Gov. Steve Beshear has asked the Cabinet for Health and Family Services to conduct an immediate review of the way state government handles reports about the abuse and neglect of residents of Kentucky's nursing homes.
"The governor is proceeding in this manner because the seriousness of the news allegations requires a quick but thorough review and response," Kerri Richardson, Beshear's spokeswoman, said Wednesday.
The Herald-Leader recently examined 107 Type A citations — those issued when a resident's life or safety has been endangered — issued over a three-year period by the Cabinet for Health and Family Services. The investigation found gaps in the system that saw only seven of the 107 cases of nursing home deaths or abuse prosecuted as crimes.
The citations involved 18 deaths, 30 hospitalizations, five broken bones and two amputations that resulted from violations of state regulations. Thirteen residents were injured as a result of lapses by staff members, according to the citations.
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Beshear is asking Janie Miller, secretary of the cabinet, to review the effectiveness of the coordination of efforts among state agencies and local prosecutors and law enforcement. In addition, he said, she should look at delays in sending the most serious citations to local law enforcement or the attorney general.
"The abuse of any nursing home resident is unacceptable and we must make sure that we are fulfilling our responsibilities to those residents," Beshear said in a letter to Miller.
Vikki Franklin, a spokeswoman for Miller, said in a statement: "We look forward to the review, which will serve as a valuable opportunity for those involved ... to review policies and procedures with an eye toward determining any potential areas of improvement."
Beshear's move came in response to a call from Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform, for a task force to study the lapses found by the Herald-Leader.
Instead of a task force, Beshear asked Miller, whose cabinet is responsible for inspecting and investigating nursing homes, to complete a review by Sept. 1.
"A task force would of necessity be much more cumbersome and time-consuming," said Richardson.
Coroners rarely notified
Beshear asked Miller to include in the review Attorney General Jack Conway, the U.S. Attorneys for the Eastern and Western Districts, local prosecutors, law enforcement, industry groups and advocacy groups, specifically Vonderheide's.
The letter asked for "a thorough review of how the Cabinet works with the rest of state government to protect nursing home residents and whether we have opportunities to improve going forward."
Vonderheide praised the governor's decision Wednesday.
"This is exciting news," he said. "It's a significant victory for the thousands of people in long-term care facilities and probably the first major significant action taken on their behalf by state government in two or three decades."
The newspaper's investigation found that police and coroners are rarely notified of nursing home deaths or serious injuries.
Although the state sends all of the reports 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.
The newspaper's examination also showed that Kentucky law does not require criminal background checks for members of the support staff at nursing homes such as janitors and dining room workers and that nursing homes often don't report the sexual abuse of residents.
Changes to law
The first objective of the review ordered by Beshear will be to "determine whether all parties are appropriately following the requirements under current law," Richardson said.
Changes to existing law will also be considered, she said.
Beshear said Conway told him his office will "participate fully" to the degree that no criminal prosecutions are jeopardized.
Allison Martin, a spokeswoman for Conway, said Wednesday that the attorney general's office has already talked with the cabinet to ensure that the attorney general's investigators and local law enforcement were receiving Type A citations in a timely fashion as required by law.
"Protecting Kentuckians from neglect and abuse is a priority for Attorney General Conway," said Martin.