temporary Medicaid add‑ons have stabilized facilities but need permanence; they also urged steps to boost regulator survey staff and better support behavioral health in long‑term care.
Several statewide associations representing hospitals, nursing homes and assisted living providers urged KDADS to pursue permanent changes to Medicaid payments and to bolster regulatory survey capacity.
Larry Vanderwig of the Kansas Hospital Association told KDADS that hospitals are facing financial strain and an aging population: “In Kansas, 67 percent of our hospitals had a negative operating margin going into 2024 and our hospital's average cash on hand sits at 62 days while the national average is 218,” he said, and he highlighted avoidable days for behavioral health patients that keep beds tied up. Vanderwig urged expanding reimbursement ideas used for behavioral health to address avoidable long‑term care days.
Linda Mowbray, president and CEO of the Kansas Healthcare Association and Kansas Center for Assisted Living, said Medicaid currently “is paying about 82 cents on the dollar for the care that's being delivered” and asked KDADS to pursue rate methodologies and tiered capacity payments that reward facilities that accept higher Medicaid shares. “The last few years, we have had a Medicaid add on. And that has kept nursing homes from closing … that money needs to come into our facilities on a sustained basis,” she said.
Haley O'Doin, the state long‑term care ombudsman, requested increased surveyor capacity at KDADS, saying residents and advocates report slow regulatory responses to problems that begin as “little things” and can grow into more serious incidents if not addressed: “Our ask would simply be for that ... increased focus of funds and attention to increase state surveyors for these homes.”
Why it matters: Testimony tied facility financial stability, Medicaid reimbursement and survey capacity together: speakers said sustained payments and timely inspection/enforcement are both needed to protect residents and keep providers solvent.
Unresolved details: No specific dollar amounts for a permanent nursing‑home Medicaid add‑on were provided in testimony. O'Doin and others urged competitive wages and hiring for KDADS survey staff but did not offer a precise staffing target. Vanderwig provided hospital finance figures and statewide avoidable‑day totals as evidence of system strain.
Ending: Speakers asked KDADS to include sustainable rate models, behavioral health add‑ons, and surveyor pay/ staffing remedies in FY27 budget requests so facility closures and delayed enforcement can be avoided.
