Nursing homes: ‘It’s a job that a lot of folks don’t, frankly, want to do.’
If you or a loved one live in a Kentucky nursing home, it can’t be reassuring that Dr. Ralph Alvarado has been named chairman of a legislative committee that has the power to block patient protections and shield the long-term care industry from accountability.
Alvarado, a Republican from Winchester elected to the state Senate in 2014 and re-elected last month, works for the nursing home industry. He is medical director of five sub-par (as measured by the federal government) facilities in Lexington, Winchester and Nicholasville, as John Cheves recently reported.
Alvarado, best known for championing ”tort reform” to limit lawsuits against nursing homes and other medical providers, should hasten to reach out to patients and their advocates and invite them to be heard.
Their insights and knowledge could help answer life-and-death questions, such as how to ensure Kentucky’s nursing homes employ enough nurses and aides not just to avert the kinds of preventable tragedies and neglect documented by Cheves in his investigation, but also enough staff to protect the dignity and welfare of patients and employees alike.
Kentucky’s nursing homes collectively have some of the nation’s worst ratings for quality of care, an out-in-the-open scandal that the legislature has ignored for too long.
Republican leaders have named Alvarado incoming chairman of the Senate Health and Welfare Committee, making him gatekeeper for nursing home legislation and the Medicaid program that provides nursing homes with most of their funding. The committee also has an oversight function and can hold hearings on issues affecting the health and well-being of Kentuckians of all ages.
The Supreme Court unanimously struck down an Alvarado-sponsored law that required people suing for medical malpractice to first take their claims to a three-doctor review panel. Alvarado has said he is considering seeking a constitutional amendment that would let voters decide the issue. (A committee other than Health and Welfare handles constitutional amendments.)
Alvarado’s sponsorship of bills helping nursing homes will strike many as a conflict of interest, but is permissible, according to the Legislative Ethics Commission, as long as his legislation helps all nursing homes or all health-care providers, not just his employers or himself.
Alvarado told Cheves that nursing home owners hired him as medical director to help improve the admittedly unsatisfactory outcomes their residents were experiencing, that they are improving and “we’re very excited about that.”
We’ve no reason to doubt that Alvarado is a fine physician. But it would be naive to think that the advantages of having a lawmaker on the payroll never crossed the minds of his for-profit employers, especially now that he will be succeeding newly elected Senate Republican caucus chair Julie Raque Adams, R-Louisville, as Health and Welfare chair.
Alvarado can protect the public’s trust in the legislature and himself by quickly showing that he is as committed to protecting elderly and disabled patients as he is to protecting himself and the industry that employs him.