First response: Call the coroner

The legislature should require that coroners be notified when someone dies in a nursing home or shortly after leaving one.

It's astounding that coroners are not already routinely notified in all such instances. Instead, state law leaves the decision to call the coroner to nursing home officials. Coroners say they are seldom notified, even when abuse or neglect is suspected in a patient's death.

Prosecuting abuse becomes much more difficult when autopsies and other evidence are not gathered.

But none of the prosecutors surveyed by Attorney General Jack Conway said they had ever had a case from a nursing home in which an autopsy had been performed.

That helps explain why, over a three-year period, only seven of 107 Type A citations, those in which a resident's life or safety is endangered, produced criminal prosecutions.

Prosecutors and law enforcement officials told Conway it would be helpful if coroners were notified of all nursing home deaths.

And last week, Conway recommended just that.

Rep. Tom Burch, D-Louisville, says he will introduce legislation to that effect in the General Assembly that convenes in January.

And the head of the state coroners association said his colleagues supported the change.

Conway made several other sound recommendations. His ideas were sought as part of a review commissioned by Gov. Steve Beshear in response to reporting by the Herald-Leader.

Conway recommended changes in the law to make it more clear to whom abuse and neglect allegations should be reported and requiring multidisciplinary teams of investigators and professionals to review all elder-abuse cases. In light of the disarray uncovered by Herald-Leader reporters, just making sure the right investigators get the most serious citations would be a big step forward.