November-December 2024

What’s New?

Overflowing Gratitude!

Lake Cumberland area residents wrote letters and poems to friends (featured below). During October Residents’ Rights Month residents repeatedly shared gratitude for their caregivers, families, friends, and ombudsmen.

Too often residents of long-term care communities do not have regular visitors and when problems arise, they do not feel confident to address those issues on their own. That’s where you can help. A certified long-term care volunteer ombudsman is an advocate for residents of long-term care communities. A certified ombudsman regularly visits long-term care facilities and works free of charge for the resident to resolve problems that arise. When a problem is presented and with the resident’s consent, the certified long-term care ombudsman volunteer can begin an investigation to help remedy the problem.

Please consider becoming a volunteer long-term care ombudsman.

Thank you to our staff and volunteers. You make a difference!

Nursing Home Residents Need Your Help!

The nursing home minimum staffing standard is at risk! Currently, Congress is negotiating an end-of-the-year deal, and some in Congress are proposing to rescind or delay the minimum staffing rule as part of this deal. Both rescission and/or delay would be catastrophic for nursing home residents. This staffing rule was the culmination of decades of advocacy by nursing home residents, their families, and other advocates. It is estimated that the rule will save 13,000 lives each year.

Better staffing leads to better outcomes. We cannot let last minute backdoor deals put nursing home residents at risk. It is critical that you reach out to your members of Congress and tell them to reject any end-of-the-year deal that rescinds or delays the minimum staffing rule.

It takes just two minutes to send a message to your members of Congress.

Holiday Hints for Residents, Families, Friends & Caregivers

The holiday season is a time for reconnecting with family, friends, and neighbors. Residents of long-term care facilities often need and enjoy your attention during the holidays. We hope these holiday hints will help loved ones and long-term care residents enjoy the holiday season.

Holiday Visiting Tips

Holidays can be meaningful enriching times for both the resident and family. Maintaining (or adapting) old family rituals and traditions can help all family members feel a sense of belonging and family identity.  For residents of a long-term care facility, a link with a familiar past is reassuring and builds self-esteem, i.e. “Look at the beautiful family I created!”

Residents, it is okay to set your own limits and be clear about them with others. You do not have to live up to the expectations of others. It is your right to choose whether or not you accept invitations to go out and visit family and friends.  It is your right to accept or not accept visitors at the facility. You are in charge!

Staff, we encourage you to be aware of situations that may confuse or frustrate residents with memory loss such as: noise and loud conversations; strange distracting surroundings; changes in light intensity-too bright or too dark; or change in regular routine.

Most severely ill residents or residents with memory disorders may be able to enjoy visits more if they have adequate rest before the visit.  Prepare visitors by explaining what has happened to the person with memory loss or disability.  Give examples of what may take place like inattention, wandering, or difficulty hearing.  Explain that the resident may not remember what is expected and acceptable.  A memory-impaired resident may not remember the visitor’s name or relationship.  Explain that memory loss is a result of an illness or isolation and not intentional.  Stress with visitors that what is important is the meaningfulness of the moment spent together and not what the person is able to do or remember.

If you or other visitors notice that a resident is in pain, dirty, or suffering from a change in their condition get help for the resident immediately.  Calmly speak with the facility’s Director of Nursing, Administrator, or other management staff. Describe your specific concerns and ask that problems be addressed as soon as possible.  The Ombudsman can help monitor the situation and make sure problems stay fixed. If you feel your concerns were not taken seriously, please don’t hesitate to contact the Long-Term Care Ombudsman toll free at 1-800-372-2991 or email us at [email protected].

Home for the Holidays

Each year, we hear from families asking, “My loved one lives in a nursing home. Can they come home for the holidays?”

The answer is YES! Your loved one can come and go.

If they are using Medicaid, they are allowed to be away from the facility for several days each year for purely social reasons.  If they are using Medicare, the facility can bill Medicare for the day’s stay if they return by midnight.

With advanced preparation, going home can be the best gift your loved one could have this season. You should talk with the nursing staff at least two to three days in advance of the outing so they can prepare for it. The staff should package needed medication, bag up incontinence supplies, write down special food preparation instructions, and anything else you might need to do.  Ask the staff to give instructions to you in writing.  If you run into trouble, you can always call the nursing home and ask questions. If there is a medical emergency while home, call 911 as you would for anyone else and then alert the nursing staff at the facility.  If your loved one tires and wants to return to her facility earlier than expected, respect her wishes.  With a little planning and a lot of love, it should go just great!

If leaving the facility is not something the resident would enjoy, then don’t feel pressure to get them “home for the holidays.”  Think ahead about what might make celebrating at the facility as enjoyable as possible.

Sharing your time and love is priceless. Happy Holidays!

Holiday Gifts and Treats

Over the years residents and families have shared some wonderful ideas. Here are a few of those gift ideas.

• Ask the resident what gifts they would like to receive. If the resident is unable to guide you check with the facility activity or social services directors to see if they have suggestions.
• Pen and pencil set, journals, stationery, box of greeting cards, and stamps
• Twin size quilts or cozy lap blankets
• Comfortable clothing such as robes, flannel shirts, slippers, pajamas, cardigan sweaters, sweat suits, jackets, gloves, earmuffs, house dresses that snap up the front, warm socks, shoes, and scarves as well as celebratory seasonal clothing, and Sunday best outfits- pay special attention to any details the resident may desire such as Velcro closures, stretch materials, size, color, and hem.
• Costume jewelry and wrist watches with large numbers
• Electric razor
• Perfume/aftershave
• Books and word puzzle books. During respiratory illness outbreaks residents say they significantly increase reading and working both word and jigsaw puzzles.
• Cookies, pie, cake, chocolate, hard candy and sugar free candy, soft drinks, drink packets for bottled water, peanut butter or cheese snack crackers, and chips
• Lip moisturizers, makeup, moisturizing and/or scented body wash, lotions, and powders.
• Coins and a change purse for purchasing snacks from vending machines.
• Gift cards for online retailers so residents can order clothing and other items they pick out on the internet. Be sure to talk with facility administration to determine how to prevent theft of these cards and how staff may help the resident search for items on the retailer’s website.
• Music (old favorites)/audio books and devices to play these audio files.
• Mobile phone, steaming TV services, or tablet- installation and monthly service fees.
• Wall art, photos, easy to read wall clocks, quilts, bulletin boards and pleasing decorative items to hang on the wall. Avoid decorative items that need to sit on a tabletop. We suggest talking with the facility maintenance staff in advance to see if wall mounting of gifts can be scheduled or if you need to provide something like 3M Command products.  Also ask if items need to be treated with a flame-retardant spray.
• Memory book that chronicles the resident’s past interests and achievements
• Personalized calendars with photos of family and friends

To reduce loss and theft of a resident’s personal items, write a full inventory of all the items you give to the resident and provide a copy to be put into the resident’s inventory file. Use permanent ink to write resident names on clothing and other items in an area that does not show when worn or used. Residents should keep only small amounts of cash on their person.  Cash gifts can be deposited to the resident’s “Patient Trust Account” which is like an individual savings account at the facility. Residents should have easy access to money placed in their account and receive quarterly statements describing account activity.  Engrave expensive items with resident name or initials. Record and retain serial numbers for electronics. Provide a small storage container with the resident’s name on it to hold items when not in use. Report every loss and theft in writing to both the facility and the ombudsman.

Community Education and Engagement

Welcome Brandon Woods

You can reach Brandon at the Nursing Home Ombudsman Agency

[email protected]

As a regional ombudsman for the Nursing Home Ombudsman Agency of the Bluegrass, Brandon will assist the State Long-Term Care Ombudsman with delivery and coordination of services statewide as well as assisting and monitoring of District Long-Term Care Ombudsman programs.  He will also create and present educational materials to ombudsmen, residents, families, and Long-Term care facility staff.

Brandon Wood has experience as a certified Long-Term Care Ombudsman and assisting a District Long-Term Care Ombudsman in advocacy. Brandon genuinely cares and has a great passion for helping others that are in need and assisting people finding solutions to problems together.

Outside of being a Regional Ombudsman, Brandon enjoys travel, flea marketing, and spending time with friends and family.  He is a musician and sings in several vocal groups throughout the state and enjoys playing some musical instruments as well.  He is also an avid roller coaster enthusiast and enjoys visiting theme parks during the summertime.

Welcome Leanne Mabrey

Leanne Mabrey is a new Certified LTC Ombudsman in the Green River area (GRADD). After retiring from a long career in Business, Education and Healthcare and becoming a widow Leanne started thinking about finding a purpose and creating a new life. Her mother had spent time in a nursing home and Leanne wanted to make sure that residents were treated as well as her mother was.

When an AmeriCorps position as an Ombudsman Assistant at GRADD became available, Leanne decided it would be a great way to serve residents of long-term care facilities in her community. She has a Bachelor of Science  and a Master of Arts in Education from Western Kentucky University.

Leanne is a mother of three sons and a grandmother. She resides in

Owensboro with her little dog Jojo (a “Chillier” breed – long haired Chihuahua and Cavalier King Charles Spaniel mix).

Leanne has a passion for making a difference in other people’s lives and being of service. We are pleased to welcome Leanne to the program.

Local Ombudsman Training on Legislative Advocacy

Staff and volunteers of the KIPDA and Lincoln Trail LTC Ombudsman Programs at Catholic Charities in Louisville received training from a special guest. From left to right on the front row are District Ombudsman Erika Rhodes-Chism, guest speaker and advocacy specialist Dr. Sheila Schuster, and staff ombudsman Jamie Barnes. In the back row from left to right are staff ombudsmen Walter Munday, Laura Krueger, and Andrea Calhoun, as well as SLTCO Program Resident Advocacy Manager Mark Burress, and KIPDA and Lincoln Trail LTCO Volunteer Coordinator Stephen M. King, Jr. Thank you to Dr. Schuster for sharing her expertise with the group!

Improving Lives and Care: the Long-Term Care Ombudsman Program

During a 1971 helicopter ride to a speech in Chicago, President Nixon and former Commissioner on Aging Arthur S. Flemming were discussing the President’s presentation of initiatives to improve nursing home care. By the time they arrived in Chicago, a new idea was added: the formation of a nursing home ombudsman program.

The idea behind the creation of the Long-Term Care Ombudsman Program (LTCOP) came from involving the community to ensure nursing homes were providing appropriate care for their residents. Engaging trained volunteers who could visit and establish relationships with the residents was the basis for the program. Read the rest of this article here.

Learning Opportunities

Resources and Information for Family Caregivers

In recognition of National Family Caregivers Month in November, the National Center on Elder Abuse hosted a webinar titled, “Conversations on Caregiving, Ethics, and Elder Mistreatment.”  The webinar featured former Kentuckian Dr. Pamela Teaster and addressed critical ethical questions that may surface when caring for a loved one, including healthcare and financial decision-making; self-determination, safety, and autonomy; the changing nature of family relationships; and the link between caregiving and abuse. NCEA also created a fact sheet featuring Tips and Tools for Safe and Supportive Caregiving.

Find further resources for family members on Consumer Voice’s website, including information for family councils.

New Podcast by The National Consumer Voice

During this time of year, nursing homes can expect to see an increase in people visiting their loved ones. This increase puts everyone at a higher risk of catching a cold or respiratory illnesses. Join the Consumer Voice for a conversation as they dive into the latest CDC guidance on respiratory illnesses, including COVID-19, for nursing home residents.

Jocelyn Bogdan, J.D., Senior Program and Policy Specialist at Consumer Voice was joined by Dr. Erika Wallender from the CDC, and Lori Walsh, Consumer Voice Policy and Program Specialist, to discuss practical steps in reducing infection risks and best practices for staying safe during this upcoming respiratory season.

A recent article in the Heath Affairs Scholar found that mortality rates among nursing home residents remained above pre-pandemic levels through the end of 2023. The mortality rate per 100,000 residents was 5,692 in December 2020, when COVID-19 was taking its greatest toll on nursing home residents, according to the new article. The authors compared this to the pre-pandemic mortality rate trend, which they estimated would have been roughly 3,500 per 100,000, in December 2020, should COVID-19 not occurred. In November 2023, the mortality rate for nursing home residents was 4,000 per 100,000 residents, still roughly 500 more residents per month, when compared to pre-pandemic trends.  In sum, more residents were dying monthly in late 2023 than pre-pandemic mortality trends.

Unfortunately, these elevated numbers are likely partly attributable to dismally low COVID-19 vaccination rates among nursing home residents. The Centers for Disease Control and Prevention’s (CDC) Nursing Home COVID-19 Vaccination Data Dashboard shows that only 32% of nursing home residents are up to date with their COVID-19 vaccinations. The nursing home staff rate is even lower, with only 7% of staff being up to date with their vaccines.

Mental Health 101, Suicide Prevention & De-escalation Strategies

This session, provided by the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF), is an introductory training to help identify, understand, and respond to mental health disorders. It also includes helpful strategies for suicide prevention and de-escalation techniques applicable to residents of nursing homes.

The primary audience for COE-NF training are nursing facility staff; however, it is important for Long-Term Care Ombudsman Programs (LTCOPs) to hear about common mental health disorders among nursing facility residents and best practices to share with nursing facility staff to support residents.

Personal Needs Allowance Increase

Kentucky nursing home residents utilizing Medicaid retain a Personal Needs Allowance (PNA) for personal and incidental needs while under the care for long-term services. As a result of House Bill 6 (RS 2024), the PNA increased from $40 to $60.00 per month effective July 1, 2024.

This increased amount for PNA is deducted from the Medicaid LTC member’s gross income when determining the patient liability for Nursing Facilities (NF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs), Institutional Hospice (IHP), and Institutional Program of All Inclusive Care for the Elderly (IPACE).

If you have any questions regarding this change, please contact [email protected].

2023 Kentucky Annual Long-Term Care Services Report Available

The report contains over 500 pages of census, payor source, resident (patient) age, death, and origin information. To access the report click here or visit the Office of Inspector General Annual Health Care Facilities and Services Reports webpage to access reports from previous years.

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!

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.