Group calls for task force on nursing homes

Advocacy group says system overhaul, adequate staffing laws needed

vhoneycutt@herald-leader.comJuly 15, 2010 

A nursing home advocacy group has asked Gov. Steve Beshear to appoint a task force to look at why there aren't more investigations and prosecutions of deaths and abuse in Kentucky's nursing homes.

Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform, said he is asking Beshear to form an ad hoc committee to make recommendations following stories in the Herald-Leader that showed that, of more than 100 citations of serious incidents at nursing homes that might have caused injury or death in a three-year period, few were prosecuted as crimes.

One initiative, Vonderheide said, should be to study "why a situation now exists in state government where enforcement of laws and regulations affecting nursing home care are being delayed and ignored, and what can be done to solve this problem."

He said the committee also should look at "how state government can be reorganized to recognize and help this growing segment of our aging population."

A Herald-Leader examination of 107 Type A citations — the most serious the state can levy — issued by the Cabinet for Health and Family Services' Office of Inspector General found a number of gaps in the system that mean few cases of nursing home deaths or abuse are ever prosecuted as crimes. Only seven of the 107 cases were charged as crimes by state or local prosecutors.

Police and coroners are rarely notified of nursing home deaths or serious injuries, the newspaper found. Although the state sends all of the most serious nursing home regulatory violations to the attorney general's office, that office can prosecute only with the permission of local prosecutors. And local prosecutors say they seldom hear about the cases.

In addition, the attorney general's office misplaced or never received at least five citations issued by the cabinet from December 2006 through 2009.

Eight of the 107 cases are open and under review by the attorney general's Office of Medicaid Fraud and Abuse Control or local prosecutors, the Herald-Leader found. Those eight open cases have been pending for an average of 19 months.

Allison Martin, a spokeswoman for Attorney General Jack Conway, said the office did not know about the request for a committee, but said that investigating cases of abuse and neglect has been a priority of Conway's.

"Our office has already reached out to the Cabinet for Health and Family Services to ensure that we are receiving citations in a timely fashion and about how processes can be improved to make these referrals more efficient and effective," she said in a statement.

Vonderheide said the state needs to completely revamp the way it looks at long-term care issues. "The difficult situation we find ourselves in will grow into crisis proportions if we do not act now," he said in a statement.

"We badly need, for example, a law mandating sufficient staff in nursing homes."

Kerri Richardson, a spokeswoman for Beshear, said the governor's staff was reviewing Vonderheide's request.

Spokesmen for the cabinet, which issues citations, said it is also reviewing the request.

Vonderheide's call for a task force received bipartisan support from lawmakers.

"I think we need to take action against the abuse and I do hope the governor appoints a task force," state Rep. Carl Rollins, D-Midway, said.

"Without a doubt we have a serious problem here," said state Sen. Tom Buford, R-Nicholasville.

Buford said the finding that so few serious citations of abuse and neglect are prosecuted "disappoints me, but it doesn't surprise me given the extensive lobbying that has been done to prevent the legislature from delving into it and possibly stiffening up the penalties."

He said there have been attempts by lawmakers to mandate staffing ratios at nursing homes, but the nursing home lobby has "fought it down."

In an interview Wednesday, Vonderheide said he thought family members, nursing home residents, ombudsmen from various parts of the state, representatives of the Cabinet for Health and Family Services, state lawmakers and nursing home industry representatives should be on the investigatory panel.

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