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Long-term care debate blames profit motive for suffering of older Kansas residents • Kansas Reflector

LAWRENCE – Dee Miller has to make a “terrible” decision.

The Lawrence resident’s disabled husband of 57 years requires more intensive care than a home service can provide. But for-profit assisted living facilities in the area will accept him only if he can pay an estimated $11,000 a month out of pocket for two years, Miller said. As a Medicaid patient, the facilities would put him on an indefinite waiting list.

She would have to sell her house to cover the costs and find her own apartment.

“What’s the average person supposed to do?” Miller asked last month at a forum hosted by Kansas Advocates for Better Care.

In an interview, Miller said her husband is a paraplegic and suffers from severe neurological pain. The couple are 78 and 79 years old.

“A lot of people you know in this area will be experiencing the same thing,” she said.

She added: “It’s just a really bad situation.”

Miller’s situation is emblematic of broader concerns raised by panelists during the forum. They described a long-term care industry focused on maximizing profits without regard for human suffering, and a Republican-controlled Legislature unwilling to intervene in the greed of the “free market.”

Janis DeBoer, a former deputy secretary of the Kansas Department for Aging and Disability Services, joined Camille Russell, a former long-term care ombudsman from Kansas, and Kansas Rep. Susan Concannon, a Republican from Beloit, who resigned this year after six years conditions waived for re-election.

Janis DeBoer (left) listens as Camille Russell speaks during the November 12, 2024 forum hosted by Kansas Advocates for Better Care at the Baker Wetlands Discovery Center
Janis DeBoer (left) listens as Camille Russell speaks during the November 12, 2024 forum hosted by Kansas Advocates for Better Care at the Baker Wetlands Discovery Center. (Sherman Smith/Kansas Reflector)

DeBoer, whose career in long-term care spanned three decades, said it has always been a challenge to find quality care in Kansas nursing homes.

“Staffing levels have always been difficult. The pay was too low. The competition was too much at times,” DeBoer said. “The fact that no one wants your business, period. I mean, no one really wants to go to a nursing facility, and yet they offer it because they can make money. Let’s just be honest. There’s generally a lot of money to be made in the nursing facility business.”

Russell pointed to a report on federal assessments that showed 80 of 300 nursing homes in Kansas are considered “problem facilities.” That number is “generous,” she said, meaning there are many more problems.

When you look at customer satisfaction, few say their nursing home is good, Russell said.

She said an estimated 13,000 early deaths a year nationwide are due to inadequate staffing levels in nursing homes. A new rule from President Joe Biden’s administration would require increased staffing requirements within three years. That means nearly 40,000 people could die before the requirement takes effect, she said. And many more will suffer as a result.

“What about the multitudes of people living in squalor, abuse and neglect because they don’t have adequate staffing?,” Russell said. “These people are making money. This is a profit center and they are making profits while their customers are in misery, abused, neglected and dying.”

Kansas Attorney General Kris Kobach joined 19 other states in filing a lawsuit challenging the new rule. The lawsuit claims new staffing requirements “pose an existential threat to the nursing home industry as many nursing homes that are already struggling will have no choice but to go out of business.”

Russell said the same companies that claim they can’t find more staff or can’t afford more appear to have no trouble finding staff when they open new facilities. Providers aren’t interested in increasing their workforce, she said, because recruiting is their biggest cost: “They’re not going to make as much money.”

Rep. Susan Concannon says those concerned with nursing home care should contact their legislators during a Nov. 12, 2024 forum hosted by Kansas Advocates for Better Care at the Baker Wetlands Discovery Center
Rep. Susan Concannon says those concerned about nursing home care should contact their legislators. (Sherman Smith/Kansas Reflector)

Gov. Laura Kelly replaced Russell as long-term care ombudsman with Haely Ordoyne earlier this year. Dan Goodman, executive director of Kansas Advocates for Better Care, said in an interview that the appointment raised concerns about conflicts of interest.

Ordoyne owned a nursing home in Washington, Kansas from 2009 to December 2023, led an industry lobbying group and continues to work as a consultant for senior care companies.

“You start to wonder, ‘Who’s our responsibility to protect older Kansas residents?'” Goodman said.

Goodman said lawmakers could address some of the concerns raised during the forum by taking action to increase staffing at long-term care facilities; Limit the use of antipsychotic medications, which are used in facilities despite health concerns to calm patients so that they require less attention. and make it easier to coordinate home services and avoid premature institutionalization.

During the forum, Concannon said she tried to enact regulations during her 12-year term but failed. When House Speaker Dan Hawkins disbanded the senior care committee she chaired, he didn’t tell her until the day of the announcement, she said.

“There’s just not a lot of appetite in our Republican-controlled Legislature to do anything that would be restrictive and what they wouldn’t call free market,” Concannon said. “And here I am again screaming, ‘This is not a free market system!’ There is no truly free market in healthcare.”

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