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Kentucky LTC Ombudsman Program Funding
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The Kentucky State Long-Term Care Ombudsman Program continues to advocate for additional funding to meet program requirements.
The Kentucky House of Representatives included the program’s full funding request in House Bill 6, which passed on February 1st.
Next, the Kentucky Senate’s Appropriations and Revenue Committee will present their budget for discussion and vote.
We are diligently working to ensure the full appropriation is included in the Senate and final budgets!
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“Difficult” is Not a Diagnosis What to Do When Your Loved One is Being Pushed to Take Antipsychotic Drugs
When a nursing home tells you that your family member is “difficult” or that they are disturbing other residents, it may feel like your loved one has done something wrong. They have not. “Difficult” is not a diagnosis and it is inappropriate to label any resident this way. Actions and behaviors are a form of communication by which residents are expressing an unmet need. There are reasons that may explain your loved one’s actions. It’s inappropriate for the facility to label a resident as “difficult.” It’s their job to evaluate and address the resident’s needs.
The nursing home may argue that because your loved one is “difficult,” they cannot provide adequate care, or they may say that their behavior is endangering other residents. These reasons can make families feel afraid or threatened, but remember, both reasons can often be addressed by understanding the reason or cause for the behavior.
No one should be given medication in place of good care or for the staff’s convenience. In fact, when antipsychotic drugs are given to older adults with dementia, they can be unsafe. They often come with a black box warning, the most serious warning required from the US Food and Drug Administration, about their dangerous, life-threatening risks. Further, these drugs only mask the problem, they don’t resolve the issue that is causing the distress.
You may feel like you’re all alone, but there are resources and supports that can help. Check out the new fact sheet “Difficult” is Not a Diagnosis to learn more about care planning, residents’ rights, good care practices, and where to turn for help. Please contact your long-term care ombudsman for more help and support.
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New Reference Guide on Related Party Transactions
The National Consumer Voice for Quality Long-Term Care has published a new reference guide, Related Party Transactions and CMS’s Role in Regulation. Each year, nursing homes funnel Medicare and Medicaid dollars meant for nursing home resident care through companies they own with little to no scrutiny on how this money is used. In the early 2000s, nursing home owners began creating separate, single-purpose corporations to avoid civil liability for negligent care. An additional benefit of this practice for owners was that they could use the corporation that owned the real estate (which they own) to charge unrestricted rent and lease fees to the nursing home (which they also own). This practice was expanded upon even further as companies set up several related party organizations with which they do business, for instance, management companies, physical therapy companies, staffing companies, and others. This practice can often translate into millions of dollars in payments by a single nursing home to companies that are in fact owned by the owners of the facility. According to some estimates, 75% of nursing homes engage in related party transactions.
Critically, related parties can serve to mask profits. When high amounts are paid to the related party, the nursing home looks much less profitable, even though they are paying the nursing home owners themselves. As a result, nursing homes can assert that their facilities are not making a profit, or are even losing money, when high amounts are being paid to related party companies.
The Nursing Home Reform Act of 1987 provides the Secretary of Health and Human Services broad regulatory authority to ensure that Medicare and Medicaid dollars are spent appropriately. Additionally, the Medicare Provider Reimbursement Manual provides in-depth guidance as to how related parties must be reported. The Centers for Medicare & Medicaid Services (CMS) requires nursing home providers to be “prudent buyers.” In other words, owners must not inflate costs paid to related parties but pay only what they would if they purchased the goods or services on the open market.
Consumer Voice recommends that CMS should:
- Require nursing homes to submit consolidated cost reports;
- Routinely review and audit cost reports;
- Require increased disclosure requirements for related parties to determine whether costs charged to nursing homes for goods and services are reasonable and prudent;
- Make information on cost reports more easily accessible to consumers; and
- Conduct targeted surveys of nursing homes with unreasonable and excessive related party transactions.
Read the full Reference Guide for more information.
To learn more about the Consumer Voice and their membership opportunities visit their website.
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Senate Aging Committee Seeks Stories from Assisted Living Residents and Their Families
The United States Senate Special Committee on Aging is seeking stories from older adults and adults with disabilities residing in assisted living facilities, and their family members. The Committee is specifically looking for stories related to the costs and quality of assisted living services and encourages sharing your stories and bills from facilities. Submit your story via the form on their website or by emailing [email protected].
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Staff and Volunteer Spotlights
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Eva Sublett joined the Lake Cumberland Area Agency on Aging and Independent Living team in 2021 and became a staff Certified LTC Ombudsman in 2023. Eva’s educational background includes a Bachelor’s degree in Marine Resources and a Master’s degree in Oceanography; however, her passion is serving her community and older adults.
Eva grew up shadowing her mother, a nursing home owner and nurse. Thus began Eva’s love of people and desire to make a difference for them each and every day.
Eva works closely with District LTC Ombudsman Mandy Weston ensuring that residents in Adair, Casey, Clinton, Cumberland, Green, McCreary, Pulaski, Russell, Taylor, and Wayne Counties receive regular visits from an ombudsman.
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Denise Wells joined the Nursing Home Ombudsman Agency (NHOA) in 2014. She served as a Regional and District LTC Ombudsman prior to becoming the Executive Director of NHOA in December 2019. She graduated from McKendree University with her B.A. in psychology and sociology. Denise is the author of Protecting Residents From Financial Exploitation.
Denise credits her background in sociology for her passion for advocacy, saying, “One of my favorite quotes is by journalist Amy Goodman. She says, ‘Go to where the silence is and say something.’ I can think of no better place to amplify the voices of people who are often unheard than in the Kentucky Long-Term Care Ombudsman Program.”
In January 2023, Denise was elected to the board of The National Consumer Voice for Quality Long-Term Care in Washington, DC.
“Being the Executive Director, I get to be an advocate for the advocates. My role allows me to meet all kinds of people and tell them about all the incredible things our ombudsmen do.”
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Thank you to our staff and volunteers.
You make a difference!
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The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) helps to improve the quality of life and care for residents experiencing a variety of mental wellness issues, focusing on Co-occurring Disorders (COD), Serious Mental Illness (SMI) and Substance Use Disorder (SUD).
COE-NF was established by the Substance Abuse and Mental Health Services Administration (SAMHSA), in partnership with the Centers for Medicare and Medicaid Services (CMS), the COE-NF offers Certified Medicare and Medicaid Nursing Facility Staff a centralized resource hub with easy access to trainings, technical assistance and additional resources, at no cost. We hope all nursing facilities in Kentucky will sign up with COE-NF to receive technical assistance, support and resources.
Residents, families, other types of LTC providers, and ombudsmen can also access free information on mental wellness and disorders by visiting the website
. Click on Resources and then select from the drop-down menus the type of resource (PDF, video, etc.) and the (mood disorders, substance abuse, trauma informed care, etc.) See sample images below of some of the PDFs available and don’t forget to check out the videos.
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What’s an Ombudsman?
Ombudsmen advocate for residents of long-term care facilities at no charge to residents or families.
Long-Term Care Ombudsmen
- Regularly make unannounced visits to long-term care facilities to visit residents.
- Protect the special legal rights of residents.
- Identify, investigate, and resolve residents’ problems and concerns.
- Empower residents to make informed choices.
- Work to monitor laws/policies to protect residents.
Long-term care ombudsmen serve residents in all counties in Kentucky. Visit our website!
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The Kentucky State LTC Ombudsman Program is housed within the Nursing Home Ombudsman Agency of the Bluegrass.
The KLTCOP is funded in part by state and federal funding provided by the Department for Aging and Independent Living.
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