The state board that oversees nursing home administrators revokes and suspends licenses, levies fines and assigns periods of probation to administrators who violate regulations. All of those board actions are public.
But House Bill 414, sponsored by State Rep. Tom Burch, adds a new twist to the board's oversight. It allows the board to give out private reprimands that "shall not be subject to disclosure and shall not be considered a disciplinary action against the licensee."
Documents obtained through the Kentucky Open Records Act and board minutes show that the Kentucky Board of Licensure for Nursing Home Administrators last year reviewed a range of serious offenses allegedly committed by nursing home administrators.
Twenty-nine complaints were referred to in the February 2010 board minutes. One was from 2006 and the rest were from 2007 through 2010. Among the cases was a nursing home administrator who did not contact authorities when aides abused a resident, an administrator criminally charged with stealing prescription drugs and an administrator sentenced to 10 years in prison for theft and exploiting an adult.
The bill does not specify what kind of infractions would result in private criticisms.
Keith Knapp, a nursing home executive on the licensing board, was chairman of the task force of the board that made recommendations for the bill.
Knapp said that the private admonishment would not be used in instances of abuse and neglect and would only be used for situations that were not serious enough to warrant action against an administrator's license.
Board members were not trying to "downgrade" serious infractions or avoid accountability, but wanted another tool to use in regulating, he said.
In rare circumstances — maybe twice over the past several years — the board has already privately delivered criticism to nursing home administrators, he said, and state law currently doesn't prohibit it.
Knapp, CEO of the Christian Care Communities group of nursing homes, also explained why the board reviews complaints for a number of months before taking final action: It has to wait until nursing home administrators have exhausted appeals with the courts or authorities who have cited their facilities.
Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform, said that the provision that keeps reprimands secret is not good for nursing home residents.
"It's not transparent. These guys must think that everyone out here is pretty naive," said Vonderheide.
Shelley Johnson, a spokeswoman for the Attorney General's office, said Friday that the AG's attorney who represents the nursing home administrators board had recommended against including the provision for private admonishment in the bill.
However, Johnson said that several state licensing boards, including those overseeing psychologists, physical therapists and dentists, can criticize privately.
Burch, D-Louisville, said that in drafting the bill he did not think that issues involving abuse and neglect would be included in the private reprimands. The bill also makes several other minor changes to the way the board works. It's an effort to reflect the changes similar boards have made nationally, said Knapp.
Also under the bill, the board's name would be changed to the Kentucky Board of Licensure for Long-term Care Administrators to reflect that the board also regulates administrators for other types of long-term care facilities, including intermediate care homes for the mentally ill and the mentally disabled.
It would also prohibit administrators who had been disciplined in Kentucky or another state in the last five years from holding a position on the board.
Burch's Health and Welfare Committee passed the bill by a 14-0 vote on Feb. 15 and the bill has been before the full House since then. As of Friday, the measure had not been voted on.
Burch said this week he did not think the bill would continue to move through the General Assembly, because on Feb. 22 State Rep. Tim Moore, R-Elizabethtown, attached a House Floor amendment on the unrelated subject of abortion.