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.
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.
Thanks to the dedicated advocacy of KABC and our coalition partners, Kansas has taken a major step forward in improving access to long-term care information. We’re thrilled to share that the Fiscal Year 2026 state budget includes $190,000 in dedicated funding for the creation of a comprehensive statewide senior resource directory , a direct result of our persistent efforts to ensure older adults and their families can navigate care options with confidence and clarity. Language in the approved budget bill reads: “That expenditures in an amount of not less than $190,000 shall be made by the above agency from such account during fiscal year 2026 to create a comprehensive statewide resource directory to provide essential information on long-term care options: And provided further, That such directory shall be accessible in an up-to-date online version as well as in a printable version.” This is a huge win for older Kansans, caregivers, and care professionals , and it builds directly on the success of local efforts like the Douglas County Senior Resource Directory . We know that when people have access to clear, trustworthy information, they are better equipped to make decisions that support dignity, independence, and well-being in aging. We are proud that our voice, and YOURS, was heard. From providing testimony, to meeting with legislators, to amplifying the call for this essential resource, this achievement belongs to all of us who believe that quality care begins with access to information. Next Steps: We’ll be working closely with the Kansas Department for Aging and Disability Services to support the development of this directory and ensure it meets the needs of Kansans statewide, both in print and online. T hank you for standing with us. This is advocacy in action and together, we’re making a difference.