A nurse asking a patient about Kentucky nursing home abuse

Grim Predictions For Kentucky’s Nursing Home Abuse Crisis

Nearly half of Kentucky’s registered nursing homes fall below the state average in terms of care. Despite the low ranking, a piece of legislation titled House Bill 210 could worsen conditions for Kentuckians.

However, some efforts are being made to improve things for seniors in the state by advocates taking a stand for the nursing home injustices.

How House Bill 210 Could Worsen Kentucky’s Nursing Home Abuse Crisis

Within its 40,409 square miles, Kentucky contains some of the lowest rated nursing homes in the entire nation, according to the Lexington Herald. In fact, 47% of the state’s nursing homes are rated as below, or far below average in terms of care. Kentucky’s nursing home abuse problems are well known.

“I do not think there would be any shortage of Kentuckians who would want to share their stories about their bad experiences with their loved ones,” Senator Tom Buford told the Lexington Herald.

Chief among the bills presented that may worsen Kentucky’s nursing home abuse problems is Kentucky House Bill 210. This initiative, proposed by Representative John Carney in Feb. 2019, seeks to limit anonymity of health inspections and curtails whistleblower actions.

If passed, the bill would require inspectors working for Kentucky’s Cabinet for Health and Family Services to allow management personnel to attend any interviews conducted with staff of the facility.

This is a concerning stipulation as many who exposed the issues of Kentucky’s nursing home abuse crisis were anonymous employees who leaked information to inspectors during private interviews.

Opponents of the bill have stated that prohibiting inspectors from conducting confidential, private interviews decreases the likelihood of abuses being exposed if management personnel are present. Many employees may not feel safe blowing the whistle on misdeeds when the threat of termination could be implied.

The second provision of Bill 210 requires investigators to sign an annually renewed non-compete, non-disclosure agreement that will prevent them from disclosing the details of any nursing home investigation to any entity other than the Kentucky Cabinet for Health and Family Services.

This initiative will disallow inspectors to blow the whistle on cabinet inaction or potential corruption, such as when former Kentucky nursing home inspector Tony Cisne alleged that his supervisors had ordered him to go easy on several nursing homes in regards to health and safety violations back in 2016.

“[I]nspectors sometimes feel obligated to publicly blow the whistle on serious issues they see at nursing homes that aren’t being addressed by their regulatory agencies, an act that would violate the confidentiality agreement. . . this bill sounds like it’s trying to restrict what the surveyors can do in uncovering problems at facilities,” senior policy attorney for the Center for Medicare Advocacy in Washington, Toby Edelman, told the Lexington Herald. 

Without the support of Kentucky state law, whistleblower inspectors like Tony Cisne will no longer be allowed to disclose evidence of misconduct without risking, in the words of the bill, “discipline, dismissal, suspension or demotion.”

Introduction of House Bill 210

Representative Carney intended for the bill to allow legal counsel to be present during state interviews with Alzheimer’s patients. Carney told the Lexington Herald that a representative from the Kentucky Association of Health Care Facilities (KAHCF), a powerful Political Action Committee (PAC), approached him and “crafted” the language of the bill to include the confidentiality agreement and management’s right to attend interviews.

Both provisions were opposed by advocates against Kentucky’s nursing home abuse problems.

KAHCF is a lobbying PAC that works on behalf of nursing home corporations and they are significant contributors in campaigns across Frankfort. By their own report, the organization has raised over $170,000 in 2017 alone.

KAHCF states patient interviews include “more clinical-type questions” that employees can’t understand and therefore “think there should be a witness in those types of interviews.”

Their justification for preventing whistleblowers, KAHCF president Betsy Johnson told the Lexington Herald, is that “state surveyors should not be out in their communities talking about their surveys.” Despite their stance on Bill 210, KAHCF claims to be a driving force for ending Kentucky’s nursing home abuse crisis.

The other bill proposed alongside Bill 210 was Kentucky House Bill 289. Bill 289, filed by Representative Steve Riley, seeks to “shield ‘passive investors’” who receive revenues from nursing homes from being involved in personal injury and wrongful death lawsuits. KAHCF also admits having a hand in this Bill with Betsy Johnson stating the bill helped prevent trial lawyers from casting a “blind net” in search of people with “deep pockets.”

But some people acknowledge that it’s not that clear cut. Christopher Goode, an attorney who represents nursing home residents and their relatives, states, “it’s not unusual for corporate-run nursing homes to have a half-dozen or more owners collecting revenue from their operations, with one management company identified for the record. Families suing a nursing home often have to go hunting as assets are shifted from one company to another.”

“It’s essentially a shell game,” Good told the Lexington Herald. 

This shell game, however, will come to an end if House Bill 210 is passed, since only parties with an active role in managing the day-to-day happenings will be prosecutable. For many people filing suit, there may be no place to go for compensation after a family member is injured or killed due to gross negligence.

If these bills pass, Kentucky’s nursing home abuse crisis could continue for some time yet as corporations gain new ways to short the system.

Attempts to Curb Kentucky’s Nursing Home Abuse

Though proposed legislation poses grim prospects for Kentucky’s nursing home abuse issue, one senator, Tom Buford, is trying to change things for the better.

Tom Buford is the sponsor for Senate Bill 206. Senate Bill  206 is a fairly simple Bill designed to address a fairly simple problem. One of the leading causes proclaimed for Kentucky’s nursing home abuse crisis is under-staffing of facilities. Senate Bill 206 seeks to institute a minimum staff-to-resident ratio.

The bill, aimed for June 2020 if passed, would make this yet-unspecified ratio a necessary part of the conditions for obtaining and renewing state licenses to operate nursing homes, and penalties would be leveled at facilities who failed to have the correct amount of staff on duty at a given time. The system would help meet the recommended attention needs of residents.

According to some studies, nursing home residents are recommended to receive at least 4.1 hours of direct care and attention from nurses or aides. At present, staffing levels are too low to address these needs, and therefore Kentucky’s nursing home abuse rate has increased in recent years due to overworked nurses and aides who neglect residents from sheer lack of numbers.

Future of Kentucky’s Nursing Home Abuse Crisis

Kentucky’s Nursing Home Abuse problems will not disappear overnight.

Unfortunately, there are many systemic problems that plague nursing homes nationwide, including the balancing act of corporate profits against the increased needs of elderly residents, the lobbying of corporations to decrease nursing home regulations, and apathy or neglect of individual nurses and aides.

In the event that a loved one is placed in a Kentucky nursing home, use the Medicare.gov resource Nursing Home Compare to compare facilities in your area and find the best quality on a nationally verified scale.