Kansas takes over 21 struggling nursing homes as the industry faces growing obstacles
So the state of
"We don't want to be a receiver or operate these facilities," said
According to industry insiders, in an average year
The financial troubles of Westview of
This year's shakeup in the
"What's going to happen to those folks and what's going to happen to the folks coming behind them who need long-term care?" said
State control
The 21 nursing homes under state control are scattered throughout the state and include three in
Those three and 13 others were purchased in 2016 by
Experts who watched Skyline fail in
"That is something that never should have happened," said
But Monroe said
Nursing homes were appealing investments from about 2010 to 2016, he said, as their values soared thanks in part to lucrative Medicare reimbursements for short-term rehabilitation stays after hospitalizations.
But since then more people have opted for privatized Medicare Advantage plans that squeeze those reimbursements and limit the length of those rehab stays.
Monroe said the shift "caught the industry with its pants down," and operators carrying a lot of debt were especially vulnerable.
"If you've got a very leveraged capital structure, in times like this, you're screwed," Monroe said.
Nursing homes run by Skyline and other companies are going into receiverships by the dozens in some other states as well, though not in
Groups that represent nursing homes say the national struggles have been amplified in
For years
"On the other hand, you're not seeing most of the homes in
A profit motive makes failing homes more likely to cut corners in tough times, she said, especially if they're run by out-of-state operators with no connection to the community.
Monger said her organization hopes the spate of receiverships spurs Kansans to try to keep the nursing home industry more locally owned.
"These companies that are coming in seem to have very little accountability in
An overdue crackdown
Since then
Keck says his agency found out that the owners of those facilities had unpaid bills for things like supplies and therapy services and were misappropriating funds, including diverting money from residents' personal trust funds to pay employees.
The other facilities the state took over include one in
Not all were owned by out-of-state investors. A former employee of the
Keck said the agency did not want to close the home and move the occupants elsewhere, but it had no choice.
"We really are just trying to take care of the residents and do that the right way," Keck said.
Industry advocates agree that the state is just doing what it has to do.
"There have been homes in trouble in
But Luxem said she feels for residents whose lives are thrown into flux when operators fail.
"If those homes close those people have to go 30 miles to 60 miles to get care," Luxem said. "That's very upsetting, but I don't know what else they can do."
Potential buyers
One thing the state could do, long-term, is build up home health care services so there is less demand for nursing home beds. But that wouldn't be a quick fix.
"We would love, love, love to see that happen and see that capacity building that we have been asking for for so long, especially in rural communities," Monger said. "(But) as an immediate solution that's probably not viable just because housing is not available in a lot of those communities."
Shortages of affordable housing mean that seniors get priced out of their homes, and home health workers, who generally don't make high salaries, may be reluctant to move to rural areas even if jobs are available.
Unless that changes, some areas of the state will need the nursing home beds that are currently in flux as the population ages.
But Lindeman also predicted that instability in the nursing home industry isn't over, in
"The next couple years we're going to have issues like this," Lindeman said. "There's going to be consolidation in the business, and people who are doing it right will do well and there will be people who shouldn't be in the business who won't do well."
Closures should be a last resort, he said, but even finding a company that could handle the 15 Skyline homes is a tall order, and
The state has so far been able to pay for the receiverships through a civil monetary penalty fund that nursing homes pay into when they're fined for deficiencies.
But the state has had to draw
"I think everyone would be in agreement you can't have this happen another time to these facilities," Flanagan said. "If the wrong operator were selected and Skyline 2 occurred, that would not be good."
The list of 21
The nursing homes taken over by the state of
Westview of
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