Advocacy in Action (May 2024): Nursing Home Minimum Staffing Rule

Libby Hastings • May 15, 2024

Recently, we have been disheartened by legislative actions that undermine efforts to improve staffing standards in nursing homes, particularly in Kansas. H.R. 5796, co-sponsored by Representatives Tracey Mann, Jake LaTurner, and Ron Estes, seeks to disapprove a federal staffing standard minimum rule that would greatly benefit residents of nursing facilities. Similarly, S.3410, co-sponsored by Senators Roger Marshall and Jerry Moran, aims to address the same issue in the Senate. If passed, these legislations would prohibit the Secretary of Health and Human Services from implementing the final settings rule for minimum staffing in nursing facilities. 

 

The Nursing Home Minimum Staffing Rule finalized on April 22nd will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day (hprd) of total staffing, including a defined number from both registered nurses (0.55 hprd) and nurse aides (2.45 hprd). It will also require facilities to have a registered nurse onsite 24 hours a day, seven days a week.

 

At the heart of this issue is the need for adequate staffing levels in nursing homes. Research consistently shows that higher staff-to-resident ratios lead to better outcomes for residents, including reduced rates of infections, fewer falls, and improved overall quality of life. By opposing the implementation of a federal staffing standard minimum rule, these legislators are failing to prioritize the well-being of vulnerable older adults in Kansas and across the nation.

 

Additionally, it's disappointing to see the nursing home industry diverting attention away from the real issue at hand. Instead of lobbying against essential staffing regulations, they should be directing their efforts towards hiring and retaining qualified staff, ensuring fair wages, and creating supportive work environments. Working in a nursing facility is a skilled job that deserves respect, and addressing the staff shortage requires dedicated time and attention.

 

However, amidst these challenges, we find hope in the actions of the Biden administration and advocacy organizations who have pushed for measures to improve staffing standards in nursing homes. We applaud their commitment to addressing this critical issue and urge them to continue their efforts.

 

In Kansas, the Medicaid program spends $95,000-$108,000 annually per resident for often sub-standard care. The state allocates approximately $862 million to long-term care facilities, yet Kansas ranks 46th in addressing the shortage of nurses and nurse aides. Taxpayers deserve greater value for their money, and older Kansans deserve improved long-term care options given the consistently poor performance of many in this industry.

 

We cannot afford to ignore this problem any longer. To effectively address the staffing shortage problem in Kansas, we must also look to other states for guidance and best practices. By learning from successful initiatives implemented elsewhere, we can tailor solutions to suit the unique needs of our state's long-term care facilities. Furthermore, it's crucial to foster a collaborative effort that includes the voices of long-term care residents and staff in these discussions. By actively involving those directly impacted by staffing challenges, we can develop more comprehensive and effective strategies to ensure quality care for all individuals in nursing homes.

 

We encourage our readers to act. Contact your Kansas Congressional delegates and share your stories about why staffing is critical to improving quality metrics across the board.

 

Your voices matter, and together, we can make a difference in the lives of countless individuals in long-term care facilities.

 

Advocacy in Action (January 2025): A Preview Into the Legislative Session

January 8, 2025
If predictions are correct, the upcoming Kansas Legislature can likely be summed up by one word: “change.” Leadership changes, a large freshman class of legislators, new committee chairs and a compressed calendar all combine to make 2025 a year full of changes. Added to the mix is a stronger Republican supermajority with an additional 2 seats in the Senate and 3 in the House of Representatives. A quick breakdown by the numbers: The 2025 Senate is comprised of 31 Republicans and 9 Democrats. There are 14 new senators; 13 of whom are Republicans. Almost half of the new senators, 6, previously served in the House. Of the 40 Senators, 27 are men (a gain of 4) and 13 are women. Of the 125 members of the House, 88 Republicans make up the majority with 37 Democrats in the minority caucus. Of the 25 House freshman, 21 are Republicans and 4 are Democrats. Women will make up almost a third of the House, 41, with a gain of 6 House seats in the last election. There are 84 men in the House. One new House member previously served in the Senate. The legislature lost decades of institutional knowledge with the retirement of 19 House members and 14 senators. Many of the retiring legislators were experienced lawmakers who served in leadership positions and committee chairs. Significant procedural changes will impact legislative dynamics. Legislative leaders have adopted a compressed timeline for the 2025 session with plans to adjourn sine die no later than April 12 (the 90th day of the legislative session). Traditionally, the 90th day occurs at the end of April/early May with the ceremonial sine die held in late May. You can view the session calendar here. A new process will change the way the State budget is developed. Instead of using the governor’s budget as the base to begin negotiations, a special legislative budget committee will introduce what is being termed the “legislature’s budget” on Jan. 13, the first day of the session. The special committee met five days during November and December to craft a budget based on the 2024 approved budget, with very few enhancements requested by State agencies. How the budget process and tight time schedule proceeds is still largely to be determined. There are major changes in legislative leadership with the Senate electing Sen. Tim Shallenberger, (R-Baxter Springs) as its new vice president and Sen. Chase Blasi (R-Wichita) as majority leader. Sen. Ty Master (R-Andover) remains Senate president Dinah Sykes (D-Lenexa) will continue as Senate minority leader. In the House, Rep. Brandon Woodard (D-Wichita), takes the reigns as the new minority leader. Committees, too, will look different led by mostly new chairs and/or vice chairs along with new members. In the Senate, a new Committee on Government Efficiency, modeled off the proposed federal Department of Government Efficiency, will explore ways to restructure and reform state government to reduce spending and increase efficiency. All of these changes and multiple moving parts, including the goal to keep a tight rein on the budget, add up to uncertainty related to health and social services issues, including those impacting older adults. With all these variables, this will, in sports terms, be a “building year.” KABC will use this opportunity to build relationships with new and returning policy makers to explore legislation that supports person-centered policies and programs while protecting the rights of aging persons and those with disabilities. We will keep you regularly updated during the 2025 session and opportunities for advocacy but we encourage you to get acquainted with your elected officials. They want and need to hear from you, their constituents. Your experiences and observations about long term care in Kansas helps build their knowledge around these issues with first-hand information about the needs of the people they serve.

What Happens When You Report to Adult Protective Services?

December 30, 2024
When you suspect abuse, neglect, or exploitation of older adults, report as soon as possible! For older adults living at home in the community or in facilities licensed by the Kansas Department of Aging and Disability Services when the perpetrator is not a resident of or staff of the facility, report to the following: Adult Protective Services (APS): 1-800-922-5330 If an emergency, call your local law enforcement agency or 911 The intent of APS is to protect the most vulnerable adults from harm while safeguarding their civil liberties. For more information, visit www.dcf.ks.gov/services/PPS/Pages/APS/AdultProtectiveServices.aspx When someone suspects abuse, neglect, exploitation, or fiduciary abuse of a vulnerable adult, reporting to APS is a critical step in ensuring the individual’s safety and well-being. Here’s what you need to know about the reporting process and what happens after a report is made. Reporter Immunity Individuals who report suspected abuse or participate in follow-up activities, including testifying in administrative or judicial proceedings, are protected under the law. This means they are immune from any civil or criminal liability, provided their report is not malicious. Additionally, employers cannot penalize employees for making a report or cooperating with an investigation. Confidentiality of the Reporter The identity of the person who makes a report is kept strictly confidential. APS will not disclose the name of the reporter or anyone mentioned in the report without written permission from the reporter or a court order. What Does APS Do When a Report is Received? Once a report is submitted, APS takes the following actions to investigate and address the situation: 1. Initial Visit: APS initiates a personal visit with the adult in question within 24 hours to five working days, depending on the risk of imminent danger to the individual. 2. Interview Process: The alleged perpetrator is interviewed unless this action could increase the risk to the adult. APS may also interview relevant individuals, such as service providers, relatives, or neighbors, to gather additional information. 3. Determination of Findings: APS evaluates the allegations and determines whether the report is substantiated or unsubstantiated regarding abuse, neglect, exploitation, or fiduciary abuse. 4. Prevention Plan: APS discusses with the adult, their guardian, conservator, or caretaker the necessary actions to prevent further harm. A service plan is developed with the adult to address unmet needs and ensure their safety. 5. Assistance and Services: APS helps the adult access services essential for maintaining their physical and mental health, such as: Legal services Medical care Safe and appropriate living arrangements Assistance with personal hygiene, food, clothing, or shelter Protection from maltreatment and transportation Services provided are tailored to meet the adult’s needs in the least restrictive way possible. 6. Advocacy: APS advocates for the protection of the adult’s rights and works to ensure they receive the necessary care and support. 7. Involuntary Intervention: If the adult is incapable of protecting themselves due to a major mental or physical disability and there are no other less restrictive options, APS may initiate legal steps such as guardianship or conservatorship. Reporting to APS is a powerful way to help protect vulnerable adults from harm. The process ensures that reports are handled sensitively, with protections in place for the reporter and a thorough investigation to address the individual’s needs. By taking action, reporters play a crucial role in safeguarding the well-being of those who cannot protect themselves.
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