Lack of Oversight

A recent NPR report highlights a growing crisis in nursing home oversight across many states. In Kansas, for example, more than half of the positions for nursing home inspectors remain unfilled, leaving serious complaints to languish for months without investigation.

One tragic case involved a 94-year-old resident who was left on the floor for 90 minutes after a fall; it took six months for an inspector to follow up, by which time the resident had died.

A 2023 U.S. Senate report identified the entire state oversight system as “in crisis,” citing chronic staffing vacancies, high turnover, and stagnant federal funding. Kansas was one of nine states where inspector vacancies exceeded 50%. Inspectors, who are typically required to be registered nurses, often earn salaries starting around $60,000, far less than they could make in hospital or private-sector jobs, making recruitment difficult. Despite federal requirements for states to oversee nursing homes to receive Medicare and Medicaid funding, there are few penalties for states that fail to meet those obligations.

As a result, vulnerable residents are left at greater risk for neglect, abuse, and preventable injuries. A class-action lawsuit in Maryland under the Americans with Disabilities Act accuses the state of discriminating against disabled residents by failing to ensure proper oversight, a legal challenge that could have nationwide implications. Advocates are calling for increased federal support, better staffing standards, and higher inspector pay to address the urgent need for stronger nursing home regulation and accountability.