Nursing home profitability of concern

Among the homes affected was Eskridge Care and Rehabilitation Center, raising concerns in particular over the quality of care available in smaller Kansas communities looking to provide for its elderly, and vulnerable, residents.

The inability of New Jersey-based Skyline Health Care to meet payroll and operate the 15 facilities in Kansas affected nursing homes housing 845 residents. The decision prompted KDADS to ask 13 district courts to place the facilities into the jurisdiction of the state agency while arrangements were made for the residents' care.

It could be that the state agency is the most desirable option for the overall care and management of such facilities. When nursing homes are operated by companies attempting to make a profit off the business of long-term care for the elderly, margins are often slim and services are often substandard. If the business cannot be sustained, elderly residents of communities suddenly are left with nowhere to go and no one to turn to if family members cannot be found to administer potentially expensive care, which often requires around-the-clock services.

In the case of the Kansas homes Skyline Health Care could no longer operate after taking over the 15 facilities in 2016, another provider, Mission Health Care, agreed to oversee operations.

In addition to Eskridge, elderly residents in such small Kansas communities as Cottonwood Falls, Downs, Neodesha, Wakefield and Wilson were affected.

The situation happened following the discovery last year that 20 percent of Kansas nursing homes were designated as "red-flag? operations - homes with at least 10 infractions for three consecutive inspections. Three-fourths of the long-term care facilities that had been identified as frequent violators by Kansas Advocates for Better Care, a Lawrence-based nonprofit, were owned by for-profit corporations.

Federal officials encouraged KDADS to conduct comprehensive inspections of Kansas nursing homes on a 12-month cycle, rather than a 15-month rotation. KDADS has pointed to staffing shortfalls as a reason for the longer cycle, though civil penalties for Kansas nursing homes have risen dramatically, to $4.6 million in 2016 from $52,000 in 2012.

Although that rate is excessive, it points to issues that exist with the assisted care provided to about 18,000 older adults and adults with disabilities in Kansas nursing homes. Again, those are the most vulnerable among the state's population, and their care is jeopardized by shortcuts taken in virtually any component associated with long-term care, including hiring of staff. The trade-off, in the case of the facilities previously managed by Skyline Health Services, was the inability to pay staff.

Mounting problems often require a state agency to step in as it did when 15 Kansas nursing homes were affected by the financial margin Skyline failed to attain. The state's involvement may intensify if costs rise and make it even more difficult for private facilities to profit by caring for the elderly.

Gatehouse Kansas