Nursing-home referral service, A Place for Mom, is funded by nursing homes and has no information about their violations

Image from home page of A Place for Mom website

Kentucky Health News

The nation's largest nursing-home referral service, A Place for Mom, does not inform users about citations of facilities for neglect or other substandard care, The Washington Post reports.

A Place for Mom charges no fees to people seeking senior housing, but "is paid large fees by assisted-living facilities and does not independently assess their records," the Post reports. "More than a third of its most highly recommended facilities in 28 states were cited for neglect or substandard care in the past two years, many of them repeatedly."

Those 28 states put nursing-home inspection reports online, enabling the Post to easily research them. Kentucky is among the 22 states that do not put inspection reports online. Medicare's Nursing Home Compare website, which ranks facilities on a five-star systen, is based on those reports.

"A Place for Mom does not include these reports in its profiles of facilities, even in cases where poor care has led to death," the Post reports. 

Some places cite for substandard care have received a “Best of Senior Living” award from A Place for Mom for providing “exemplary care and support to aging loved ones.” The company says the awards are based on user reviews, "which are often anonymous," the Post reports.

"Current and former staff of some large chains told The Post that these reviews are often manipulated by the care providers; some claimed they were encouraged to obtain fake reviews from their own friends and relatives. . . . None of the sources suggested that A Place for Mom itself is involved in generating fake or manipulated reviews. But they say the site’s prominence creates incentives for facilities to push for favorable ratings."

Scorecard for long-term care services and supports puts Ky. 42nd

AARP's Long-term Services and Supports Scorecard places Kentucky in the next-to-lowest tier. 

By Melissa Patrick

Kentucky Health News

The American Association of Retired Persons' latest Long-term Services and Supports Scorecard, three years after the Covid-19 pandemic, ranks Kentucky 42nd in the nation. That put the state in the next-to-lowest tier, but that was a move up from the the last report, when it was in the bottom tier.  

A state's score is determined by 50 indicators grouped in five dimensions, including affordability and access, choice of setting and providers, safety and quality, support for family caregivers and community integration. Among the 26 indicators with a trend, Kentucky saw "significant improvement" among eight of them, little or no change in 17 of them and a "significant decline" in one of them. 

That was in the "home care cost" indicator in this category, which measures the median annual home-care private-pay cost as a percentage of median household income for people 65 and older. Kentucky's percentage increased to 93%, from 77% last year.

The scorecard ranked Kentucky 42nd for affordability and access, which looks at indicators of whether consumers can easily find and afford services, with a "meaningfully available safety net" for those who can't afford services. 

In the "choice of setting and providers" category, Kentucky ranked 37th, placing it in the bottom tier for this measure. The indicators in this category look at whether the state has a person- and family-centered approach that allows for consumer choice and control of services. This measure also looks at whether the workforce is well-trained and adequately paid, whether home and community-based services are widely provided and whether provider choice fosters equity. 

In this category, Kentucky had the fourth highest average hourly wage shortfall for direct-care workers, with a shortfall of $1.75 less per hour than those of other occupations with comparable or lesser entry requirements across all states.

The state ranked 45th in the "safety and quality" category, which looks at whether consumers are treated with respect and whether they honor their wishes. It also looks at whether residential facilities and other care settings are adequately staffed and are prepared for emergencies and whether its policies and systems prevent disparities in quality and outcomes. 

The report ranked Kentucky 38th for "support for family caregivers," looking at measures that determine whether caregivers are getting the supports they need to continue their essential roles. 

The state ranked 40th for "community integration," which looks at whether consumers have access to services that facilitate long-term services and supports , including affordable housing, age-friendly, livable and drive-equitable communities. In this category, Kentucky was among one of the sixth lowest states when it came to transportation convenience, safety and options. 

The report's executive summary says AARP's "intention is to identify strengths and weaknesses in state systems to spark and inform the development of actionable solutions at the local, state, and national levels— solutions that respond in meaningful ways to individual preferences and family choices and care needs as well as to new pressures and challenges." 

Feds will raise nursing-home payments, not cut them as planned

Nursing homes will get a big increase in payments from Medicare payments instead of the cut that the Centers for Medicare and Medicaid Services originally planned.

"In April, CMS proposed cutting Medicare Part A payments to nursing homes by $320 million. The transition to a new nursing-home payment model in 2019 inadvertently led to a 5% pay increase in fiscal 2020, requiring a decrease in payments next year, according to the draft regulation," Modern Healthcare reports. "But the agency has changed course, and will phase in that payment correction over two years to ease the burden on providers still struggling with the Covid-19 pandemic, the final rule says."

That means nursing homes will get a 2.7% increase next year in Medicare rates, an overall increase of $904 million. "While this is relatively more advantageous for skilled nursing facilities than the initial proposal, it falls short of the three-year phase-in the American Health Care Association/National Center for Assisted Living requested," MH reports. "AHCA President and CEO Mark Parkinson nevertheless believes the final rule will help providers during a stressful time."

LeadingAge, the lobby for not-for-profit providers, was unhappy. “We warned CMS that this is not the time to cut payments," President and CEO Katie Smith Sloan said in a news release. "Spreading the impact of the adjustment over two years . . . is helpful, but the end result adds to the chronic financial neglect of our nation’s nursing homes—in a time of real crisis."

Cases keep trending up; long-term-care visits will come with restrictions; Ky. researchers developing masks that attack virus

Video from Health and Family Services Secretary Eric Friedlander runs 5 minutes and 35 seconds.

If you plan to visit a long-term-care facility in Kentucky as visitation reopens, be prepared to follow some tight restrictions. Visitation opens Monday, June 29 for personal-care homes, assisted-living communities and family-care homes, and July 15 for skilled nursing facilities. (The facilities are not obligated to open visitation on those days.)

Visitors will have to schedule in advance, no more than two people can visit a time, they must be socially distanced, and they won't be in patients' rooms. Facilities must have a designated visitation room near the main entrance or outdoors so the area can be sanitized between visits. Inside visitors must be masked, and will be screened for possible signs of covid-19.

“This is done balancing needs of individuals, needs of families, needs of folks in these facilities themselves to start seeing each other again,” Health and Family Services Secretary Eric Friedlander said in an online message.

Visitation is resuming after "three months of forced isolation," notes the Lexington Herald-Leader. "Residents who mostly have been confined to their rooms since March will be able to resume some group activities and communal dining in their facilities.:

Most of Kentucky's deaths from covid-19 have been among residents of long-term-care facilities, and a few nursing homes have lost "close to a quarter of their populations," the Herald-Leader notes. "A spike in cases announced Friday at a nursing home in Corbin shows the facilities remain potentially vulnerable."

There are other restrictions. Before they can allow visitors and resume group activities, the facilities that can start Monday must have gone two weeks without a new coronavirus infection, and those starting July 15 start date must have gone four weeks.

Kentucky Health News chart

The state reported 316 new cases of the coronavirus Saturday, close to the record of 322 on April 19 (except the day it included all results from a prison in the daily report). Saturday's cases raised the seven-day rolling average to 229 from 216; that increase was the sixth in a row.

The number was driven partly by the Corbin nursing-home outbreak; Knox County had 43 new cases. Fayette County had 49, and Jefferson County led the list with 56. Warren County, with 26, was the only county in double figures.

Reporting via press release, Gov. Andy Beshear said, “This virus is not going away yet. We see numbers spiking in states all across the country. We need to be vigilant so that doesn’t happen here in Kentucky.” Hospitalization figures in the state's daily report remained stable.

One death from covid-19 was reported Saturday, a 78-year-old woman from Fayette County, raising the state's death toll to 554.

In other covid-19 news Saturday:

• "University of Kentucky and Somerset Community College professors could soon deliver 3D-printed, customizable masks that hold a re-usable, washable filter that can inactivate covid-19," reports Rick Childress of the Herald-Leader. Isabel Escobar, a UK engineering professor, "said her long-term goal is to get the masks — which would be effective against many viruses and bacteria — on the faces of first responders and eventually the general public. Since the masks are so early in development, Escobar said it’s hard to pinpoint when that’ll be and what the price of the masks might be."
• The Herald-Leader's Liz Moomey reports on the reopening of the free Red Bird Clinic in northern Bell County, closed for three months due to the pandemic. Renovations allow it to see as many as before, and accommodate University of Louisville dental students in the fall.
• People needing help with unemployment claims can make appointments for next week in Frankfort from 8 a.m. to 4 p.m.; and for Monday or Tuesday from 9 a.m. to 6 p.m. local time at community colleges in Owensboro and Grayson. Appointments can be made at kcc.ky.gov and going to the In-Person UI Services "View Services" button. Assistance is also available at through the website's "Chat Now" button or by calling 502-564-2900.
• Pfizer Inc. CEO Albert Bourla "said the company anticipates it will have safety and efficacy data from phase 3 trials of its covid-19 vaccine available by the fall, perhaps as early as September," in time for Food and Drug Administration approval or authorization in October, Inside Health Policy reports. With an FDA green light, "Pfizer will likely be able to have hundreds of millions of doses of the vaccine available by the end of this year, and 1 billion by 2021, he added." Speaking Friday, he also cautioned: “You need to have the stars aligned to accomplish what I'm describing. And frankly, I'm still surprised that things are still aligned.”

State evacuates 18 from Louisville senior community, sends med students to help one in Kuttawa where at least one resident died

Jean Massamore, 94, and granddaughter Lee Ann Teague.
Massamore died at Teague's home after a hospital wouldn't
admit her and a senior community refused to let her back in.

By Al Cross
Kentucky Health News

First responders and the National Guard evacuated 18 residents from a senior living community in Louisville Thursday, the latest sign that nursing homes and other long-term-care facilities are the biggest immediate concern about the coronavirus in Kentucky.

“This is where the coronavirus wreaks havoc,” Gov. Andy Beshear said as he announced three more deaths in such facilities, bringing the death toll to at least 16.

He said four had died at Treyton Oak Towers, the 12-story apartment building where 18 were evacuated “to make sure that we had the care that they needed and also to protect other residents” and staff members, he said. The Louisville Courier Journal reported five residents there had died of covid-19.

Beshear thanked Norton Healthcare, which set aside a floor on one of its hospitals for the evacuees. He said 21 residents and eight staffers at Treyton Oak Towers have tested positive for the virus. State Health Commissioner Steven Stack said the facility "had exhausted every option."

"We can’t do this solution for every facility," Stack said. "We are working hard to find solutions that we can deliver for the entire commonwealth." Beshear said his team is working on pre-planning for other mass transfers and will talk Friday about an "advisory task force" for long-term care.

Asked at his daily briefing what advice he would give other states, Beshear listed many actions he has taken and concluded, "Really start concentrating on your nursing homes.

The state's other big worry appears to be the River’s Bend Retirement Community in Kuttawa in Lyon County, which has "reported 10 confirmed cases, including seven-assisted living residents and three staff members," the Courier Journal reports. "Three tests from the skilled-nursing wing have come back inconclusive."

Officials say one River's Bend resident has died, but that doesn't include one who died after the facility refused to let her return after she had gone to a hospital that wouldn't admit her because her symptoms weren't severe enough, her granddaughter told the Courier Journal's Mandy McLaren.

Lee Ann Teague said Jean Massamore, 94, formerly of Dawson Springs, died at Teague's home in Paris, Tenn., on Saturday, April 4.

"The family's plight illustrates an increasingly urgent problem barreling down on assisted living facilities across Kentucky: what to do with ill residents not sick enough to remain in a hospital, but too much of a risk to live among other vulnerable elders," McLaren writes.

The places they live are in a bind, too, said Betsy Johnson, president of the Kentucky Association of Health Care Facilities and Kentucky Center for Assisted Living. McLaren writes: "Hospitals, in preparation for an expected surge of coronavirus cases, are releasing patients who don't require extensive care — even if they're suspected of having covid-19, Johnson said."

Stack, who Beshear said is spending most of his time helping long-term-care facilities, said River's Bend, the Lyon County Health Department and local officials sought the state's help Tuesday afternoon, and the decision was made to send four medical-student volunteers to the facility. They are working 12-hour shifts and staying at a nearby state park, he said.

Stack's voice cracked as he thanked the students and looked at an email from one. "These nursing homes get a bad rap too many times," he said. "These teams love these residents."

Overall, Kentucky's nursing homes have the third highest number of serious deficiencies per home in the nation, according to ProPublica's analysis of three years of inspections almost a year ago. Neither River's Bend nor Treyton Oak Towers had a serious deficiency, and each had eight total violations, a relatively low number, with no fines or payment suspensions, according to ProPublica's list. The state was about average in suspensions of payments from Medicare and/or Medicaid.

"In Louisville, federal data show that most nursing homes have struggled with being prepared for, or dealing with, issues around infection," Jared Bennett reported for Louisville's WFPL last month. "Inspectors flagged deficiencies related to infection control at 38 of Jefferson County’s 45 federally regulated nursing homes in at least one inspection since 2017."

The state says 104 residents and 48 staff members in 26 nursing homes have tested positive for the virus, but has declined to name the facilities, the Lexington Herald-Leader reports, noting "The Northern Kentucky Health Department refused to release the names of nursing homes affected in its district even though at least one nursing home in Kenton County has confirmed cases independently."

Johnson told the Courier Journal that nursing homes are "short on masks, gloves and gowns," Bailey Loosemore reports. "And many homes don't have the tools or the authority to test residents for covid-19 — including those who are coming from a hospital," transfers that may be happening more frequently as hospitals free up beds in anticipation of covid-19 patients.

Legislature's many health bills include some with life-saving potential, better prevention, greater access and help for children

By Melissa Patrick
Kentucky Health News

One paragraph in this story was incorrect and has been stricken.

FRANKFORT, Ky. -- Kentucky legislators have all but ended their regular session without agreeing on a budget, but were able to pass a wide range of health bills that await Gov. Matt Bevin's signature or veto.

Legislators can still pass more bills, including a budget, when they return for one day, April 12, and reconsider any bills the governor vetoes (except the budget, if one passes that day).

Many of the health bills deal with regulation, such as which agency oversees home medical equipment and licensing rules for physicians. Others, like SB 211, sponsored by Sen. Alice Forgy Kerr, R-Lexington, establish a special day to encourage research for amytrophic lateral sclerosis by officially naming Feb. 21 "ALS Awareness Day."

But several others will impact the daily lives of Kentuckians, directly or indirectly. Some have the potential to save lives.

Senate Bill 33, sponsored by Sen. Max Wise, R-Campbellsville, requires every Kentucky high-school student to receive compression-only CPR training. "Each year nearly 424,000 people have sudden cardiac arrest outside of the hospital and only 10 percent of those victims survive," Wise said at a Jan. 13 Senate Health and Welfare Committee meeting. "Yet when a CPR trained bystander is near, they can double or triple these victims survival rate."

Another bill with life-saving potential would let Kentuckians take time off work to be "living donors" or donate bone marrow without the risk of losing jobs or income. House Bill 19, sponsored by Rep. Ron Crimm, R-Louisville, requires paid leave of absence for such reasons, and offsets this cost to the employer with tax credits.

(An amendment to this bill, illustrating how legislation gets passed in unusual ways during the closing days, would allow Lexington to impose an additional 2.5 percent hotel-room tax to improve its convention center.)

A minor housekeeping bill had an important health amendment attached to it that mandates assisted-living communities to provide residents with educational information about the flu by Sept 1 of each year. SB 22 is sponsored by Sen. Ralph Alvarado, R-Winchester. The CDC estimates that between 80 and 90 percent of seasonal flu-related deaths occur in people over 65.

Colon cancer, which kills more than 850 Kentuckians a year, remained in the spotlight with passage of HB115, sponsored by Rep. Tom Burch, D-Louisville. It would expand eligibility for screenings to age-eligible, under-insured Kentuckians, or uninsured persons deemed at high risk for the disease. This bill is aimed at the 7 percent of Kentuckians who have remained uninsured since the state expanded Medicaid under federal health reform, and those who have insurance but can't afford deductibles or co-payments.

Other bills intended to create better access to care for Kentuckians would expand the duties of advanced practice registered nurses (SB114); decrease the oversight of physician's assistants (SB154); create a pilot program to study telehealth and how it's paid for (HB 95); and better define who can perform administrative duties in pharmacies (HB 527).

Children: "Noah's Law," or SB 193, sponsored by Alvarado, mandates the coverage of amino-acid-based formulas for eosinophilic esophagitis and other digestive disorders. It will have an impact on more than 200 Kentucky families. It is called "Noah's Law" after 9-year-old Noah Greenhill of Pike County who suffers from the disease, which requires him to get this formula through a feeding tube four times a day because of severe food allergies, at a daily cost of more than $40. This bill has already been signed by the governor and took effect immediately.

HB148, sponsored by Rep. Linda Belcher, D-Shepherdsville, allows day-care centers to be able to obtain and store epinephrine auto-injectors for emergency use. This bill was amended to include "participating places of worship" as a location that newborns up to 30 days old can be left without threat of prosecution to the parent or family member who leaves them there.

The latest Centers for Disease Control and Prevention study found that one in 68 of the nation's children have autism, and Kentucky legislators passed two bills this session to address their needs. SB 185, sponsored by Sen. Julie Raque Adams, R-Louisville, creates the Office of Autism and guidelines for an Advisory Council on Autism Spectrum Disorders. This bill has already been signed by the governor. HB 100, sponsored by House Minority Leader Rep. Jeff Hoover, R-Jamestown, requires insurers to maintain a website to provide information for filing claims on autism coverage and make autism-benefit liaisons available to facilitate communications with policyholders.

Big bills: One of the high-profile health bills that passed this session is SB20, sponsored by Alvarado, which creates a third-party appeals process for providers to appeal denied Medicaid claims. Alvarado has said that 20 percent of Medicaid claims are denied, compared to the national average of around 6 percent. He suggest that bringing this bill will help bring these numbers more in line with each other and thus will encourage more providers to participate in Medicaid.

A bill that will eventually increase accessibility to drugs made from living tissues that are very expensive, but also very effective, also passed. SB 134, sponsored by Alvarado, would allow pharmacists to substitute a less-expensive "interchangeable biosimilar" drug for its name-brand "biologic" one, even though the U.S. Food and Drug Administration hasn't approved these interchangeables yet. Humira and Remicade for arthritis, and Enbrel for psoriasis, are a few of the most common biologics on the market.

Another bill is aimed to help small-town pharmacies stay competitive with chains. SB 117, sponsored by Wise, allows the state Insurance Department to regulate pharmacy benefit managers, like Express Scripts, much like insurance companies. It would also provide an appeal mechanism to resolve pricing disputes between pharmacies and PBMs. The state has more than 500 independent pharmacists that will be affected by this law.

Bigger issues: Health officials say the single most important thing that Kentucky can do to improve the state's health at no cost is to pass a statewide smoking ban for workplaces. Rep. Susan Westrom, D-Lexington, filed a smoke-free bill late in the session that didn't even get a hearing in committee, despite having passed the House last year. Bevin opposes a statewide ban.

Adams and Alvarado filed a bill to require insurance companies to pay for all evidence-based smoking cessation treatments in hopes of decreasing the state's smoking rate, but it was filed late in the session and only brought up for discussion.

Democratic Rep. David Watkins, a retired physician from Henderson, filed three bills to decrease smoking in the state: one to increase the cigarette tax, one to raise the legal age for buying tobacco products to to 21, and one to require retail outlets to conceal tobacco products until a customer requests them. All were to no avail.

Rep. Darryl Owens, D-Louisville, filed bills to continue the Kynect health-insurance exchange and the state's current expansion of the federal-state Medicaid program. The bills passed mostly among party lines in the House, but the Senate has not voted on them as Senate President Robert Stivers said he would if the House did.

Nursing homes and other elderly caregivers will have to do national, fingerprint-based background checks on employees

Nursing homes and many other health care providers will be required to obtain national criminal background checks on new employees and others who provide direct one-on-one care to elderly residents or patients, under an emergency regulation outgoing Democratic Gov. Steve Beshear issued Friday.

Besides nursing homes, which have been the focus of concern about elder abuse, the regulation also applies to personal-care homes, intermediate care facilities, adult day health-care programs, assisted living communities, home health agencies, hospices, personal-services agencies, providers of home and community-based services, and staffing agencies, "including nursing pools that have contracts to provide staff to one or more of the listed employer types," a state news release said.

Only 7 percent of those providers are using a voluntary system to do national, fingerprint-supported background checks, Cabinet for Health and Family Services spokeswoman Beth Fisher told Kentucky Health News.

“Protecting the elderly and other individuals residing in these facilities is not only important – it is our duty as state leaders,” Beshear said in the release. “All too often, these vulnerable citizens become victims of the very individuals who are supposed to be caring for them. This regulation, based upon a federal law allowing these background checks, will ensure we are able to thoroughly track the history of anyone who has committed such an offense, whether it occurred in Kentucky or out of state, and ensure they will not be working at health care facilities in the commonwealth.”

State law requires only name-based, Kentucky-specific background checks, "creating a loophole that allowed applicants seeking employment in these long-term care and other settings to hide criminal actions committed in other states," the release said. "Meanwhile, the prevalence of alleged abuse or exploitation of seniors in these settings remained significant."

The release said that since May 2014, over 2,600 complaints have been filed against long-term care providers, almost 30 percent directly related to suspected abuse or exploitation of residents. Requiring fingerprint-supported background checks means that "applicants will not be able to hide criminal actions committed in other states," Cabinet for Health and Family Services Secretary Audrey Tayse Haynes said in the release. "National background checks are a critical initiative that dramatically improve the ability of long-term care and other providers to timely and accurately research the backgrounds of potential employees, ruling out individuals with histories of violence, abuse or exploitation that occurred in other states."

The state has operated a fingerprint-supported vetting program since 2011, using federal grants. “This program . . . has now been fully tested by voluntary participants over the last 18 months, and the feedback has been overwhelmingly positive regarding its ease of use, cost effectiveness and speed,” CHFS Inspector General Maryellen Mynear said in the release. “Our office will assist providers as they apply for initial licensure or renew their existing license to ensure a smooth and timely transition to a national criminal background check program that meets the requirements of this regulation.”

The program usually returns results in 24 to 72 hours, compared to three or more weeks using the traditional, paper-based process, the release said. However, only 85 of the 1,267 providers who will be covered by the new rule use the voluntary program, CHFS spokeswoman Beth Fisher said.

Because the rule is in an emergency regulation, Republican Matt Bevin could revoke it after he becomes governor Dec. 8, but Beshear's news release quoted Republican state Sen. Tom Buford of Nicholasville as saying,  “I commend Gov. Steve Beshear for this action to provide protections for our senior citizens.”

State Rep. Linda Belcher, D-Shepherdsville, said in the release, “I have been working on legislation to accomplish this for some time now and am very pleased Gov. Beshear has taken this step to further protect the elderly residents and patients.”

The release said the voluntary program "has performed more than 2,200 background checks and has screened out applicants who had been convicted of serious violent offenses in other states but had no criminal history in Kentucky." The program’s website, http://chfs.ky.gov/os/oig/kares, contains provider enrollment information, general information for both providers and the public, frequently asked questions and links to related programs and content. Additional information is available via email to KARES.Helpdesk@ky.gov or by calling 502-564-2159.

The Homeplace at Midway opens, with cottages for nursing, assisted living, memory care; first 'Green House' facility in Ky.

By Kacie Kelly and Al Cross
University of Kentucky School of Journalism and Telecommunications

The Homeplace at Midway was formally opened Thursday, June 25, bringing to fruition a 16-year campaign for a nursing home in the Woodford County town of 1,700. For photos from its June 28 open house, click here.

Construction this spring (Christian Care Communities photo)

The Homeplace, which has four residential buildings that look like single-family homes, is more than a nursing home. Two of the buildings are for skilled nursing, but one is for assisted living and the other is for "memory care" or personal care of patients with dementia and other cognitive impairments.

“The Homeplace at Midway represents a new beginning for older adults in Kentucky and for communities across the commonwealth to embrace them as living treasures, not a burden or a challenge,” Dr. Keith Knapp, president and chief executive officer of Christian Care Communities, which built the Homeplace and will operate it, said at the ribbon-cutting ceremony.

Assisted living cottage (Photo by Kacie Kelly)

“We are extremely grateful to the City of Midway, the Midway Nursing Home Task Force, Midway College, state and local government agencies, our capital campaign’s Leadership Council and all our friends and supporters who championed this new direction and envisioned with us a new day when older adults would receive the highest quality care and support, without feeling their lives are being disrupted or overtaken,” Knapp said. “We trust that it will inspire other senior living providers to move in a similar direction.”

The Homeplace is the first facility in Kentucky built with The Green House model, which includes home-like environments and strong relationships with caregivers, with the goal of meaningful lives for residents. Dr. William Thomas, creator of the model, told the crowd at the event, “The Homeplace, with its emphasis on home, shows how care can be made more loving, community centered and effective.”

One of the two skilled-care cottages (Photo by Kacie Kelly)

Patients have been moving in all month. The staff at The Homeplace is trained to use the “best friend approach,” Laurie Dorough, the facility's community-relations manager, said in an interview. Staff and volunteers are to treat residents as they would treat a best friend.

Knapp said at the ribbon-cutting, “Each resident will have a private bedroom and bath and share, just as people do in any home, the kitchen, living room, den and porch areas. It’s all designed to give residents the freedom to set their own daily routines and to live life to its fullest, while receiving the individual care they need – within each cottage.

The assisted-living cottage is larger than the others, to provide room for more activities and “the potential for spouses to live there,” said Laurie Dorough. “It’s kind of the first step out of independent living,” she said. The cottage has an open kitchen where residents can get involved with meal preparation or “come out and see what’s cooking.”

Skilled-care cottage bathroom lift system (Photo by Kacie Kelly)

The skilled-nursing cottages have bedrooms with medicine cupboards rather than medical carts, and a bathroom lift system (photo at right) that takes the resident straight to their own bathroom. The bedrooms are relatively small, an incentive for residents to spend more time in the communal living space.

The Homeplace campus, across Weisenberger Mill Road from Midway College, also includes an administrative cottage and the Lucy Simms Lloyd Gathering House for special gatherings, worship services and activities.

Between the cottages is the courtyard, with lighted walking paths from building to building, a gazebo, and space for outdoor activities. “Our hope is to maybe start a community garden,” said Dorough.

The long campaign for a nursing home, led by the Midway Nursing Home Task Force, began to see success in 2010 when Louisville-based Christian Care agreed to be the developer. Christian Care has facilities in 11 Kentucky cities, and a church-outreach program with more than 230 churches as partners.

The Homeplace will have a partnership with Midway College, which becomes Midway University July 1. “We are excited to work with Midway College to not only provide learning opportunities for students but also for the residents of The Homeplace,” said Tonya Cox, the facility's executive director.

The Homeplace will be offering internships and other learning opportunities for students. This partnership will also benefit residents, Cox said: “Our residents will also have the opportunity to attend events and classes to foster their lifelong learning.”

Cox said The Homeplace aims to provide “unique long-term care in a way that honors their preferences and desires to be home.” More information is on the facility's website. It will host an open house from 1 to 3 p.m. Sunday, June 28.

Cost of long-term-care insurance going up, but it's still a wise investment, depending on your income

Judy Witte says her long-term-care insurance premiums
are going up at a worrying rate. C-J photo by Matt Stone.

Seniors are facing increases in their premiums for long-term-care insurance as insurance companies scramble to deal with increasing longevity of seniors and low interest rates that are "crimping investment returns," Chris Otts reports for The Courier-Journal.

Louisville retiree Judy Witte, 72, said she received a letter from her insurance company recently saying her premiums will go up by 77 percent, from $986 to $1,746 per year.

Her situation is part of a larger trend in which the cost of an average policy has increased by 6 to 17 percent from 2011 to 2012. Long-term-care insurance helps pay for the cost of assisted living, nursing homes, hospice care and home care.

In the Louisville area, assisted living costs about $45,000 per year and nursing homes cost about $72,000 per year and more.

People should buy long-term-care insurance if they can't afford the care they might need without dipping into their savings, Otts reports. "For example, someone who receives $100,000 a year in retirement income but spends only $30,000 might be able to afford an assisted-living center or nursing home," Otts notes. But if that same person spends $80,000 a year, then it would be a wise investment to buy long-term-care insurance because they would not be able to afford the assisted living or nursing home costs.

The right time to buy long-term-care insurance is between age 50 and 60. If Witte had waited to buy hers today, it would have cost her more than $26,000 a year, Otts reports. "To me, it's a precious possession," she said. "It helps me sleep at night to know I have this." (Read more)

Nursing-home violations went up in third quarter, but a record 8 facilities had no deficiencies

In the third quarter of 2011, inspectors found 403 deficiencies in 56 Kentucky nursing homes, an average of 7.2, up from 5.9 in the second quarter. But no deficiencies were found in eight facilities, the first time that has happened in so many.

"I guess you could call that progress," Bernie Vonderheide of Kentuckians for Nursing Home Reform told The Courier-Journal's Deborah Yetter. The non-profit organization advocates for nursing home residents and obtains this data regularly through open-records requests to the Kentucky Cabinet for Health and Family Services and distributes it statewide. The information is posted as part of Medicare's nursing-home comparison data.

Inspections assess a facility on the care of residents and how that care is administered; on how staff and residents interact; and on its environment. Certified nursing homes must meet more than 180 regulatory standards. The state Office of Inspector General website has more data, such as the results of inspections and the ownership of each facility.

Nursing homes with 10 or more deficiencies in the third quarter were: Christopher East Health Care Center, Louisville, 20; Glasgow Health & Rehabilitation Center, Glasgow (18); Springhurst Health and Rehab, Louisville (17); Woodland Terrace Health Care, Elizabethtown (16); Parkview Nursing and Rehabilitation Center, Pikeville (16); Windsor Care Center, Mount Sterling (14); Bluegrass Care & Rehabilitation Center, Lexington (14); The Good Samaritan Society, Jeffersontown (12); Green Valley Health & Rehabilitation Center, Carrolton (12); Carmel Manor, Fort Thomas (12); Breckinridge Memorial Nursing Facility, Hardinsburg (11); Glenview Health Care Facility, Glasgow (11), Professional Care Health & Rehabilitation Center, Hartford (11); Salyersville Health Care Center (10); Stanton Nursing Center, Stanton (10); Colonial Health and Rehabilitation Center, Bardstown (10); Owsley County Health Care Center, Booneville (10); and Edgemont Healthcare, Cynthiana (10).

Nursing homes with no deficiencies were: Lourdes Transitional Care (Paducah); Westport Place Health Campus (Louisville); Carter Nursing & Rehabilitation Center (Grayson); Regional Medical Center of Hopkins County (Madisonville); Belle Meade Home (Greenville); Robertson County Health Care Facility (Mount Olivet); Windsor Gardens (Bardstown); and the Loretto Motherhouse Infirmary (Nerinx).

For the first time, inspection results were also released for assisted-living facilities. Inspectors found 19 deficiencies at Charleston Assisted Living in Danville, by far the highest number among the 10 facilities inspected. Other inspection results at assisted living facilities were: The Harrod Assisted Living, Harrodsburg (12); Highland Ridge Assisted Living, Glasgow (7); Atria Highland Crossing, Fort Wright (6); Bluegrass Assisted Living, Elizabethtown (4); Bowling Green Retirement Village, Bowling Green (4); Trinity Station Retirement Community, Flatwoods (4); The Neighborhood of Somerset, Somerset (2); Twin Oaks Assisted Living, New Castle (2); and The Village of Lebanon, Lebanon (2). There are 100 assisted-living facilities in Kentucky. (Read more)

Federal grant will help build assisted-living and hospice facility in Maysville

Gov. Steve Beshear presented a $800,000 community development block grant (federal money administered by the states) for the construction of a Maysville assisted-living facility and hospice inpatient facility Friday, The Ledger Independent reports.

The Hospice of Hope projects will include 32 apartment-style units in the assisted-living facility, and eight units for hospice care. The $7- to $8-million project is slated for construction this spring.

At the check presentation, Beshear said Kentuckians are finding ways to improve health care-related services, despite tough economic times. Beshear spoke of his administration's efforts to increase enrollment in KCHIP, a free or low cost health insurance program for children, and the efforts to secure $62 million for the Kentucky Prescription Assistance Program. (Read more)