Those are some of the complaints long-term care ombudsman Lisa Smith investigates at nursing homes and assisted living facilities in the St. Louis area. She travels about 100 miles and visits eight to 10 facilities each month.

But Smith is only able to do that much, thanks to outside grant funding. Many long-term care ombudsmen in the state lack such financial resources.

That may soon change after Missouri lawmakers in May approved a $2.2 million increase for the state’s chronically underfunded Long-Term Care Ombudsman Program.

Long-term care ombudsmen investigate complaints, educate residents and families about their rights and help them assert those rights, among other duties.

The state’s program has long been unable to meet the recommended industry standard of one ombudsman for every 2,000 long-term care beds. Missouri has less than half of the paid staff needed to meet that standard, and has struggled to adequately cover the state’s 84,000 long-term care beds—despite increases in federal funding over the years, says Jenny Hollandsworth, the state’s top ombudsman.

The state allocates about $300,000 in general revenue funds annually to the ombudsman program, Hollandsworth says.

But staffing shortages have remained persistent—forcing difficult choices such as prioritizing visits to nursing homes over assisted living facilities, she says. The newly approved funding would allow the program to hire more staff. As of press time, the governor had not signed the bill that includes the funding.

“It will help us reach a lot more people,” she says.

The money will also pay to train volunteer ombudsmen, who visit care facilities weekly or biweekly and play an important role in extending the program’s reach across the state.

“Missouri’s ombudsmen volunteers have been carrying the weight in identifying problems in long-term care throughout the pandemic,” says Jay Hardenbrook, AARP Missouri’s associate state director of advocacy.

Smith, the St. Louis ombudsman, has seen firsthand the difference more funding can make. The St. Louis City ombudsman program is able to meet the goal of one ombudsman per 2,000 beds with the help of grants from foundations. She’s been able to train more workers, make more visits to facilities and get to know residents better.

“They’re happy to see me, and they know I’ll be back,” she says. “When the staff knows I’m around more, it builds credibility. It really is a more thorough way to do my job.”

Other ombudsmen around the state don’t have the same advantage. In nearby St. Louis County, for example, three full-time and one part-time ombudsmen oversee facilities with a capacity of more than 18,000 beds.

Many residents at long-term care facilities have no one else to speak for them, says Marjorie Moore, executive director of Voyce, a nonprofit that the state contracts with to oversee ombudsmen in the St. Louis area.

“They’re people who’ve outlived their families, live far away or may not talk to their kids,” Moore says. “This additional money will make the program stronger than ever.”

AARP strongly advocated for the funding increase, which was largely the result of a multibillion-dollar state budget surplus, says AARP’s Hardenbrook.

“This funding will ensure that people in nursing homes are safe and have an advocate,” he says.

Learn more at aarp.org/mo. —Tim Poor