Wednesday 9 November 2011
Kentucky voices: Money for nursing home ombudsman critical
Nursing home ombudsmen are involved in investigations of alleged resident abuse, neglect and other problems at long-term care facilities. These are the so-called "angels of mercy" who look after nursing home residents.
Surveys show that in the average nursing home more than half of the residents have only one visitor, and that's the ombudsman.
Ombudsmen do all kinds of things, from going to bat for the resident on serious issues to just being a friend and bringing a smile and a "hello" to lonely folk.
There weren't always full-time ombudsmen in each of the 15 Area Development Districts in the state. In fact, it came as a surprise to advocates for better nursing home care about eight years ago that there were only four full-time ombudsmen statewide.
The rest were part-time workers. Upon learning this, advocates for better nursing home care and an ombudsman leader rushed to Frankfort to find out why this was happening.
The answer was simple, as it usually is in Frankfort. Money.
Paul Patton was governor then. Advocates for nursing home residents met with his budget officials in an emergency meeting. The advocates said that such poor care and attention to nursing home residents must not continue.
They suggested that Patton do something about it which, by the way, would be a feather in his cap among the senior citizen population when he would make a try for the U.S. Senate.
Patton agreed. Of course, he ran into some problems and never ran for the Senate, but he did find money to fund full-time ombudsmen in every one of the 15 districts. Patton went to something called the Civil Monetary Penalty fund and found the money, a fund where fines against nursing homes for violating federal regulations are placed, and found the $500,000 that was needed annually. Patton's secretary for the Cabinet for Health and Family Services made sure the money was used to help maintain full-time ombudsmen statewide.
Then Ernie Fletcher was elected governor, and he also protected a full-time ombudsman program. And so it has been also in the Beshear administration, until now.
This well-run program is being threatened right now and hardly anyone knows about it, even though there currently stands about $15 million in the Civil Monetary Penalty fund just waiting to provide support.
Word began leaking out last summer from the Centers for Medicare and Medicaid Services in Washington that it would no longer allow money from the Civil Monetary Penalty fund in each state to be used to supplement salary monies for nursing home ombudsmen.
Kentucky officials have since been scrambling to effect a compromise with the feds or find the necessary money somewhere in state coffers.
Their problem: Either find a half-million dollars a year, or convince the federal bureaucrats of the importance of a good ombudsman program so they'll relax their arbitrary position.
A lot of this, by the way, is being blamed on the Affordable Care Act. And it's also affected 13 other states that use CMP funds for the long-term care ombudsman program.
Kentuckians for Nursing Home Reform, the statewide advocacy group, said this in a statement:
"We are concerned about the callous and apparently clueless action by the federal Centers for Medicare and Medicaid Services. .... This arbitrary move by CMS could put the Kentucky ombudsman program back to where it was eight years ago. It is obvious that the Washington bureaucrats who make decisions like this have never been in a nursing home and are oblivious to the needs of the people."
Attention by state leaders and Kentucky's congressional delegation needs to be given immediately to this impending crisis.
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