October 2025

The 2023 Annual Report of the Kentucky Office of the State Long-Term Care Ombudsman Program is complete. Our Office serves as an independent advocacy service for individuals living in Kentucky’s long-term care (LTC) facilities. Long-term care ombudsmen, or advocates, provide services to residents while advancing systemic change to improve the quality of care and lives of all those living in LTC.

The Kentucky Office of the SLTCO is required by federal law and regulation to complete an annual report that describes ombudsmen program activities, analyzes program data, identifies problems and barriers to resolving complaints made by or on behalf of LTC residents, make policy, regulatory and legislative recommendations, analyze the success of the Program, and describe barriers that prevent the optimal operation of the Program (45 CFR §1324.13(g)). The report is available on our website.

“Government Shutdown” Could Have a Significant Impact on Nursing Home Care Quality and Place Residents at Risk

On October 1, 2025, current funding for the federal government expired. As a result, funding for discretionary federal programs will not continue until Congress agrees on a funding extension.  While some discussions are underway in Congress to pass a continuing resolution that would extend funding for discretionary programs, it is unclear when the House and the Senate will reach a consensus.

The impact of the funding expirations will affect federal programs deemed “non-essential,” or those programs without mandatory funding. Critical programs, including Medicare, Medicaid, and Social Security, have mandatory funding; however, the services that support them will be impacted.

The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have posted contingency plans for the shutdown, noting that nearly half of CMS will not be retained during the shutdown. The plan makes clear that the impact of a shutdown will be significant on nursing home survey and certification. The suspension of recertification surveys puts residents at risk.

Visit The National Consumer Voice for updates as the situation develops.

Violation of Requirements for a Safe Discharge

Unlawful or poorly managed transfers and discharges are among the most common and distressing violations of regulations experienced by residents. These actions can lead to trauma, hospitalization, and even homelessness.

In this issue of the Elder Justice newsletter the Center for Medicare Advocacy and Long Term Care Community Coalition highlight deficiencies where nursing homes failed to follow federal requirements, putting vulnerable residents at serious risk. Real life case examples described in this issue include: Blue lips and unresponsive: Resident discharged without oxygen, arrives in medical crisis; Medication confusion: Five residents discharged without medications or follow-up care; Kicked out on Christmas: Resident discharged without proper notice; Resident discharged to a homeless shelter; “Walking with a Swiffer brand mop”: Resident discharged twice without equipment, care, or housing; and Residents discharged without home health, equipment, or wound care.

Families, ombudsmen, and advocates must remain vigilant in ensuring residents’ rights are protected during any discharge or relocation process. Improper discharge cases are the most time-consuming cases that LTC Ombudsmen address. The cases often involve administrative hearings, extensive negotiations with facilities, records reviews, and report submissions to the Office of Inspector General and Adult Protective Services. If you or someone you love is threatened with discharge from a long-term care facility and you do not agree please contact your ombudsman immediately. Residents have 15 days to appeal a discharge from the date that they receive notice of the intent to discharge them.

Requirements and Guidance Regarding Transfer and Discharge Notices

Check out the Highlights of Federal Nursing Facility Requirements and Guidance Regarding Transfer and Discharge Notices from the National Ombudsman Resource Center.

Congress Must Protect Long-Term Care Residents

The Older Americans Act (OAAA), this year celebrating its 60th anniversary, encodes protection of the rights of long-term care residents and preserves their quality of life, dignity and safety.  The Act is a key part of the system that exists to protect all older adults in the nation by providing critical services that help people live in their communities and protect those who are most vulnerable who live in licensed care settings such as nursing homes.

The Older Americans Act authorizes funding for critical programs such as the Long-Term Care Ombudsman Program (LTCOP), home delivered meals, elder abuse prevention and response, and family caregiver support, for example. These and other activities funded by the Act serve one in six older adults, according to the Department of Health and Human Services.

The LTCOP visits investigated more than 205,000 complaints and provided more than 710,000 instances of information and assistance to residents, family members, concerned individuals and facility staff. Long-term care ombudsman representatives help address serious complaints, including involuntary discharge or eviction, physical abuse, neglect, poor staff response to requests for assistance, inadequate or poor medication management, insufficient quality or quantity of food and many other issues. These services help support the 6 million people on Medicaid who live in institutional settings.

However, funding for the Long-Term Care Ombudsman Program and other services authorized by the Older Americans Act has not kept pace with the growth in our population of older Americans. Federal funding falls far short of meeting the needs of all long-term care residents.

According to a Kaiser Family Foundation analysis of Congressional Research Service reporting, just 1 percent of funding authorized under the act is designated for grants for the Long-Term Care Ombudsman Program and Elder Abuse, Neglect, and Exploitation Prevention Programs.

Long-term care residents deserve, and are legally entitled, to receive stable, high quality care that upholds their dignity and respects them as individuals.

Americans agree — public opinion surveys show overwhelming concern about poor conditions in America’s nursing homes, and support federal investment in long-term care.

Congress can demonstrate that it is sincerely interested in reducing the burden on our regulatory system, lowering health care costs and protecting older Americans, by reauthorizing the Older Americans Act and increasing funding for the Long-Term Care Ombudsman Program.

Article Recommends Improvements to Substance Use Disorder Care in Skilled Nursing Facilities 

A recent Health Affairs article, “Improving Access To Substance Use Disorder Care In Nursing Facilities,” outlines the need for comprehensive substance use disorder (SUD) care in nursing facilities. The article also provides an overview of the current relevant regulatory landscape, efforts to improve care as well as the need for broader reforms. Per Health Affairs, “Federal law requires equitable care regardless of diagnosis; denial of admission based on SUD status violates the Americans with Disabilities Act of 1990 and has resulted in legal action, complaints to federal agencies, enforcement actions, and fines. However, these challenges have not resulted in sustained improvements in SUD access or care delivery in nursing facilities.”

Read more at medicareadvocacy.org/substance-use-disorder-care-in-snfs

Nursing Homes Failed To Report 43% of Falls With Major Injury and Hospitalization

The U.S. Department of Health and Human Services Office of Inspector General recently released a report, Serious Falls Resulting in Hospitalization Among Medicare-Enrolled Nursing Home Residents, July 2022–June 2023. The report indicates that more than 40,000 Medicare-enrolled nursing home residents experienced serious falls—those resulting in major injury and hospitalization—over a 1-year review period. These falls reduced residents’ quality of life and were costly for the Medicare program. More robust fall prevention programs and other quality improvement initiatives can help reduce falls among nursing home residents.

What OIG found

• Medicare-enrolled nursing home residents experienced 42,864 falls with major injury and hospitalization and 1,911 residents died while hospitalized.
• Medicare and enrollees paid more than $800 million for the resulting hospital care.
• Most residents had fall risk factors identified by nursing homes prior to their falls.
• Female residents, older residents, and residents with short stays had the highest fall rates.
• Nursing homes with lower nurse staffing levels and lower quality ratings had higher fall rates.

CMS Nursing Home Staffing Financial Incentives Delayed to Spring 2026

The Centers for Medicare & Medicaid Services (CMS) has announced a delay in its nursing home staffing campaign financial incentive program, pushing the launch of the program to spring 2026. Originally expected to begin in 2025, the initiative aims to recruit registered nurses and licensed practical nurses through grants and stipends.

CMS Administrator Mehmet Oz recently unveiled $75 million in federal funding sourced from civil monetary penalties. In a letter to Governors, Oz encouraged states to contribute their own CMP funds to expand recruitment efforts and improve nurse aide training programs.

While CMS will eventually distribute funds through selected financial incentive administrators, the agency noted that the selection process won’t begin until spring 2026, followed by several months of infrastructure setup before incentives are awarded.

In Kentucky’s LTCOP, our staff and volunteers make a real difference in the lives of those we serve. Check out some awesome advocates below!

The KIPDA LTC Ombudsman Program Advisory Council received training from Assistant State LTC Ombudsman Jodi Holsclaw. In front, from left to right, are  District LTC Ombudsman Ty Clemons, Anna Marie, and District LTC Ombudsman Erika Rhodes-Chism. In back, from left to right, are Suzanne Bittenneder, Andrea Calhoun, Walter Mundy, Jodi Holsclaw, Laura Krueger, and Jamie Barnes.

The Gateway Program serves residents in Bath, Menifee, Montgomery, Morgan, and Rowan counties.

Welcome Holly Rapier

Holly Rapier is an employee of Legal Aid of the Bluegrass and serves as the new Gateway District LTC Ombudsman.

Holly has a Bachelor’s degree from Morehead State University in Early Childhood Development and a minor in Sociology/Criminology.

Before becoming the District LTC Ombudsman, she was a liaison between state licensing and childcare facilities.

In her spare time, Holly enjoys snuggling with her English Bulldog, Matilda. She also loves crafting, DIY, UK football tailgates, football Sundays, and the color pink.

Welcome Angela Farthing

Angela Farthing is the new Purchase District LTC Ombudsman. Angela is a long time resident of Mayfield. She attended Murray State University, where she received a Bachelor of Science in Education.

Angela’s background is in advocacy. She assisted the previous District LTC Ombudsman. Angela has experience working in a long-term care facility and as a homecare case manager. Her passion is to help vulnerable populations through advocacy and to educate individuals on self-advocacy to be treated with dignity and respect and to improve their quality of life.

In her spare time  Angela likes to

spend time with her family and friends. She loves music and enjoys concerts, movies, and hiking.

The Purchase District Long-Term Care Ombudsman serves residents and families in Ballard, Calloway, Carlisle, Fulton, Hickman, Graves, Marshall, and McCracken counties.

HHS Advisory Nominee

Denise Wells, Executive Director of the Nursing Home Ombudsman Agency (NHOA), was nominated to serve on the Department of Health and Human Services (HHS) Healthcare Advisory Committee. Denise Wells has spent the past eleven years as an advocate for residents of long-term care facilities

in Kentucky through the Older Americans’ Act Long-Term Care (LTC) Ombudsman Program. Before working with the LTC Ombudsman Program, Denise worked for St. Louis’ Lutheran Senior Services Meridian Village Continuing Care Community. Denise’s 15 years of varied experiences working directly with consumers of long-term care facility services made her a natural candidate for the committee position. Those appointed to the committee will serve as advisors to the Secretary of the Department of Health and Human Services and the Administrator of the Centers for Medicare & Medicaid Services on programs and policies that can help improve the United States’ healthcare system. Those selected for the committee will be notified by the end of October.

The new Purchase District Long-Term Care Ombudsman, Angela Farthing, hosted a training for staff and volunteers in October. Brandon Wood, Regional Ombudsman with the State Ombudsman Office, provided Residents’ Rights training to the council.

We need volunteers to serve as certified long-term care ombudsmen. Visit our website for more information.

Information

 Check out the Consumer Voice’s emergency prep fact sheet!

New KY Caregiver Resource!

Learning Opportunities

Dementia Webinar Series

The Office of Dementia Services (ODS) partnered with the Alzheimer’s Association of Greater Kentucky and Southern Indiana for the 2025–2026 Dementia Webinar Series. The series is a collection of free, virtual programs designed for professionals, caregivers, and individuals living with dementia.

The series kicks off November 12, 2025, at 10:00 a.m. ET. Registration is now open for all events. You are encouraged to register for each session you wish to attend.

2025–2026 Dementia Webinar Series Lineup

November 12, 2025  Building Foundations of Caregiving
Learn caregiver roles, build support networks, and manage stress effectively.

January 14, 2026  Supporting Independence
Strategies to help individuals maintain dignity, autonomy, and daily function.

March 11, 2026  Living with Alzheimer’s: For People Living with Dementia (Part 1)
Understand diagnosis, plan ahead, and navigate early-stage dementia confidently.

May 13, 2026  Living with Alzheimer’s: For People Living with Dementia (Part 2)
Explore mid-stage changes, communication tips, and support planning tools.

July 15, 2026  Healthy Living for Your Brain & Body
Practical lifestyle habits to reduce risk and promote brain health.

September 9, 2026  Advancing the Science: The Latest in Alzheimer’s and Dementia Research
Discover emerging breakthroughs and current directions in dementia research.

2025 Consumer Voice Conference

Join Consumer Voice November 3-6, 2025, at the Renaissance Arlington Capital View Hotel. In celebration of the organization’s 50th Anniversary, the conference is returning to the Washington, DC area. Connect with advocates from across the country to learn, network, and exchange ideas on long-term care issues, including current trends, best practices, and advocacy opportunities. See the preliminary agenda, and register now. Visit the Consumer Voice website for more information about discounts for members and groups.

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.

Our Contact Information
Nursing Home Ombudsman Agency of the Bluegrass
3138 Custer Drive
Suite 110
Lexington, KY 40517
8592779215
http://www.ombuddy.org