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.
Kansas has announced that it is exiting the Money Follows the Person (MFP) program, citing a drastic reduction in and possible elimination of federal funding. According to the Kansas Department for Aging and Disability Services (KDADS), the state had planned to reinstate the program on July 1 after several years of inactivity. Instead, Kansas is now withdrawing from the program altogether. For many Kansans, this decision represents a significant missed opportunity. The MFP program was created to help states rebalance their long-term services and supports systems by making it easier for people to move from institutional settings, such as nursing facilities, back into homes and communities. The program provided funding for critical transition expenses, including home modifications, furniture, bedding, kitchen supplies, and other necessities that help make community living possible. At its core, MFP recognized a simple truth: most people want to live in their own homes and communities, not institutions. Research consistently shows that older adults overwhelmingly prefer to age in place. In an AARP survey, 75 percent of older adults reported wanting to remain in their homes as they age. Yet many feel they will eventually have no choice but to move into a facility because the supports needed to remain at home are unavailable or unaffordable. Programs like MFP help bridge that gap. When people remain in nursing facilities despite being able to live safely in the community, there are consequences, not only for the individual, but for the state as a whole. First, individuals lose autonomy and control over their daily lives. Living in the community allows people to decide when they wake up, what they eat, who they spend time with, and how they participate in their neighborhoods. These choices may seem small, but they are fundamental to dignity and quality of life. Second, unnecessary institutionalization can contribute to social isolation. People living in their own homes can remain connected to friends, family, faith communities, volunteer opportunities, and local activities. Community integration promotes both physical and emotional well-being. Third, keeping people in nursing facilities when they could thrive in the community often comes at a higher cost to the Medicaid system. Home and community-based services are frequently less expensive than institutional care while also aligning with what most people prefer. Helping individuals remain in the least restrictive setting can benefit both taxpayers and the people receiving services. Finally, programs like MFP help remove barriers that prevent people from exercising their right to choose where they receive care. Transitioning from a nursing facility to the community is often not as simple as opening the front door and leaving. Many individuals need assistance securing housing, obtaining household items, modifying their homes for accessibility, or coordinating services. Without dedicated funding and support, these barriers can become insurmountable. Kansas has made progress over the years in expanding home and community-based services, but significant challenges remain. Housing shortages, workforce shortages among direct care workers, and waiting lists for services continue to make community living difficult for many people. The loss of Money Follows the Person means one fewer tool available to help Kansans return home.
2026 legislative wrap-up for long-term care advocates in Kansas.