68% of Kansas continuing care providers weren’t in compliance

TOPEKA (KSNT) – An audit from Kansas Medicaid Inspector General Steven D. Anderson found that Kansas lost $88 million in Quality Care Assessment (QCA) revenue and interest.

A press release from the Kansas Attorney General’s Office shows a recent audit found the Kansas Department of Insurance improperly gave continuing care certificates to facilities that didn’t meet the statutory requirements.

“Continuing care” facilities provide care like independent living, assisted living and skilled nursing care in a single location. The facilities pay less for QCA than normal nursing homes. Typically QCA cost $4,908 per bed, with the reduced rate set at $818, according to the report.

The audit found 68% of certifications between July 1, 2020, and Aug. 31, 2023, weren’t in compliance with state law. The audit also found 24% of facilities were assessed at a reduced rate even though they weren’t true continuing care providers.

More than $33 million was needed to supplement the lost revenue the state didn’t collect so the state could obtain matching federal funds, according to the report. The facilities also didn’t provide an annual audit report that is included in the estimated $88 million revenue loss.

Between 2020 and 2023 the audit found there were 285 facilities with incomplete continuing care provider applications. The loss amounts were found by combining the total bed counts for each skilled nursing facility that had an incomplete application. In total, 21,301 beds were identified. The number of beds were multiplied by the difference in QCA rates to determine the $88 million shortfall.

You can view the audit findings by clicking here.

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