Continuing care retirement communities and nursing homes in Kansas could face additional scrutiny — and in some cases, higher fees — after a recent audit from the Kansas Medicaid inspector general’s office revealed that the Sunflower State lost almost $88 million last year from incorrectly assessing some nursing homes as CCRCs.
SNFs pay quality care assessment fees to the state for Medicaid reimbursement purposes. The assessments also are matched by federal funds. For CCRCs, however, the fees are lower ($818 per skilled nursing bed) than they are for stand-alone SNFs ($4,908 per bed).
“Because the Quality Care Assessments are much lower for continuing care facilities, there’s obviously an incentive to be a continuing care facility,” Kansas Medicaid Inspector General Steven D. Anderson said in a press release. “However, lenient oversight allowed numerous nursing homes to qualify as continuing care facilities without sufficient evidence that they met the requirements for the reduced rate.”
The audit found that 68% of the CCRC certifications issued by the Kansas Department of Insurance between July 2020 and August 2023 did not comply with statutory requirements of the state, including one to submit an annual audit. Additionally, up to 24% of the assessments were found to have gone to facilities that were incorrectly assessed at the CCRC rate even though the facilities did not provide a full continuum of care.
The state had to make up a shortfall of about $33 million from the incorrect assessments so that it could obtain the full federal matching funds.
A bill, HB 2784, was introduced in the Kansas Legislature early this year and is meant to more clearly define CCRCs under state law, and LeadingAge Kansas supports it, Kylee Childs, LMSW, director of government affairs, told the McKnight’s Business Daily.
