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Rankings Show Wildly Different Views Of Nursing Home Quality In Missouri And Kansas

FamilyAsset's rankings are based on hundreds of thousands of customer reviews of nursing homes on the internet.

Kansas City and St. Louis have some of the worst-rated nursing homes in the country, while Topeka, Overland Park and Wichita have some of the best.

That’s according to rankings published by FamilyAssets, a New York-based company that offers assessments and planning for people seeking home health care services.

The rankings are based on hundreds of thousands of customer reviews across the web, according to FamilyAssets. The company looked at the prevalence of “bad” reviews (1 or 2 stars) and “good” ones (4 or 5 stars) and ignored average ones.

“The reviews for nursing homes are alarmingly bad compared to other health care services for aging populations,” said James Johnson, chief technology officer of FamilyAssets. “More than 25 percent of nursing homes reviews are one star compared to just 8 percent for assisted living.”

Kansas City was ranked the 10th  worst in the country, and St. Louis was ranked 7th worst. Topeka was ranked 2nd best, Overland Park 8th best and Wichita 25th best.

And among the best-ranked states, Kansas was No. 9. 

Credit FamilyAssets

The cities were ranked based on their percentage of negative or positive reviews. Kansas City’s percentage of negative reviews was 45.5 percent and St. Louis’ 48 percent. By contrast, Topeka’s percentage of positive reviews was 80. 3 percent, Overland Park’s 75.7 percent and Wichita’s 70.1 percent.

Atlanta topped the list of cities with the worst-rated nursing homes, with 59.6 percent garnering negative reviews. Evansville, Indiana, topped the list of cities with the best-rated nursing homes, edging out Topeka with 80.5 percent garnering positive reviews.

“In some cities, 80 percent of the reviews are positive and in other cities, 50 percent of the reviews are negative,” Johnson said. “So there’s this big difference when you go into different geographies.”

Credit FamilyAssets

Johnson was unable to account for the geographical differences.

The ratings don’t entirely line up with other metrics.

For one thing, Kansas took over 21 nursing homes in the past year — far and away the most it's placed in receivership in any single year — after they defaulted on payments to vendors. Fifteen of the nursing homes were owned by a New Jersey company, Skyline Healthcare, whose nursing homes have been taken over by other statesas well.

For another thing, data published by the investigative news organization ProPublica shows that of Kansas’ 334 nursing homes, 140 of them were cited for serious deficiencies over the past three years, meaning patients were placed in immediate jeopardy of harm. Collectively, Kansas nursing homes were assessed $7.88 million in penalties during that period.

In Missouri, 60 of the state’s 519 nursing homes were cited for serious deficiencies, according to ProPublica. They were assessed $4.22 million in penalties over the past three years.

Credit Kansas Health Care Association
Kansas Health Care Association
Cindy Luxem, president and CEO of the Kansas Health Care Association, said the heavy fines imposed on Kansas nursing homes were, in part, the product of a broken inspection system.

Cindy Luxem, president of the Kansas Health Care Association, the lobbying group for the state’s for-profit nursing homes, said she wasn't familiar with the FamilyAssets survey but appreciated its consumer orientation.

“In a lot of respects, I kind of admire these people putting together these statistics because we believe that, in all honesty, people that actually receive these services and are familiar with them oftentimes look at them in a lot better respect than the regulators,” Luxem said. “And I will be the first to admit that.”

Luxem said the heavy penalties levied against Kansas nursing homes were, in part, the product of a broken inspection system in Kansas.

“We have not had enough surveyors,” she said, referring to state nursing home inspectors. “And they often overreached their responsibility and cited to levels much higher than they should have.”

Luxem said some nursing homes were hit with $300,000 and $400,000 penalties, forcing at least one of them out of business.

“It didn't matter whether you were a rural home or an urban home, whether you were a 50-bed home or a 250-bed home, you were getting the same kind of fines,” she said.

The government publishes its own ratings of nursing homes. The Centers for Medicare and Medicaid Services (CMS) in 1998 launched its Nursing Home Compare website, which relies to a great extent on self-reported data.

Nursing Home Compare uses a five-star quality rating system, with one star being the lowest possible score and five the highest. The ratings are based on a variety of factors, including health inspection reports, quality of care measures and overall staffing.

Johnson said FamilyAssets did not check to see how its rankings aligned with those of CMS, although he said the company might do so in the future.

Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies

Dan Margolies has been a reporter for the Kansas City Business Journal, The Kansas City Star, and KCUR Public Radio. He retired as a reporter in December 2022 after a 37-year journalism career.
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