Kansas long-term care ombudsman reports 2024 complaint surge, cites staffing and medication errors as top concerns

Hailey O'Doing, Kansas long-term care ombudsman, told the Bethel Joint Committee on Home and Community Based Services and KanCare Oversight that her office investigated more than 1,000 complaints in calendar year 2024 and resolved or partially resolved about 58 percent of those cases.

O'Doing said the office performed 2,328 facility visits last year, attended 95 resident and family council meetings, provided information and assistance to more than 2,000 individuals and completed 255 survey participations with KDADS. The ombudsman office certified three new ombudsmen and completed 10 facility staff training sessions during the year.

Why it matters: the ombudsman office serves residents in 298 nursing facilities (a little over 18,000 licensed beds) and 504 residential care and assisted-living settings (close to 16,000 licensed beds), a total the ombudsman described as “close to 34,000 licensed beds” across Kansas. The office acts as an advocate for residents who lack family or other supports, O'Doing said.

O'Doing told legislators that staffing shortages in facilities are a recurring driver of complaints. She said agency staff are often unfamiliar with residents, leading to missed or late medication administration, wrong-person medication events and care that is ‘‘task oriented’’ rather than individualized. "We find it to be very frequently that staff is not familiar with the people they are caring for," she said. The ombudsman said such problems often involve temporary agency staff who do not know residents’ normal routines.

Committee members pressed the ombudsman on follow-up and enforcement. O'Doing said the ombudsman can investigate and will refer serious issues to KDADS surveyors, KDHE for Medicaid eligibility matters, Adult Protective Services and other agencies, but that penalties and licensure enforcement lie with the state survey agency and, for federal programs, with CMS. She said slow survey response times can leave residents without a timely enforcement remedy; KDADS surveyors prioritize complaints and sometimes take weeks to respond.

O'Doing also described recurring systemic concerns that her office included as opportunities for change in its annual report: increases in ombudsman staffing, more KDADS surveyors, clarification around pharmacy provider choice and higher personal needs allowances for residents. She said some facilities charge $200–$300 per month for medication administration setup when families use an outside pharmacy and urged consideration of a higher personal needs allowance, currently cited in the report as $62 per month, which O'Doing said is inadequate for small personal items.

On Medicaid eligibility, O'Doing said many facility admission problems stem from missing information or delayed documentation by guardians, powers of attorney or families rather than agency processing times; she said KDHE has been responsive when the ombudsman asks it to expedite eligibility questions. The ombudsman also praised recent legislative moves to tighten guardianship accountability as helpful in reducing eligibility delays she sees caused by guardianship or power-of-attorney inaction.

O'Doing said the office supports additional dementia training required by recently passed legislation and that the ombudsman program already includes dementia training in its annual training calendar.

The ombudsman’s written annual report, submitted to the committee, contains more detailed case-type breakdowns, a map of regions and the staff directory. O'Doing said volunteer ombudsman declined from about 150 pre-COVID to 10 today and said recruiting volunteers is a priority for the year ahead.

Ending: Committee members thanked the ombudsman and several asked for follow-up information: a map keyed to region numbers and details about job qualifications and application steps for ombudsman positions. O'Doing said she would follow up with the committee.