Challenges and Financial Strain Facing Kentucky Nursing Homes

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Kentucky nursing homes are facing significant financial distress, struggling to compete for workers, and grappling with Medicaid reimbursement issues. The sector has experienced the worst job losses in healthcare, with facilities in dire need of financial support and operational restructuring to ensure adequate care for residents.


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  1. Kentucky Association of Health Care Facilities Kentucky Center for Assisted Living Senate Standing Committee on Appropriations and Revenue February 14, 2024 Advocate. Educate. Promote

  2. Advocate. Educate. Promote KAHCF | KCAL

  3. Kentucky Association of Health Care Facilities Kentucky Center for Assisted Living NURSING HOMES: WORST IMPACTED THAN ANY OTHER HEALTH CARE SECTOR Percent Change in Health Care Sector Employment since Feb 2020 10.2% 9.4% 8.3% 4.2% Physicians' Offices Home Health Outpatient Care Hospitals Nursing Homes -8.3% Advocate. Educate. Promote Source: Bureau of Labor Statistics (BLS) February 2020 January 2024 3

  4. Nursing Home Struggle to Compete for Workers Nursing Home Struggle to Compete for Workers Long term care is experiencing the worst job loss of any other health care sector. (BLS) Nursing homes have increased nurses wages by 17.3% since 2019. Wage increases in 2020 and 2021 outpaced those working at other types of care facilities. (JAMA) More than 9 out of 10 nursing home providers have increased wages and offered bonuses to try to recruit and retain staff, but still struggle to hire due to a lack of interested or qualified candidates. (Provider Survey) KAHCF | KCAL

  5. Nursing Home Financial Crisis Nursing Home Financial Crisis 79.9% of facilities are in financial distress or at-risk for financial distress*; Cost of wages for health care workers and goods has skyrocketed; KAHCF | KCAL

  6. Current State of Nursing Home Care Reimbursement Current State of Nursing Home Care Reimbursement 76% of residents rely on Medicaid as their payor in Kentucky; Medicaid rebasing aligns a standardized price to reimburse for the costs of care; Last full rebasing took happened in 2009; KAHCF | KCAL

  7. Inflationary Medicaid Rates KAHCF | KCAL

  8. Rebasing Needs $220 million in fiscal year 2025 $62.5 in General Fund $157.5 million in Federal Funds $235 million in fiscal year 2026 $67 million in General Funds $168 million in Federal Funds KAHCF | KCAL

  9. Our Ask Fully fund rebasing for both FY 25 and FY 26 Ensure adequate baseline funding for the Medicaid program Continue to collaborate with providers ensuring they have the resources to meet the needs of the Kentuckians they serve Thank you for your support KAHCF | KCAL

  10. Questions? Adam Mather President amather@kahcf.org KAHCF | KCAL

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