Medicaid Nursing Home Rates by State

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Kansas

Medicaid nursing facility payment · Cost-based · researched October 2026

Kansas’s Medicaid agency and its state plan are the official source for these rules. This page summarizes them as researched in October 2026; check the state’s own documents, listed under Sources, before relying on them.

At a glance

Rate method

Cost-based

Case-mix level

Facility average

Classification

PDPM

Rate updates

Twice a year

Managed care (LTC)

Yes

Quality program

Incentive Factor + PEAK

Paid outside the rate

None

Bed hold

Hospital and leave

Published rates

Rates only

Assisted living

Covered

Personal needs allowance

$62 / month

Overview

• Kansas pays each home its own rate, built from that home's own costs and capped by statewide limits.
• It averages the home's audited cost reports for the last three calendar years (2023-2025 for SFY2027) and inflates them to December 31, 2026.
• Each of three cost centers is capped at a share of the statewide day-weighted median: operating 110%, indirect care 115%, direct care 130%.
• Direct care is then scaled by the home's Medicaid case-mix index (CMI, a measure of acuity).
• Several add-ons sit on top: a capped property fee, an incentive factor worth up to $7.50/day, PEAK culture-change incentives of $0.50-$3.00/day, and a flat Medicaid add-on ($15.00/day in SFY2027).
• The July 1, 2026 list has 289 homes: average rate $309.96 (+1.80%), median $316.60, range $147.56-$492.68.
• The state projects SFY2027 rates pay 102.87% of day-weighted average inflated allowable cost.

What matters in Kansas

• Nothing is paid outside the per diem; all incentives and the flat Medicaid add-on are inside the posted rate.
• Rates rebase every July 1 on a rolling three-year cost average; SFY2027 rates pay 102.87% of average inflated cost.
• Medicaid rates are not capped at private-pay charges (K.S.A. 75-7435(h)); in July 2026, 142 of 289 homes had a Medicaid rate above their private-pay rate.
• $15.00 per Medicaid day flat add-on in SFY2027, cut from $20.00, which held the average increase to 1.80%.
• $4,908 per bed provider tax; homes with over 25,000 Medicaid days pay $818, a high-Medicaid discount.
• Up to $7.50/day quality incentive is lost with any H-level survey deficiency and halved for a G-level one.
• Bed hold pays 67% of the per diem, up to 10 days per hospital stay and 18 leave days a year.

Frequently asked

Does a Kansas home with high Medicaid use pay less provider tax per bed?

Yes. The tax is $4,908 per bed per year, but high-Medicaid, small and CCRC homes pay $818.

Does a serious survey citation remove a Kansas home's Medicaid quality add-on?

The add-on of up to $7.50 per day is lost with any H-level survey deficiency and halved for a G-level deficiency.

Does renovating a Kansas nursing home raise its Medicaid property payment?

Only through a provider rebase request after capital spending of $25,000 or more (50 or fewer beds) or $50,000 or more (51 or more beds). The fee stays capped, at $10.84 per day for SFY2027.

Is a Kansas nursing home's Medicaid rate capped at its private-pay rate?

No. Kansas law says Medicaid rates are not limited by private-pay charges (K.S.A. 75-7435(h)), though homes must report private-pay rates quarterly. In the July 2026 list, 142 of 289 homes had a Medicaid rate above their posted private-pay rate (median private pay $308 vs median Medicaid $316.60).

How much is paid outside the posted rate in Kansas?

None, about 0% of base; all incentives and add-ons sit inside the posted per diem.

What does Kansas Medicaid pay on Medicare coinsurance days?

Medicaid pays only its rate minus Medicare's payment, so homes usually receive $0 of the coinsurance.

Does Kansas require a minimum share of spending on care?

No; fund money may not pay bonuses or profit-sharing to officers or parent companies, but no recoupment is described.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Kansas Nursing Facility Financial and Statistical Report, form MS-2004 (K.A.R. 129-10-17), a state-specific calendar-year cost report. It is due by the end of February, desk-reviewed by KDADS auditors February to early May, and field-audited during the year. Ownership costs (mortgage interest, depreciation, lease, leasehold amortization) are reported but paid through the property fee instead.

Base year and rebasing

Rebased every year on a rolling three-year base: each rate year uses the combined calendar-year cost reports of the last three available years. SFY2027 (7/1/2026) uses CY2023-2025; SFY2026 used CY2022-2024; SFY2025 CY2021-2023; SFY2024 CY2020-2022; SFY2023 CY2019-2021 (KDADS: 'Average of three base years were utilized in FY2023'). Each year's data is inflated from its midpoint to December 31 of the rate year. K.A.R. 129-10-18(a)(1)(A) only requires the base to be re-established at least every seven years. A change-of-provider home keeps the prior owner's base for 24 months, then its own first calendar-year report.

Components

Component	Method	Notes
operating (administration, plant, etc.)	Facility cost per day, capped at 110% of the statewide resident-day-weighted median. For homes with more than 60 beds, days are the greater of actual days or 85% of licensed bed days.	SFY2027 limit $64.34/day (SFY2026 $60.48; SFY2025 $57.16; SFY2024 $55.15). Owner, related-party, administrator and co-administrator pay is capped separately (Schedule C: 90th percentile of non-owner administrator pay for homes with 50+ beds, scaled by bed size below 50; owner work capped to a Kansas civil-service salary chart).
indirect health care (dietary, laundry, housekeeping, food, utilities)	Facility cost per day, capped at 115% of the day-weighted median. For homes with more than 60 beds, the 85% minimum occupancy applies, except to food and utilities, which use actual days.	SFY2027 limit $77.29/day (SFY2026 $73.49; SFY2025 $70.24; SFY2024 $68.78).
direct health care (nursing)	Each home's inflated direct cost is first normalized to the statewide average CMI (divided by the home's cost-period CMI) and capped at 130% of the day-weighted median of those normalized costs. The allowed amount is then multiplied by (the home's Medicaid CMI / the statewide average CMI). Actual days are used, with no occupancy floor.	The SFY2027 limit is $203.76/day at the statewide average CMI of 1.2936 (PDPM nursing). Rapid Response Staffing grant costs (KFMC emergency staffing, 2022+) are added back into direct care costs for the homes that received them. Per K.S.A. 75-7435(d)(4)(F), leftover quality care fund money goes first to raising this limit toward 150% of the case-mix-adjusted median.
real and personal property fee (capital)	A facility-specific fee paid instead of ownership costs (K.A.R. 129-10-25). It was historically set as property allowance + value factor, fixed since 7/1/2002, and is not reset on change of ownership. Inflated, then capped at 105% of the day-weighted median fee in effect April 1. Homes can rebase the fee after a capital project of $25,000+ (50 or fewer beds) or $50,000+ (51+ beds).	SFY2027 cap $10.84/day. New buildings: projected/historic ownership costs divided by the greater of actual days or 85% of licensed capacity.
incentive factor + PEAK + Medicaid add-on	Per diem add-ons on top of the cost-based rate (see quality_incentive and other_add_ons).	Up to $7.50 quality/efficiency incentive + up to $3.00 PEAK + flat $15.00 Medicaid add-on (SFY2027).

Inflation

S&P Global (formerly IHS Global Insight) CMS Nursing Home without Capital Market Basket. Each base-year report is inflated from its cost-period midpoint to December 31 of the rate year (12/31/2026 for SFY2027), using the latest quarterly forecast, and the table is not revised mid-year. Not inflated: owner/related-party pay, interest, and real and personal property taxes.

Verified October 11, 2026

Case mix

System

PDPM

Applied at

Facility average

How it works

Each home gets one per diem for all its Medicaid residents: the direct-care component is scaled by the home's average Medicaid CMI (PDPM nursing component) over the two quarterly snapshots before the rate date, so an individual resident's acuity does not change that resident's claim (SFY2027 notice, section 7).

Classification

PDPM nursing component only: the 25 PDPM nursing case-mix groups, using CMS's nursing CMIs effective 10/1/2019, with no state-specific weights. PT, OT, SLP and NTA components are not used. Assessments that cannot be classified get the lowest CMI in the state. Before 7/1/2024 Kansas used RUG-III 34-group (version 5.12).

Applies to

Direct health care cost center only, for both the upper limit (cost normalization) and the semi-annual Medicaid acuity adjustment. Operating, indirect, property and add-ons are not case-mix adjusted.

Acuity measured from

Snapshot of residents in the building on the first day of each calendar quarter (Jan 1, Apr 1, Jul 1, Oct 1), each classified from their most recent MDS. Payment uses the Medicaid-average CMI: residents with Medicaid as a per diem payer on the snapshot date or at any time in the prior quarter, including hospice residents. It is a simple average to four decimals. Cost neutralization uses the facility-wide (all-resident) CMI, day-weighted over the four quarters matching the cost report. Ventilator-dependent residents who get the vent add-on are excluded. Homes get resident listings to review and correct before rates are set.

Updated

Semi-annual. July 1 rates use the Jan 1 and Apr 1 snapshots; January 1 rates use the Jul 1 and Oct 1 snapshots.

Move to PDPM

Switched from RUG-III 34-group to the PDPM nursing component effective 7/1/2024 (SFY2025), in one step with no blend. Kansas had kept running the RUG-III 34 grouper through SFY2024 (the SFY2024 notice still cites RUG-III version 5.12). The change re-scaled the statewide average CMI from 1.0813 (SFY2024, RUG-III) to 1.2906 (SFY2025, PDPM nursing). Because direct costs are normalized by each home's own CMI, the switch is roughly self-neutralizing in aggregate, but no budget-neutrality step is described. The SFY2025 notice was re-issued (revised final, 6/20/2024) to fix the 1/1/2024 Medicaid CMI data. Sources: https://sos.ks.gov/publications/Register/Volume-43/Issues/Iss… ; https://rules.ks.gov/browse/collections/29b1a920-facc-44b1-89…

Verified October 11, 2026

Low-acuity residents

None found. Kansas has no reduced or flat rate for low case-mix residents. All Medicaid residents in a home get the same per diem; low acuity only lowers the home's average Medicaid CMI and so its direct-care component. Related rules that are not low-acuity carve-outs: (1) assessments that cannot be classified get the lowest statewide CMI (K.A.R. 129-10-18(a)(4)); (2) NF level of care is gated by the CARE assessment and functional eligibility, so residents below level of care are not covered rather than paid less. Checked: the SFY2027 final rate notice (4.19-D Exhibit C-1 text), K.A.R. 129-10-18, and the KMAP Nursing Facility manual (06/2026).

Verified October 11, 2026

Capital

Facility-specific 'real and personal property fee' (K.A.R. 129-10-25). This is not fair rental value and not actual cost: it is a legacy fixed fee (property allowance + value factor, merged 7/1/2002) that stays with the building through ownership or lease changes. It is inflated and capped at 105% of the resident-day-weighted median fee (SFY2027 cap $10.84/day). It goes up only through a provider rebase request after capital spending of $25,000+ (50 or fewer beds) or $50,000+ (51+ beds). The added per diem (interest + depreciation + amortization over desk-reviewed days with 85% minimum occupancy) is stacked on the original fee and is still subject to the cap. New buildings get a fee from projected and then historic ownership costs divided by the greater of actual days or 85% of capacity.

Verified October 11, 2026

Budget adjustment factor

None in effect for SFY2027. No across-the-board cut or budget-neutrality factor appears in the SFY2023-SFY2027 notices. KDADS lists 'Budget Adjustment: any adjustments requested by legislation' as a standing step. Under K.S.A. 75-7435(f)(3)(B), the provider assessment becomes void if rates are cut below the 12/31/2009 rates plus quality care fund increases, which effectively blocks deep cuts. Historical: a Medicaid rate cut on 1/1/2010 was restored with quality care fund money from 7/1/2010. Aggregate SFY2027 payment = 102.87% of day-weighted average inflated allowable cost (SFY2026 105.74%; SFY2025 104.49%; SFY2024 100.43%; SFY2023 90.67%).

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

none

Estimate

About 0% of base. No supplemental, UPL, IGT or directed payments to NFs appear in the SFY2023-SFY2027 rate notices; the incentive factor, PEAK and the $15 Medicaid add-on are all inside the posted per diem. Derived from the absence of any such program in the 4.19-D text reprinted in the Register notices. Not checked: CMS directed-payment preprints and MCO value-based arrangements.

Components

None found. QCA money returns through the rate, not as lump sums.

Source

https://rules.ks.gov/browse/collections/29b1a920-facc-44b1-89…

Verified October 11, 2026

Payments by owner type

Applies

no

Detail

No ownership-based payments found. County, hospital-based (hospital LTC units) and private homes are paid under the same cost-based formula. The only owner-related difference is that state-owned homes (Kansas Soldiers' Home, Kansas Veterans' Home) are exempt from the QCA; they are still on the regular rate list (SFY2027 $354.23 and $360.56).

Funding

No IGT-funded NF program found.

Source

https://www.ksrevisor.gov/statutes/chapters/ch75/075_074_0035…

Verified October 11, 2026

Quality program

Program

Two add-ons. (1) Nursing Facility Quality and Efficiency Incentive Factor, in the state plan rate formula. (2) PEAK 2.0 (Promoting Excellent Alternatives in Kansas Nursing Homes), a culture-change/person-centered care pay-for-performance program run by KDADS with Kansas State University. NF-for-mental-health homes have a separate points-based incentive.

Funding

Built into the Medicaid per diem (state plan add-on). There is no separate pool and no budget neutrality: it is paid as part of the rate KDADS sets, funded by state general fund, quality care fund (provider assessment) and federal match.

Size

Not stated as a pool. Per home: incentive factor up to $7.50/day plus PEAK up to $3.00/day, paid per Medicaid resident day. Statewide total not published.

Paid as

Per-diem add-on to each home's Medicaid rate (adds up the components it qualifies for).

Measures

Measure	Source	Weight	How points are earned
Case-mix-adjusted nurse staffing ratio	MS-2004 cost report staffing hours, adjusted by CMI	$3.00/day at or above the 75th percentile; $0.50/day if below it but improved by 10% or more	SFY2027 75th percentile = 5.61
Staff retention rate	Cost report / state staffing data	$2.50/day at or above the 75th percentile; $0.50/day if below it but improved by 10% or more	SFY2027 75th percentile = 71%. Both tiers are paid only if contracted (agency) labor is under 10% of total direct-care labor costs.
Medicaid occupancy	Cost report	$0.75/day	Medicaid share of days 65% or more
Long-stay quality measures (CMS Five-Star long-stay QM score)	MDS QMs via CMS Care Compare, scored with the current Five-Star Technical Users' Guide as of March 15	$1.25/day	At or above the 75th percentile; SFY2027 cutoff = 560 QM points
PEAK 2.0 person-centered care level (12 PEAK core areas)	KDADS/KSU self-evaluation, action plans, Zoom or in-person evaluations, random site visits	Level 0 $0.50; L1 (0-2 cores) $0.75; L2 (3-4) $1.00; L3 (5-6) $1.25; L4 (7-8) $1.50; L5 (9-11) $1.75; L6 (all 12 cores, person-centered care home) $2.00; L7 (sustained 2 yrs) $2.50; L8 (mentor home) $3.00 per Medicaid resident day	Cores are passed on evaluation and re-evaluated every 2 years. Levels 7-8 are granted for two fiscal years.

Scoring period

The incentive factor is set each July 1 from base cost-report data and the QM data available March 15. Survey eligibility is rechecked quarterly against the 12 months ending one quarter before (Jul 1 uses the year to Mar 31; Oct 1 to Jun 30; Jan 1 to Sep 30; Apr 1 to Dec 31). PEAK incentives start July 1 of the program year, and Level 0 can be dropped mid-year for non-participation.

Payment formula

Fixed dollar amounts for meeting percentile thresholds; the components are added up (max $7.50). Survey gate: any deficiency at scope/severity H or higher in the review period = $0. G-level deficiencies (no H+) corrected within 30 days = 50% of the factor. F or lower = 100%. PEAK amounts are added separately and also depend on survey eligibility.

Eligibility

All Medicaid NFs (NF-MH homes use their own 5-measure, 8-point, 4-tier scale paying $0/$2.50/$5.00/$7.50). The retention measure is disqualified if agency labor is 10% or more of direct-care labor. Survey H+ deficiencies remove the incentive; G deficiencies halve it.

Cadence

Set annually (July 1) and paid on every Medicaid day in the rate. Survey eligibility is reviewed quarterly.

Scores published

Partly. The Kansas Register rate notice publishes the thresholds, and the KDADS rate list (xlsx) shows only the final rate and CMI, not each home's incentive. Each provider gets its own detailed rate computation. No public per-facility incentive or PEAK level list was found.

Notes

Incentive factor amounts and thresholds have been unchanged in structure since at least SFY2023. The Medicaid occupancy measure rewards high-Medicaid homes. The NF-MH scale awards a point for total occupancy at or below 90%, rewarding discharge to the community.

Verified October 11, 2026

Provider tax

Charged

per bed (licensed beds on July 1; prorated for beds added mid-year; no refund for beds removed, and decreases take effect only the next July 1)

Standard amount

$4,908 per licensed bed per year (statutory maximum), paid quarterly (due Oct 30, Jan 30, Apr 30, Jul 30). Rate set in K.A.R. 129-10-31 as amended 6/26/2020 and confirmed in the KDADS QCA FAQ 2026.

Tiers

Who	Test	Amount
Homes with more than 25,000 Medicaid days on the latest MS-2004 cost report ('high Medicaid volume')	volume	$818 per bed per year (1/6 of standard)
Homes licensed for fewer than 46 beds (45 or fewer)	size	$818 per bed per year
NFs that are part of a continuing care retirement facility registered with the Insurance Dept. before the SFY starts	ccrc	$818 per bed per year
State-owned homes (Kansas Soldiers' Home, Kansas Veterans' Home)	public	exempt (excluded from the statute's definition)

Lower for high-Medicaid homes

yes

Returned in the rate

The QCA is an allowable cost on the cost report, so the Medicaid share flows back through the cost-based rate (K.S.A. 75-7435(b)(4)/(d)(4)(C)). The rest of the fund pays for higher NF rates (restoring 2010 cuts and FY2011 rebasing and inflation, then raising the direct care limit). No separate add-on amount is published.

Source

https://www.kdads.ks.gov/home/showpublisheddocument/5807/6391…

Verified October 11, 2026

Provider tax notes

Quality Care Assessment (QCA), K.S.A. 75-7435 and K.A.R. 129-10-31, in place since SFY2011. It is $4,908 per licensed bed per year (the statutory maximum), or $818 per bed (1/6) for CCRC-registered homes, homes with fewer than 46 beds, and homes with more than 25,000 Medicaid days on the latest cost report. Paid quarterly, by EFT only from 7/1/2026. State-owned homes (Kansas Soldiers' Home, Kansas Veterans' Home) are excluded. The assessment is an allowable Medicaid cost, and the Medicaid share is returned in the rate. Fund money must go to NF payments (restoring the 2010 cuts, the FY2011 rebase/inflation, then raising the direct care limit toward 150% of the case-mix-adjusted median, then panel-approved quality initiatives). The fund may not supplant state spending and is void if diverted to the general fund. Homes may not line-item it to residents.

Verified October 11, 2026

Supplemental payments

None found. The SFY2023-SFY2027 rate notices list no UPL, IGT-funded or MCO directed payments for nursing facilities. The aggregate UPL test (42 CFR 447.272) is described only as a compliance check. K.S.A. 75-7435(d)(6) allows quality care fund 'adjustment payments' quarterly or in the daily rate within the UPL, but current practice puts everything in the per diem. CMS directed-payment preprints for Kansas NFs were not checked.

Verified October 11, 2026

Other add-ons

(1) Medicaid add-on: a flat per Medicaid resident day for all enrolled providers, 'to compensate and incentivize providers with high Medicaid participation'. SFY2024 $19.58 (CY2022 Medicaid days); SFY2025 $15.18 (CY2023 days); SFY2026 $20.00; SFY2027 $15.00. (2) Rapid Response Staffing Grant adjustment: KFMC-provided emergency staffing (2022+) is added back into direct care costs for homes that received it, so it flows through the rate. (3) Ventilator-dependent resident add-on: prior-authorized per resident (see special_payment_systems). (4) Incentive factor and PEAK (see quality_incentive). (5) Private rooms: since 2/1/2024 private rooms may be billed, but the home still gets its normal per diem and a third party may pay the private-room difference.

Verified October 11, 2026

Units paid separately

(1) Ventilator-dependent residents (K.A.R. 129-10-18(i); KMAP NF manual): with prior approval from KDHE-DHCF and KDADS, the home gets its per diem plus a negotiated add-on based on an itemized care-plan budget. The total is capped at the lower of the care-plan cost or the Medicare SNF PPS (PDPM) rate for that resident ('VENT Medicaid rate'). Reviewed quarterly; the resident is dropped from the facility CMI. (2) Nursing Facilities for Mental Health (NF-MH): same cost-based formula but a separate incentive scale, 21-day psychiatric bed-hold, and 21-day crisis stabilization placements. (3) Hospital long-term care units: paid under the same NF method. (4) State-owned Kansas Soldiers' Home and Kansas Veterans' Home are on the same rate list and exempt from the QCA. (5) Out-of-state NFs: a rate approved by the agency with prior authorization. (6) Secretary's discretion (K.A.R. 129-10-18(j)): a rate can be raised for exceptional access jeopardy, but not above the state average rate.

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

yes

Detail

KanCare (Sunflower, UnitedHealthcare, Healthy Blue)

Verified October 11, 2026

Who pays

managed_ltss (KanCare). Nearly all Medicaid nursing facility days are paid by KanCare's three MCOs: Sunflower Health Plan, UnitedHealthcare Community Plan and Healthy Blue, under contracts running 1/1/2025-12/31/2027. KDADS sends its July and January rate files to 'the State and MCOs'. The SFY2027 notice puts the fee-for-service-only federal share of the rate increase at just $310,973 for FFY2027, which implies FFS is a tiny share of NF spending.

Verified October 11, 2026

Managed care rate floor

Probably yes in practice, but no primary text was found. KDADS sends the facility rates to the MCOs each July 1 and January 1 ('End of May = Rates to State and MCOs'; 'December 1 = adjustments submitted to KMAP and MCO for Jan 1 rates'), and the state's fiscal notes treat the posted rates as the program's cost. The KanCare 2025-2027 MCO contract clause that would require MCOs to pay at least the KDADS per diem could not be retrieved (it is only on the Dept. of Administration e-Supplier site, bid EVT0009267). Sources: https://www.kdads.ks.gov/partners-providers/nursing-facilitie… ; https://www.kancare.ks.gov/data-policy/updates/kancare-2025-r…

Verified October 11, 2026

Included in the daily rate

Included (KMAP NF manual §8400): room, board, nursing, and a long list of DME and supplies (oxygen and equipment, wheelchairs, walkers, beds, nebulizers, IV and enteral pumps, trach kits, ostomy and urinary supplies, nutritional supplements). Also included: PRN over-the-counter drugs; all therapies (PT, OT, speech, respiratory, with the Medicaid share of therapy costs allowed through the cost report); non-emergency transport of residents including new admissions; laundry; specialized rehabilitative services; and dialysis if done by NF staff. Paid separately: scheduled OTC and prescription drugs through the KMAP pharmacy program/MCOs; physician, dental and other ancillary providers that bill separately; and the flu vaccine through the physician. Hospice residents: the hospice is paid room and board and the NF may not bill Medicaid for those days. Source: https://portal.kmap-state-ks.us/Documents/Provider/Provider%2…

Verified October 11, 2026

Bed hold

Hospital stays

Paid at 67% of the facility per diem (K.A.R. 129-10-18(h)). Up to 10 days per hospital stay for an acute condition (no annual cap stated). The resident must intend to return and the hospital must give a discharge plan. NF-MH residents admitted to a state mental hospital or psychiatric unit: up to 21 days per admission.

Leave days

Paid at 67% of per diem for home visits or state-approved therapeutic or rehab programs in the plan of care. Up to 18 days per calendar year for NFs (21 for NF-MH) including travel; more days need prior authorization for severe hardship.

Occupancy rule

None for bed-hold days.

Notes

Hospice residents: the hospice is paid 67% of room and board for leave days (up to 10 per hospital stay; 18 non-hospital days per year). Observation stays without admission count as regular NF days. Days must be billed consecutively from the hospital admission date.

Source

https://www.law.cornell.edu/regulations/kansas/K-A-R-30-10-21

Verified October 11, 2026

Personal needs allowance

Per month

62

Effective

In force; the KEESM edition KDHE still serves is labeled August 2017 (page marker 08-17), so the amount dates to 2017 or earlier (the 2018 date from the compilation looks wrong).

Notes

KEESM 8115 (Resident Status Review) refers to 'the $62 personal needs allowance' and lets a couple in the same institution be budgeted together for a total $124 needs allowance. The current KEESM index and section 8143 returned 403/404, so a newer edition could not be checked. Not COLA-indexed.

Confidence

confirmed

Source

https://khap.kdhe.ks.gov/KEESM/Aug_2017_Output/ROBO_Output/ke…

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

Lesser-of. Part A coinsurance for SNF days 21-100 is billed to KMAP on the UB-04 after Medicare pays, but when 'the Medicare payment equals or exceeds the lowest of the Medicaid or Medicare allowable' the claim pays $0 (CARC 23 / EOB 0095). Medicaid pays only up to the facility's Medicaid rate minus the Medicare payment. The FFS manual does not address Medicare Advantage cost-sharing; under KanCare the MCOs handle it, and no MA-specific rule was found.

Effect

Since Medicare's Part A SNF rate is usually well above the Kansas Medicaid per diem (average $309.96), the home usually gets $0 of the coinsurance on days 21-100.

Source

https://portal.kmap-state-ks.us/Documents/Provider/Provider%2…

Verified October 11, 2026

Required care spending

Applies

no

Rule

No required care-spending share or recoupment. Related limits: (1) K.S.A. 75-7435(d)(5): money a home gets from the quality care fund may not pay bonuses or profit-sharing to officers, employees or parent companies, but may pay direct-care employees (no audit or recoupment mechanism described). (2) Cost-based rates mean unspent direct-care money lowers future rates through rebasing. (3) The staff-retention incentive is lost if agency labor is 10% or more of direct-care labor.

Source

https://www.ksrevisor.gov/statutes/chapters/ch75/075_074_0035…

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

(1) Homes with more than 60 beds (open 12+ months): operating and indirect costs (excluding food and utilities) are divided by the greater of actual days or 85% of licensed bed days, for both the home's rate and the limit arrays. Direct care, food and utilities use actual days. Homes with 60 or fewer beds use actual days. All licensed beds must be Medicaid-certified. (2) Property fee for new buildings and rebases: divided by the greater of actual days or 85% of licensed capacity. (3) Administrator compensation arrays use 85% occupancy for homes over 60 beds. (4) A new provider taking over a home inherits the 85% rule if it applied to the prior provider. (5) Incentive: +$0.75/day if Medicaid occupancy is 65% or more. NF-MH homes earn a point for total occupancy of 90% or less.

Source

https://rules.ks.gov/browse/collections/29b1a920-facc-44b1-89…

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

semiannual

When

Jul 1 annual rate; Jan 1 case-mix adjustment

Verified October 11, 2026

When rates change

July 1 (state fiscal year) annual rate from the rolled-forward three-year cost base, plus a January 1 case-mix-only adjustment if the home's Medicaid CMI changed (K.A.R. 129-10-19(d)). Timeline: cost reports end of February; proposed methodology and rates in the Kansas Register mid-April (comment to mid-May); rates to state and MCOs end of May; final notice early-mid June; Jan 1 adjustments to KMAP and MCOs by December 1. Mid-year changes: property fee rebases (1st of month after documentation or bed certification), desk review or field audit corrections with cash settlement, and incentive eligibility changes each quarter from survey results.

Verified October 11, 2026

Posted rates

Home-level rates published

Yes

Where

https://www.kdads.ks.gov/partners-providers/nursing-facilitie… ('Nursing Facility Medicaid / MediKan Rate Lists'). The full per-facility list with Medicaid CMI is also printed in each Kansas Register final rate notice (rules.ks.gov).

Format

xlsx (KDADS rate list: provider name, city, rate effective date, rate, Medicaid CMI, private-pay rate); html/pdf in the Kansas Register

Cadence

Twice a year: July (annual rebase) and January (case-mix update).

History

KDADS page: July 2022 (SFY23) through July 2026 (SFY27), plus Medicaid occupancy reports for 2018-2022 and 2020-2024. Kansas Register final/proposed notices with full rate tables are on rules.ks.gov from Volume 40 (2021) on, with older ones in the 1982-2020 archive.

Home identifier

Name and city only. No Medicaid provider number, NPI or CCN in the xlsx or Register list. Matching to CMS data needs name/city fuzzy matching.

Verified October 11, 2026

Rate build-ups

Published

No

Where

Not posted. K.A.R. 129-10-18(a)(7) requires that each provider 'be given a detailed listing of the computation of the rate' (rate letters sent to providers in early-mid June and early December). Public detail is limited to the Register notice: methodology text, the cost-center limits, statewide CMI, incentive thresholds, aggregate justification statistics, and each home's final rate and Medicaid CMI.

What they show

Public: final rate and Medicaid CMI per home, statewide limits (operating $64.34, indirect $77.29, direct $203.76 at CMI 1.2936, property $10.84), and the maximum allowable rate ($356.23 at average CMI). Not public: each home's cost by center, the limits it hit, property fee, incentive factor or PEAK level.

Format

xlsx (final rates only)

Example file

https://www.kdads.ks.gov/home/showpublisheddocument/5753/6391…

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

yes

Program

HCBS Frail Elderly (FE) 1915(c) waiver (and the Physical Disability waiver), delivered through KanCare MCOs. Licensed assisted living, residential health care and home plus facilities can enroll as providers of FE personal care (Level III) services.

What is paid

Services only, mainly personal care (billed S5125, 15-minute units). Room and board are paid by the resident; no state room-and-board supplement was found. ALF residents are not eligible for waiver adult day care.

Limits

Waiver enrollment and functional eligibility (KDADS publishes monthly waiver participation); no FE waitlist confirmed. Available statewide wherever a licensed ALF/RHCF/home plus is enrolled.

Source

https://portal.kmap-state-ks.us/Documents/Provider/Provider%2…

Verified October 11, 2026

Sources

1. Kansas Register Vol. 45 No. 24 (6/11/2026): Notice of Final Nursing Facility Medicaid Rates for SFY2027 (4.19-D Exhibit C-1 text, limits, rates, justification) · state plan
2. Kansas Register Vol. 44 No. 24 (6/12/2025): Notice of Final NF Medicaid Rates for SFY2026 · state plan
3. Kansas Register Vol. 43 No. 25 (6/20/2024): Revised Notice of Final NF Medicaid Rates for SFY2025 (PDPM nursing CMI) · state plan
4. Kansas Register Vol. 42 No. 23 (6/8/2023): Notice of Final NF Medicaid Rates for SFY2024 (RUG-III 34; first Medicaid add-on) · state plan
5. Kansas Register Vol. 41 No. 22 (6/2/2022): Notice of Final NF Medicaid Rates for SFY2023 (three-year base 2019-2021) · state plan
6. KDADS Nursing Facility and Adult Care Home Programs page (rate setting basics, timeline, rate lists, QCA EFT notice) · agency page
7. KDADS July 2026 SFY27 NF Rate List (xlsx) · rate file
8. KDADS Quality Care Assessment FAQ 2026 · agency page
9. KDADS Bed Changes FAQ 2026 · agency page
10. K.S.A. 75-7435 Quality care assessment; quality care fund · statute
11. K.A.R. 129-10-31 Nursing facility quality care assessment program · regulation
12. K.A.R. 129-10-18 Per diem rates of reimbursement (cost centers, limits, case mix, private-pay registry, reserve days 67%, ventilator) · regulation
13. K.A.R. 129-10-19 Per diem rates; effective dates · regulation
14. K.A.R. 129-10-25 Real and personal property fee · regulation
15. K.A.R. 30-10-21 Reserve days · regulation
16. KMAP Nursing/Intermediate Care Facility FFS Provider Manual (updated 06/2026) · agency page
17. KMAP HCBS FE FFS Provider Manual · agency page
18. KanCare 2025 RFP / MCO selection page · agency page
19. Personal needs allowance · secondary

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