Kansas Struggles with Low-Care Nursing Home Residents, Ranking Among the Worst in the Nation

Libby Hastings • September 3, 2024

The United Health Foundation recently released the America’s Health Rankings® 2024 Senior Report, offering a detailed look into the health and well-being of older adults across the United States. The report examines 52 measures of health from 24 distinct data sources, providing a comprehensive overview of how each state supports its aging population. Unfortunately, Kansas continues to lag in a crucial area—low-care nursing home residents.


Kansas ranks #47 in the nation (same as last year, 2023) for the percentage of low-care residents in nursing homes, meaning that a higher proportion of older adults who require minimal assistance are still being placed in institutional settings. With 17% of Kansas nursing home residents classified as low-care, the state is among the worst in the nation, surpassed only by Missouri and Oklahoma, which have even higher percentages.


Alaska wasn’t rated in this category, which means Kansas might be the 4th worst, or possibly the 3rd worst, depending on how you interpret the data. In contrast, Hawaii leads the nation with only 2.6% of its nursing home residents classified as low-care, followed by Maine at 2.9%. Montana narrowly edged out Kansas, ranking 46th with 16.3%.


This troubling statistic highlights the need for more readily available long-term care services and supports within Kansas communities, allowing residents aged 65 and older the option to delay or avoid institutional care. The availability of these services is vital for maintaining the independence and quality of life for older adults.


In the broader context of national healthcare rankings, Kansas fares somewhat better, coming in at 25th overall. However, neighboring states show a wide range of rankings, with Colorado ranking 2nd, Nebraska at 14th, Missouri at 41st, and Oklahoma close to the bottom at 46th.


The report also identifies other critical areas where Kansas must improve:


  • Drug Deaths Among Older Adults: The number of drug-related deaths per 100,000 adults aged 65 and older has risen dramatically in Kansas, increasing by 61% from 5.7 (2017-2019) to 9.2 (2020-2022).
  • Healthcare Disparities: There is a significant disparity in avoiding care due to cost among older adults in Kansas. Those with less than a high school education are 15.2 times more likely to avoid care compared to those with a college degree.


These findings underscore the importance of addressing the systemic issues in Kansas’ long-term care and healthcare systems to ensure that all older adults have access to the care they need, regardless of their level of required assistance or socioeconomic status. As the state continues to rank poorly in areas like low-care nursing home residents, it’s clear that more needs to be done to support our aging population.

A close up of a person holding another person 's hand.

Advocacy in Action (June 2025): One Investigator, 70 cases, APS is Stretched Too Thin

May 29, 2025
In a recent article published by The Beacon, reporter Blaise Mesa spotlights a heartbreaking case that exemplifies both the critical importance and serious strain facing Kansas Adult Protective Services (APS). The article, “One elder abuse investigator has 70 cases. Kansas doesn’t say how swamped other caseworkers are,” tells the story of Shirley Crow, an 85-year-old woman with Alzheimer’s whose family trusted a caretaker to manage her daily medications and appointments. That trust was broken. Despite filing a report with APS, Shirley’s family received few updates. Weeks after their report, Shirley passed away. Her case remains open—one of 10,000 APS investigations initiated in Kansas each year. The assigned APS caseworker? She has 70 other cases. This is not a story about blame. As Shirley’s daughter-in-law, Stacy Crow, told The Beacon , “We got an investigator that I truly believe has a heart… I understand they have an overwhelming demand… I don’t fault them. I just want things to change.” And so do we. Systemic Overload and the Urgent Need for Reform The Kansas Department for Children and Families (DCF), which oversees APS, has not publicly disclosed average caseloads. While DCF clarified post-publication that they do track this information, they choose not to release it, citing confidentiality. The lack of transparency and standardization prevents meaningful accountability and reform. National standards suggest 20–25 cases per worker is a manageable caseload. Kansas APS staff, in some cases, are handling double or triple that amount. With cases increasing year over year— 18,056 in fiscal year 2025 alone—the risk of delayed intervention or missed warning signs only grows. This Is a Wake-Up Call. At KABC, we continue to push for better protections for older adults, more robust support for APS investigators, and greater transparency and accountability from state agencies. In our recent blog post, “ What Happens When You Report to Adult Protective Services? ” we outline the crucial role APS plays in protecting vulnerable adults and how reporting suspected abuse can quite literally save lives. To report suspected abuse, neglect, or exploitation of a vulnerable adult in Kansas: For older adults living at home in the community or in facilities licensed by the Kansas Department of Aging and Disability Services when the perpetrator is not a resident of or staff of the facility, report to the following: Adult Protective Services (APS): 1-800-922-5330 If an emergency, call your local law enforcement agency or 911 Reporting initiates a multi-step process involving a prompt in-person visit, interviews, and, when needed, development of a service or prevention plan. The goal of APS is to protect, not to punish- to connect individuals to medical care, housing, legal services, or safety planning. But APS cannot fulfill that mission if it's underfunded, overwhelmed, and operating in the dark.  What Needs to Change: Transparency: Kansas must publicly release average caseload data and investigation timelines. Support for APS Workers: State leaders must prioritize hiring and retaining qualified APS staff and ensure manageable caseloads. Federal Investment: Continued and expanded federal funding for APS is essential—not optional. Public Awareness: Communities need to understand when and how to report suspected abuse, and how they can be part of the safety net. The APS system should be a lifeline, not a last resort.

5 Questions to Ask When Choosing a Long-Term Care Facility

May 21, 2025
Choosing a long-term care facility for yourself or a loved one is one of the most important decisions you can make. Beyond basic safety and cleanliness, the right facility should support a person’s independence, dignity, and overall quality of life. To help you make an informed choice, here are five essential questions to ask, along with key follow-ups that can give you a deeper sense of what daily life will be like at the facility. 1. How does the facility support independence and person-centered care? Person-centered care means that residents are active participants in their care and daily routines. Ask: Can residents choose when to wake up and go to bed? Are meals and activities tailored to individual preferences? Is there flexibility for “early birds” and “night owls”? Look for signs that staff respect residents’ individuality—such as accommodating dietary preferences and encouraging participation in meaningful activities. 2. What medical and rehabilitation services are available on-site? Quality care goes beyond assistance with daily activities. Ask about: Access to hospice care and pain management Availability of wound care and ostomy specialists In-house physical, occupational, speech, and mental health therapies Staffing levels—how many nurses and aides are on duty at different times of day? These services can have a major impact on recovery, mobility, and comfort. 3. What is the atmosphere like during meals and activities? Daily life should be engaging and social. Ask to observe a meal or an activity session. Consider: Are residents out of their rooms and interacting with others? Do meals look appetizing and meet special dietary needs? Is assistance with eating provided promptly and respectfully? Also ask about field trips, volunteer involvement, and whether there is an active activities room or calendar of events. 4. What do current residents and families say about their experience? Talking to those already living in or visiting the facility can give you valuable insight. Ask residents: Do staff respond quickly when you call for help? Do you enjoy your meals and feel your privacy is respected? Are you involved in decisions about your care? Ask families: Are you promptly notified of any accidents or health changes? Do you feel comfortable raising concerns? Is there a Family Council and does the facility listen to it? 5. How transparent and responsive is the administration? A responsive leadership team is key to resolving issues and maintaining quality. When meeting with the Administrator or Director of Nursing, ask: How do you handle complaints? How are staff trained and how long do they typically stay? What’s your policy on resident rights, such as refusing treatment? You can also ask to review the admission contract, learn about costs and refund policies, and understand how care decisions are made if the resident is unable to speak for themselves. Want more questions to ask? Visit our full guide: Is This the Nursing Home to Choose?  It includes detailed sections on services, nursing care, residents' rights, and conversations to have with administrators, staff, and families. At Kansas Advocates for Better Care, we believe everyone deserves compassionate, dignified, and person-centered long-term care. Asking the right questions is the first step to getting it.