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Kansas Pay-for-Performance

Kansas utilizes a "Nursing Facility Quality and Efficiency Factor" to calculate a per diem add-on factor for nursing homes. The factor is determined by the measures: case-mix adjusted staffing ratio, operating expense; staff turnover rate; staff retention rate and occupancy rate. Reduced operating expenses and turnover along with increased retention and occupancy rate are posited to be outcomes of culture change. Given the extensive education that the Kansas Department of Aging provides through it's Promoting Excellent Alternatives in Kansas (PEAK) program, a correlation between culture change initiatives and beneficial outcomes in P4P is theoretically possible.