Opinion Piece from Dave Ranney, KABC Board Member
Dave Ranney • April 1, 2025
Opinion piece from Dave Ranney, current KABC Board Member and retired newspaper reporter:
In a recent Kansas News Service story on Sen. Roger Marshall’s appearance at a town hall meeting in Oakley, Kansas, (pop. 1,982), a board member with the local nursing home said he’d hoped to hear about issues “…affecting nursing homes right now. Rural hospitals are hurting but all people wanted to do was scream at the senator.”
The board member’s concerns are valid and deeply troubling. Cuts in Medicaid spending will be devastating. Medicaid is the backbone of long-term care in Kansas; 57 percent of the state’s nursing home residents rely on Medicaid for their care. These are frail elders whose estates have been depleted. They have no money.
Medicaid reimbursement rates are, at best, break-even. They’re not ‘profit centers.’ Even a small reduction in rates will push many rural facilities to the brink of closure. Quality of care, too, is sure to suffer.
Medicare, unfortunately, does not cover nursing home care.
Rural families will be left with no choice but to move their loved ones far from home to receive the care they need and deserve. Already, eight of the state’s 105 counites are without a nursing home; at least 40 have only one.
National surveys have found that a fourth of the nursing homes in Kansas are providing sub-standard care, usually due to inadequate staffing. Recruiting and retaining nurses and healthcare staff in small towns is critical.
The board member would do well to consider what’ll happen when DOGE figures out that Medicaid is paying for care that often falls short of federal standard.
Lawmakers on both the state and national levels have a responsibility to ensure stable Medicaid funding to keep existing facilities open while, at the same time, investing in community-based services that offer lower-cost, in-home care options that allow people to remain in their communities.
Sincerely,
Dave Ranney
Dave Ranney is a retired newspaper reporter, he lives in Lawrence, Kansas.
Dan Goodman, KABC Executive Director, recently provided testimony to both the Kansas Department for Aging and Disability Services (KDADS) and the Kansas Department of Health and Environment (KDHE) during their Fiscal Year 2026 budget hearings. Our message was clear: Kansas must invest in systems that protect the dignity, independence, and well-being of older Kansans. Key Recommendations from KABC Protect Access to In-Home Services • Projected shortfalls of $27M in FY26 and $70M in FY27 threaten the HCBS Frail Elderly Waiver. • Without funding, older Kansans may face a waitlist for services, leading to premature nursing home placement. Strengthen Care Coordination • Frail Elderly, Physically Disabled, and Brain Injury waiver recipients currently lack dedicated case management. • KABC urged implementation of the long-overdue $20M Community Care Coordination Service. Improve Oversight & Resident Protections (KDADS) • Surveyor vacancies are near 50%, delaying inspections and weakening resident protections. • We called for wage increases and innovative staffing models to close gaps in oversight. Increase the Personal Needs Allowance • Nursing home residents in Kansas receive only $62/month for personal expenses. • KABC supports raising this allowance—closer to the $70 national average—and tying it to cost-of-living adjustments. Continue the Statewide Senior Resource Guide (KDADS) • KABC requested $150,000 to maintain and distribute the statewide guide annually. • This investment ensures older Kansans have access to accurate, trusted information on care and services. Why It Matters By 2030, more than 20% of Kansans will be age 65 or older. Budget decisions made today will directly impact whether older Kansans can age with dignity, safety, and independence. Read KABC’s full testimonies to KDADS here and KDHE here .
Steve shares his journey through multiple long-term care facilities after a major surgery, describing repeated medication errors, poor food quality, untrained staff, and systemic neglect. His story highlights how understaffing, weak oversight, and profit-driven management leave residents without advocacy and dignity.