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Push For Better Care, Transparency in Missouri Nursing Homes

Man sitting in a wheel chair in front of a window

Kathy Bullis’ aunt suffered from dementia, not COVID-19, but the 72-year-old still died alone when her Farmington nursing home locked down because of the pandemic. 

“It’s hard on the families and hard on the people inside the nursing home,” said Bullis, who worked in such facilities for 15 years before joining Aging Matters, a state Area Agency on Aging.

The coronavirus has bolstered the need for nursing home residents to be allowed to have video equipment installed in their rooms so that family members can monitor their care, said Jay Hardenbrook, advocacy director for AARP Missouri. 

Earlier this year, the General Assembly passed a law allowing the practice, but AARP continues to fight barriers, such as overly stringent consent requirements.

“There’s a concern if that nursing home doesn’t want you to see what’s going on,” he said. 

Video monitoring is just one area where AARP Missouri is focusing its efforts to improve the quality of nursing home care across the state. 

Older Missourians have good access to affordable long-term care, but the quality of those services ranks near the bottom of states nationwide, according to a new analysis issued by AARP Foundation and supporting organizations.

The 2020 Long-Term Services and Supports State Scorecard measures long-term care systems, which help older adults, people with physical disabilities and family caregivers.

“We’ve improved in some areas and declined in others,” Hardenbrook said.

The scorecard looks at affordability and access, choice of providers and settings, quality of life and care, family caregiver support, and transitions to hospitals or communities. 

Among the most recent findings: The quality of life and care in Missouri’s nursing homes ranked 48th out of the 50 states and the District of Columbia.  Pushing lawmakers to improve the level of care is among AARP Missouri’s chief aims in next year’s legislative session.

The scorecard doesn’t reflect the impact of the coronavirus pandemic, which Hardenbrook called “the overarching issue with long-term care now.” 

Nursing home residents have accounted for about 45 percent of COVID-19 deaths in Missouri.

“It’s a very dangerous situation for folks to be in,” he said. “We want to make sure people have the personal protective equipment they need in those facilities, and for visitors.”

Use of antipsychotic drugs

Another AARP Missouri goal is better regulation of antipsychotic drugs, since some less scrupulous nursing homes use them just to make residents more docile. Hardenbrook noted that the scorecard ranked the state 49th on the issue. 

“Only people who actually need those drugs should have them,” he said. “They can be incredibly dangerous to use on vulnerable populations.” 

Bullis said understaffing can prompt use of the drugs by aides who must care for multiple people. She said state regulations on staffing were relaxed in the past and should be reinstated.  

“That would make a big difference in the use of psychotropic drugs,” said Bullis, whose agency serves 18 counties in southeast Missouri. 

Go to for the full report.

Tim Poor is a writer living in Clayton, MO.

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