The Missouri Alliance for Long-Term Care Reform released a bombshell report titled “Missouri’s Troubled Nursing Facilities.“ The report reveals the widespread neglect and financial misconduct plaguing nursing homes across the state. The report highlights how inadequate staffing, lax oversight, and economic exploitation are leaving over 8,000 vulnerable residents at risk.
What the Report Uncovered
The report identifies 68 “Troubled Nursing Facilities” throughout Missouri, each facing severe quality issues related to poor staffing, lack of supervision, and even physical and sexual abuse. These facilities are scattered across the state, from urban centers to rural areas, demonstrating that the crisis knows no geographic boundaries.
One particularly troubling finding was that many nursing homes are manipulating financial structures to prioritize profit over care. The report states, “Many nursing home operators divert Medicaid and Medicare funds through complex business structures, prioritizing profit over resident care.”
The report also revealed that Missouri ranks among the worst states for nursing home quality, with repeated citations failing to prompt meaningful improvements. Chronic understaffing is at the heart of the problem, leading to preventable harm such as untreated pressure ulcers, medication errors, and failure to respect end-of-life wishes.
Heartbreaking Stories from Missouri’s Troubled Nursing Facilities
The report brings to light real stories of neglect and harm that put a human face on the crisis:
- Staff at a facility in one small town failed to provide adequate care for pressure ulcers, resulting in a resident requiring amputation. The State cited the facility for failing to provide enough staffing to ensure the well-being of its residents.
- In an urban facility, a resident struck another on the head with a rock hidden in a sock. Despite the known risk of violence, the facility failed to implement sufficient supervision.
- At a rural facility, a medication error occurred when a resident was mistakenly given a powerful antipsychotic medication over three consecutive shifts. This caused dangerously low blood pressure that required emergency treatment.
These stories paint a disturbing picture of a system failing those most in need of care and protection.
What Needs to Change
To address the crisis, the report calls for comprehensive reforms, including:
- Increased funding for the State Long-Term Care Ombudsman Program to advocate for residents’ rights.
- Strengthened oversight of nursing home ownership transfers and licensure applications to prevent bad actors from taking over facilities.
- Establishing a minimum direct care staffing requirement to ensure adequate resident care.
- Quarterly audits of staffing levels using CMS Payroll-Based Journal data to enforce compliance.
- Enhanced Medicaid cost report audits to prevent financial abuse and ensure funds directly support resident care.
Moving Forward
The release of this report is a call to action. Lawmakers, regulators, and the public must stand up for those living in long-term care facilities. We must demand greater accountability, stronger oversight, and robust staffing standards to protect our most vulnerable citizens.
To read the full report and learn how to support reform efforts, visit Missouri’s Troubled Nursing Facilities Report.
Let’s ensure Missouri’s nursing homes become places of safety and dignity—not danger and despair.