Long-term care ombudsman flags staffing shortfalls, facility closures and recommends monitoring staffing formulas

Hailey Ordewine, the State Long Term Care Ombudsman, briefed the Public Health and Welfare committee on oversight activity, staffing pressures and trends in long-term care facilities. Ordewine said Kansas has about 292 nursing facilities (roughly 18,000 licensed beds) and 538 residential care communities and that the ombudsman program operates with 12 regional ombudsmen plus volunteer ombudsmen; in some areas a single regional ombudsman serves more than 9,000 individuals.

Ordewine described the ombudsman role as resident advocate, noting the office handles complaints, provides information and assistance, attends resident and family councils when invited, and participates in facility surveys and transitions. She explained consent rules for investigations and the ombudsman’s referral partners, which include adult protective services, KDADS, the attorney general’s office and the Medicaid inspector general.

Ordewine reported involvement in seven home closures or terminations during the reporting period and described the logistical and human impacts of such closures — including one closure affecting about 100 people and subsequent monitoring that found additional resident deaths in the following year. She said the program often coordinates resident transfers with social workers, discharge planners and managed care organizations to preserve resident choice and safety.

On complaint trends, Ordewine said resident-rights and resident-care issues comprise more than 75% of calls; common problems include alleged abuse, neglect, financial exploitation, discharge disputes and insufficient staffing. She noted Kansas’s current nursing staff-to-resident ratio requirement of 1-to-30 and argued that case-mix differences mean a single ratio can fail to reflect differing resident needs; she recommended considering staffing formulas tied to a home’s case-mix index.

Ordewine reported the program’s complaint-resolution rate rose from about 56% last year to 63% this year, but said the office is handling more complex cases that require longer interventions. She also raised concerns about staffing-heavy administration versus direct caregivers and recommended continued attention to recruitment and training.

Committee members thanked Ordewine for the briefing. No votes or formal committee actions occurred during the presentation.