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.

Dan Goodman testifies before legislative committee

KABC Testifies Before Bethell Committee

By Libby Hastings • October 16, 2025
On Monday, October 13th, Dan Goodman, Executive Director of Kansas Advocates for Better Care (KABC), delivered testimony before the Robert G. Bethell Joint Committee on Home & Community Based Services & KanCare Oversight. His remarks focused on the urgent need to strengthen Kansas’ long-term care system through sustainable funding and workforce investments. Goodman urged legislators to provide additional funding for the Home and Community-Based Services (HCBS) Frail Elderly waiver , noting projected shortfalls of $27 million in FY26 and $70 million in FY27. Without intervention, hundreds of older Kansans could face placement on a waitlist as early as this fall—delaying access to critical in-home services and increasing the risk of premature institutionalization. He also highlighted the need to support and stabilize the state’s long-term care workforce by exploring innovative approaches used in other states. For example, New Mexico’s Competitive Pay for Professionals program has helped attract and retain workers by linking higher wages to improved reimbursement rates and accountability measures. Goodman suggested Kansas consider similar models to strengthen its caregiving workforce and ensure providers can offer competitive pay. KABC remains committed to advocating for policies that promote quality care, protect older adults, and sustain a strong, well-supported caregiving system across Kansas. Read KABC’s full testimony here: View Testimony (PDF) Watch a full recording of the committee here: YouTube Link

Legislative Update: Nursing Home Oversight in Kansas

By Libby Hastings • October 6, 2025
On October 1st and 2nd, the 2025 Special Committee on Health and Social Services met, with the first day devoted to nursing home surveying and credentialing. The joint committee of both House and Senate members heard from the Kansas Department for Aging and Disability Services (KDADS), the Long-Term Care Ombudsman, industry representatives from Kansas and out of state, administrators, and contractors. Notably absent were the voices of consumers, their family members, and facility staff , the people most affected by long-term care policy. The committee heard information about: Survey Backlogs and Staffing Challenges KDADS contracts with the federal government to inspect adult care homes for health and safety compliance. KDADS has struggled for years to meet federal requirements, due in large part to recruiting and retaining nurse surveyor positions. More than half of the 60 approved positions were vacant earlier this year. As a result, Kansas currently averages 19.9 months between nursing home inspections , far beyond the federal requirement of 12-15.9 months. With just over 300 federally licensed facilities in the state, timely inspections are critical to protecting residents. To address this, KDADS eliminated 15 vacant positions and raised starting pay: up to $60,000 for multidisciplinary surveyors and $67,000 for RNs . The agency is also considering incentives to encourage more RNs to work as surveyors. Kansas has one of the highest rates of the most serious deficiencies, known as Immediate Jeopardy (IJ) deficiencies, in the nation , citations for situations where resident health and safety are at serious risk. The committee explored the possibility of privatizing the survey process. Resident Rights at Risk Testimony also revealed troubling practices in some nursing homes, including charging residents $200–$300 per month in “pharmacy provider” or “medication set-up” fees if they choose to use an outside pharmacy. This practice undermines residents’ right to choose their own providers and unfairly penalizes private-pay residents, already shouldering an average of $7,000–$8,000 per month in nursing home costs. Involuntary Discharges and the Ombudsman’s Recommendation The Long-Term Care Ombudsman urged lawmakers to expand discharge reporting requirements. As she noted: “Federal regulations require a notice to be sent to our office for a facility-initiated transfer (involuntary discharge) in federally licensed nursing homes, but that is not the case for state licensed homes, assisted livings, home pluses and residential health care facilities. With the help of our office, we can often help resolve the reason for the discharge notice to prevent a resident transfer or support the resident to ensure a transition occurs safely.” The committee heard concerns from representatives of the nursing home industry and decided to delay making a recommendation on this issue, noting that additional information is needed. KABC has advocated for not only strengthening the reporting requirements but also giving residents of assisted living facilities the same right to appeal an involuntary discharge that nursing home residents enjoy. Raising the Personal Needs Allowance The Personal Needs Allowance (PNA) for nursing home residents is a monthly stipend that Medicaid recipients can use for personal expenses. In Kansas, the PNA is just $62 per month. Many residents express concern that this amount is insufficient to cover basic personal expenses such as haircuts or undergarments. An immediate increase to the allowance is needed, along with an ongoing adjustment to keep pace with rising costs. The Long-Term Care Ombudsman recommended a PNA increase to the national average of $72 with an additional annual Cost of Living Adjustment. KABC’s Position KABC will continue to advocate for: • Strong oversight of nursing homes. • Resident rights protections, including freedom of choice in providers. • Central inclusion of residents and staff voices in all policy discussions. You can watch the hearing on the Kansas Legislature’s YouTube channel here . KABC will continue to monitor these conversations closely as the 2026 legislative session approaches.