2011 General Assembly

Proposals to curb nursing home abuse faltering in Frankfort

Supporters say state budget, industry lobbying are to blame

vhoneycutt@herald-leader.comFebruary 19, 2011 

Two proposals aimed at preventing and investigating abuse of nursing home patients appear to be dead or stalled in the ongoing state legislative session, according to their sponsors.

In Kentucky, nursing home deaths from neglect and abuse often aren't criminally prosecuted because the coroner isn't called to investigate. But a bill that would require Kentucky nursing homes to report all deaths to the local coroner will not go forward this session because of opposition, its sponsor said.

Rep. Tom Burch, D-Louisville, said he won't call House Bill 69 for a vote in his House Health and Welfare Committee, citing opposition from the nursing home industry and budget concerns from the state's chief medical examiner, Tracey Corey.

Corey has said she would need to hire three medical examiners and support staff to handle the additional death investigations that could result from calling coroners after each nursing home death.

Burch said he tried to compromise with nursing home industry leaders with no success.

"All that I had when they got through compromising was the title (of the bill) and my name on it," Burch said. "I think right now as far as that bill is concerned, it's dead. As much as I want it, I can't move it that fast. I wasn't getting that much support on my committee."

Meanwhile, a bill requiring nursing homes to conduct criminal background checks on all employees appears to be blocked in the Senate. Under current law, employees who provide direct care to residents must have criminal background checks, but custodians, food service workers and others do not.

In 2008, a Lexington nursing home hired a maintenance worker after he had been arrested for sexual solicitation of a minor and kept him on after he was placed on Kentucky's sex offender registry, according to a lawsuit filed against the home.

Senate Bill 44 is stalled in the Senate Judiciary Committee, where sponsor Tom Buford, R-Nicholasville, says he and committee chairman Tom Jensen, R-London, are "waiting on the go-ahead from the leadership office to move the bill."

In an interview Thursday, Jensen said he has spent much time on a bill dealing with state prisons and has not reviewed with Senate leaders SB 44 and several other bills before his committee.

Jensen said he thinks SB 44 has merit but it may be getting too late in the session to consider it. Friday was the 18th day of the 30-working day session.

Senate President David Williams, R-Burkesville, was unavailable for comment on the bill.

Democratic Gov. Steve Beshear said last week that he supported the background-check bill and Buford said many members of the state's nursing home association support the measure.

Tim Veno, president of the Kentucky Association of Homes and Services for the Aging, said last week that his group hadn't taken a position on the bill, but that the vast majority of members "already do criminal checks for all of their employees, direct care and non-direct care."

Officials from the Kentucky Association of Health Care Facilities did not return telephone calls seeking comment.

Last summer, Beshear ordered his administration to implement 20 recommendations aimed at improving investigations of abuse and neglect at nursing homes. One of the recommendations directed the Cabinet for Health and Family Services to explore ways to involve coroners more directly in investigations, saying "the role of the coroner is critical to a complete investigation."

House Bill 69 would require a specific staff member at a long-term care facility or hospice to report all deaths to the county coroner within 24 hours. The proposed law also requires coroners to involve law enforcement officers or prosecutors if they suspect abuse. It gives coroners discretion in choosing which deaths need to be reviewed by other officials.

The bill also calls for improving nursing home death investigations on several other fronts, including training nursing home investigators on preserving evidence. The bill also would increase the penalty for failing to report abuse and neglect in nursing homes and require nursing home staffs to be trained in preventing abuse and neglect.

One bill affecting nursing home residents that has had more success is House Bill 101. The House approved the bill, which would require the Cabinet for Health and Family Services "to prepare to implement a registry" of each person against whom a charge of abuse, neglect, or exploitation of an adult has been substantiated by the Cabinet.

Under that bill, nursing homes and other facilities could not employ a person whose name appears on the registry.

Advocate Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform, noted that other nursing home bills, including one that would set staff-to-resident ratios, have not moved in the legislature.

"I think it's because of pressure from the very strong and wealthy lobbyists from the nursing home industry," Vonderheide said.

Overall, the industry gave at least $222,121 to state legislative campaigns in the past decade.

"Until the advocates get more money to tell their story ... or the nursing home industry decides to do what is right, I don't think anything meaningful is going to happen," Vonderheide said. "What we need is some real leadership ... not just from advocates, but from legislators."

Staff writer Jack Brammer contributed to this story.

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