Elder care advocates in Kansas are expressing concerns that lapses in nursing home inspections in the state are endangering vulnerable residents, according to a KMUW report.
The backlog in inspections of nursing homes is said to be due to the problem of understaffing. The report cites data on the shortage of nursing home inspectors, with information from May and June indicating that over half of surveyor positions for nursing facilities and state-licensed adult care homes were vacant.
Only 29 of 61 positions are filled on the team of inspectors assigned to investigate claims of abuse, neglect and exploitation at federally and state-licensed adult care homes. There have been between 7,000 and 9,000 such complaints in recent years.
Representatives of the Kansas Department for Aging and Disability Services (KDADS) were not made available for an interview regarding the report, but the agency’s communications director Cara Sloan-Ramos sent an email that stated KDADS recognizes “the crucial role our surveyors play in ensuring the health and safety of residents in Kansas long-term care facilities by thoroughly and promptly investigating allegations of neglect and abuse.”
“We agree that an appropriate staffing level is essential to maintain the timeliness and thoroughness of these critical investigations,” she added. “Increased staffing would allow us to fulfill our oversight responsibilities more effectively and better protect vulnerable individuals in our state.”
Advocates for seniors say residents are put at risk of abuse, neglect, and even death by the state’s failures to investigate nursing home complaints on a timely basis. One case spotlighted as an example of this involved Joan Cody, a 94-year-old woman with dementia who was a resident at the Santa Marta memory care facility in Olathe. Family members had expressed concerns about the quality of her care she was receiving. They were assisted in their efforts by long-term care ombudsman Hector Rodriguez, who wrote to state regulators in January seeking to call their attention to what he called “a serious situation.”
In an email to Dawne Altis, the KDADS assistant commissioner who manages nursing home surveyors, Rodriguez described alleged harassment from the facility’s wellness director, retaliatory withholding of pain medication, staff tampering with a camera that Cody’s family installed in her room, and repeated falls by the woman resulting in a broken pelvis that went unnoticed by staff until a change in shifts.
“From both the (family’s) and my perspective as a long-term care ombudsman, the resident is at serious risk,” Rodriguez wrote. “I know your team is very busy, but I believe this matter requires immediate attention.” The ombudsman office said Altis never replied to the email, and Cody died two weeks later of what a coroner stated were complications from a fall. For months before her death, Cody’s family said they made numerous calls to KDADS and lodged two formal complaints about her situation, but no one from the agency was sent to investigate.
“Our office has seen times where a resident has passed before KDADS is able to go out and investigate,” said Haely Ordoyne, the lead long-term care ombudsman in Kansas and Rodriguez’s supervisor. Santa Marta administrators declined to discuss the allegations about Cody’s care for the report, citing patient privacy.
“We are sorry to hear of Ms. Hernandez’s concerns regarding the care of Ms. Joan Cody and extend our deepest sympathy during this difficult time,” Colleen Hollestelle, Santa Marta’s president and CEO, said in an email. “At Santa Marta, we are fully committed to providing high-quality care to each of our residents. Out of respect for patient privacy, and in compliance with federal regulations, we cannot discuss individual care. We take all concerns seriously and are reviewing this matter in accordance with our internal policies and applicable state regulations.”
The staffing issues and lack of oversight of Kansas nursing homes have long been the subject of concerns, and were documented in a report from the U.S. Senate Special Committee on Aging. It found that the state’s surveyor vacancy rates climbed from 4% to 51% between 2003 and 2023, making it one of the nation’s most understaffed agencies.
In a letter to congressional leaders in 2023, the state’s long-term care ombudsman Camille Russell said “Too few survey staff create failures at all levels,” despite “significant effort on the part of individual survey staff in ever more difficult conditions.” She added, “Poor conditions in nursing homes are directly connected to insufficient enforcement capacity of survey, certification, and licensing entities.”
Last year the Kansas ombudsman’s office reported some of the most common complaints at the state’s nursing homes, including physical and verbal abuse by staff members, injuries and death resulting from inadequate staffing, resident “dumping”, and errors in distribution of medication. But it said only 58% of the thousands of complaints received each year are fully or partially resolved.
At a Kansas legislative meeting in April, Ordoyne urged lawmakers to expand the KDADS budget so that the agency can offer higher pay for the hiring of inspectors.
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