nursing homes

Andy Marso / Kansas News Service

Kansas continues to rank among the worst states when it comes to sedating nursing home residents with powerful antipsychotic drugs.

Janell Wohler and Kate Rieth of the Linn Community Nursing Home told their colleagues Tuesday that it doesn’t have to be that way.

Wohler is the administrator and Rieth is the director of nursing at the facility, which has eliminated off-label use of antipsychotics for residents over the last five years.

File Photo / Kansas News Service

KanCare is a $3 billion program that provides health insurance to more than 425,000 Kansans — complex and bureaucratic by its nature.

And lately it seems the privatized Medicaid program has drawn more than its share of complaints from Kansas medical providers, beneficiaries and applicants.

Some are the result of a switch in 2013 to management not by the state but instead by three private insurance companies, while others stem from court rulings or policymaker decisions.

Andy Marso / Kansas News Service

All that Michael Sykes has to show for his months-long quest to get his mother’s nursing home bed covered by Medicaid is a pile of paperwork.

Kansans like Sykes have been facing long waits to find out if they qualify for health coverage under KanCare, the state’s privatized Medicaid program. The state has cleared up much of the backlog over the past year, but thousands of applications for long-term care coverage remain hung up.

File Photo

An Oklahoma company said Thursday it has reached an agreement with the Kansas Department of Health and Environment and won’t have to suspend dental services to about 360 Kansans in nursing homes.

Leaders of Sterling Dental said earlier in the week that they would halt services to Kansans whose Medicaid applications are pending because of payment delays caused by a persistent backlog of applications.

Andy Marso / Kansas News Service

Editor’s note: An update to this story was posted at 5 p.m. Jan. 26.

About 350 elderly and disabled Kansans are suddenly without dental care after an Oklahoma City company informed nursing homes that it was suspending services for Kansas residents whose Medicaid applications are pending.

The company, Sterling Dental, sends dentists to nursing homes in Oklahoma, Missouri and Kansas for on-site care.

Andy Marso / Kansas News Service

The Brownback administration has increased advance payments to nursing homes while a backlog of Kansas Medicaid applications persists.

The administration instituted advance payments of 50 percent for nursing homes residents with pending applications last spring, when almost 11,000 applications backed up past the 45-day federal processing limit.

Andy Marso / Heartland Health Monitor

The Medicaid application backlog in Kansas is on its way back up, threatening months of progress on a coverage problem that has vexed health care providers across the state.  

For more than a year, providers that rely on Kansas Medicaid, or KanCare, have been stung by delayed payments as they wait months for eligibility determinations that by federal rule are supposed to take no more than 45 days.

For three months, 32-year-old Tara Hegger has lived in the intensive care unit at Mercy Hospital.

She passes the time listening to music, visiting with family members and watching TV, mostly comedies. They keep her mind off of a painful decision that inches closer every day.

“The social worker came to me and basically told me I had to leave, because my days ran out," Hegger said, pausing between the pumps of oxygen provided by a ventilator next to her. "I had to make a choice.”

Like other Missouri patients in her situation, she will have to leave the state to find a nursing home that accepts her insurance — a dilemma tied to the state's low Medicaid reimbursement rate for long term care.

Jim McLean / Heartland Health Monitor

Legislative auditors said Wednesday they can’t confirm that the Medicaid application backlog numbers state officials have reported are correct.

Applications have been backlogged for about a year following the rocky rollout of a new computer system, an administrative decision that funneled all applications through a single state agency and a larger-than-expected influx of applications during the Affordable Care Act open enrollment period.

Andy Marso / Heartland Health Monitor

The state’s Medicaid application backlog is making work more stressful for Angela Moore, executive director of Sharon Lane Health Services in Shawnee.

Moore’s nursing home has 110 employees caring for about 70 elderly and disabled residents, and she has cash flow worries because of persistent problems with the state’s Medicaid eligibility system.

At one point recently she was waiting on Medicaid coverage approval for 17 residents — which means Sharon Lane was providing free care for almost one-fourth of its clients.

Dan Margolies / Heartland Health Monitor

At Truman Medical Center’s nursing home facility in eastern Jackson County, Missouri, Dr. John Dedon drops by to chat with one of his patients, a spritely 82-year-old woman who’s lived there for the last four years.

“I’m just stopping by to say hi and see how you’re doing today,” he says, taking a seat next to her in the facility’s bustling hallway. “How are you feeling? Are people treating you O.K.?”

Dedon is probing not just for physical symptoms but looking for changes in his patient’s mood and affect. 

File photo / Heartland Health Monitor

Nursing home representatives breathed a sigh of relief Friday as the state announced a program to help them get Medicaid money for some residents whose applications are stuck in processing delays.

The delays — traced back to a computer system switch in July and administrative changes in January — have led to thousands in unpaid bills for facilities and prevented some frail Kansans from finding a nursing home bed.

File photo / KHI News Service

Kansas legislators adjourned their regular session and left on a monthlong break without passing a “bed tax” increase that nursing home organizations say is vital to their members.

Golden Years Senior Care Center

Word that the Kansas Legislature has passed a bill allowing the state to fine adult care facilities that aren’t paying into a statewide medical liability protection fund brought Marie Jenks to tears.

For Jenks, the owner and operator of Golden Years Senior Care Center in Hutchinson, Thursday’s news was the last straw in what has been a series of difficult months.

The small facility she has owned for 30 years lost its coverage after a storm damaged the roof, and she’s been unable to secure a new plan that will satisfy the requirements of the Health Care Stabilization Fund.

Andy Marso / Heartland Health Monitor

Judy Kregar is not a member of the Rotary Club in nearby Greensburg, but she decided to go when she heard Gov. Sam Brownback would be at the club’s recent meeting.

Kregar, the administrator of a small nursing home in nearby Bucklin, wanted to tell Brownback in person about the struggles some of her residents are having getting their Medicaid applications and annual renewals processed.

Advocates for nursing home residents want legislators to mandate that facilities have more and better-trained staff.

Nursing home representatives say they would like to provide that, but they don’t have the money or the available workforce to do so.

Several members of the House Children and Seniors Committee expressed skepticism Tuesday about a bill that would increase staffing and training requirements at the state’s assisted living facilities.

A representative of a large Kansas nursing home system testified Wednesday for the right to self-insure its facilities under the Health Care Stabilization Fund, as hospitals are allowed to do.

Legislation passed last year added hundreds of nursing homes to the state fund, which backs up health care providers’ private medical malpractice insurance with additional coverage to diminish their financial risk.

Hundreds of nursing homes and other assisted living facilities in Kansas will be required to participate in a fund meant to spread the risk of malpractice lawsuits starting next month. Advocates for those facilities say the change is a plus, but it has insurance agents scrambling to find liability coverage for their assisted living clients in a limited market.

The Kansas Health Care Association and Kansas Advocates for Better Care don’t usually see eye to eye on much.

KHCA, which represents the state’s for-profit nursing homes, is quick to argue against passing laws that might increase their costs or add to their regulatory burden.

KABC typically says the state doesn’t do enough to improve conditions in poor-performing nursing homes and advocates for tighter regulation.

Susie Fagan / KHI News Service

 

Experts say powerful antipsychotic drugs — sometimes given in combination — are used too much and often inappropriately as “chemical restraints” or sedatives to control the behavior of Kansas nursing home residents suffering from Alzheimer’s or other dementias, and that efforts to curb the practice so far are showing weak results compared with other states.

Dave Ranney / KHI News Service

The Kansas Department for Aging and Disability Services is changing the way it shares its reports on nursing home conditions with the public.

The new system, officials say, will make the reports more accurate and more accessible.

But for a group that supports nursing home residents and their families, the changes will make it harder to know which homes are the subjects of complaints and investigations of substandard care.

KHI News Service

Providers of home and community-based (HCBS) Medicaid services and their state overseers are preparing for a raft of new federal rules that are intended to assure that the people who receive the services have more say in how they are helped and that their living conditions are “non-institutional.”

The regulations could have major consequences for many beneficiaries and the businesses and organizations that help them, particularly for some senior care providers who operate assisted living facilities attached to or in near proximity to nursing homes.

Mark-Adkins / Flickr-CC

As the parents of baby boomers move into their twilight years, an elephant enters the room: when should we start to talk about long-term care? 

With 12 million Americans already in need of attention and a further 15 million just around the corner, that question of how to best look after ourselves and loved ones is becoming more important by the day.

Atchison Nursing Home Tops State List

Feb 13, 2014

The non-profit Kansas Advocates for Better Care is out with its annual list of nursing homes cited by state inspectors for the fewest deficiencies.  The facility at the top of the list is in Atchison, Kan.

The Dooley Center, in Atchison, has not been cited for a single violation the past three years. Mitzi McFatrich, who heads Kansas Advocates for Better Care (KABC), says 20 nursing homes in the state have had five or fewer deficiencies in the last three years.

Group Seeks To Increase Kan. Nursing Home Requirements

Sep 11, 2013

A nursing home watchdog group says Kansas nursing home residents would benefit from increased requirements for direct care from nurses and nurse-aides in nursing homes. Current regulations require adequate staffing to provide each resident a minimum of two hours of direct care daily.

The state is recognizing eight nursing home facilities for offering innovative ways of caring for older Kansans. The PEAK awards recognize facilities that focus on providing better quality of life for seniors.

“For the longest times, nursing homes and senior living communities have been patterned after hospitals and warehousing-type structures that were very rigid and very structured environments and gave very few limited number of choices to those that live there,” said Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services.

Choosing a Long Term Care Facility

Jan 24, 2011

Kansas City, MO –

Few Kansas Nursing Homes Deficiency-Free

Jan 7, 2011

Prairie Village, KS – For more than a decade, the non-profit Kansas Advocates for Better Care, or KABC, has released an annual report detailing the best and worst performing nursing homes in the state. The findings are based on state inspections over a three year period (the inspections occur once every 12 to 15 months).