Kentucky nursing homes rank 40th in the nation in new survey; reformers ask governor to create special task force for action

Kentucky got a D grade and a rank of 40th among the states in a new national survey of nursing-home care, and reform advocates are calling on Gov. Steve Beshear and other policymakers to take corrective action.

The state ranks lowest in the Southeast, the lowest ranked region, in nursing home care quality; one in five Kentucky nursing homes were cited as having a severe deficiency, "indicating widespread abuse, neglect and mistreatment of residents," says the report of the survey, created by a Florida-based advocacy group Families for Better Care.

"The results of this first-ever survey sadly represent real people, human beings being abused and neglected every day," writes Bernie Vonderheide, president of the Kentuckians for Nursing Home Reform, the lobby that spearheaded the call for action. A representative of the Kentucky Association of Healthcare Facilities, the lobby for for-profit nursing homes in the state, was unavailable for comment.

The survey analyzed eight federal measures gauging nursing home care, and the state's nursing homes scored below average in five of the eight categories. For example, only a third of Kentucky facilities reported health inspections above average. Click here for more information or to see survey results.

In the letter to the governor, Vonderheide requested the creation of a special task force to address the issues, which they say affect thousands of Kentuckians, many who cannot speak up for themselves: "It’s time to stop this growing crisis in our state before it gets so big that we cannot manage it."

Nursing home ombudsman program at risk because of 'callous and apparenly clueless' move by feds, advocate writes

The Kentucky long-term care ombudsman program is at risk in Kentucky due to a change in federal policy. The Centers of Medicare and Medicaid Services is "quietly telling some state aging leaders that by Jan. 1 they will no longer be allowed to use civil monetary penalty funds to help pay for the nursing home ombudsman program in their states," Bernie Vonderheide, president and founder of Kentuckians for Nursing Home Reform, writes an op-ed piece in The Courier-Journal.

The civil penalties are assessed for violations in nursing homes. In Kentucky, the fund contains about $15 million. But if the move by CMS goes through, Kentucky "stands to lose more than a half million dollars a year from the CMP fund that has gone into supporting full-time ombudsmen in all of the 15 area development districts in the state," Vonderheide writes. "We are concerned about the callous and apparently clueless action by the federal Centers for Medicare and Medicaid Services. It is obvious that the Washington bureaucrats who make decisions like this have never been in a nursing home and are oblivious to the needs of the people."

Nursing-home ombudsmen investigate alleged abuse and neglect in facilities, and visit residents. "In the average nursing home, surveys show that more than half the residents never have a visitor — family member or friend — except for one, and that's the ombudman," Vonderheide writes. "We can't lose our nursing home residents' best friends — those angels of mercy, the ombudsmen." (Read more)

Justice Dept. accuses Erlanger nursing home of collecting on 'worthless services;' suit is first of its kind in Kentucky

The U.S. Justice Department has filed a civil complaint against Villaspring Health Care and Rehabilitation in Erlanger and its parent company, Carespring Health Care Management, claiming they "billed Medicare and Medicaid for services purportedly provided to its residents despite knowing that the services were so inadequate that they were essentially worthless," Valarie Honeycutt Spears of the Lexington Herald-Leader reports.

The complaint was the first in Kentucky alleging that a nursing home violated the federal False Claims Act. "Today's filing represents an important milestone in the effort to ensure effective care for Medicare and Medicaid recipients in long-term care facilities," U.S. Attorney Kerry Harvey said.

The list of allegations include failures to follow physicians' orders, treat wounds and pressure sores, update resident care plans, give enough to drink, give regular baths and monitor diabetics' blood-sugar levels, Spears reports. The complaint alleges there were numerous injuries and at least five deaths from 2004 to 2008 due to improper care.

Officials of the nursing home officials invited journalists to tour the facility and denied any wrongdoing. "We do not feel that the government's case has any merit, and we will defend ourselves vigorously," Carespring spokeswoman Kim Majick said. "Villaspring has consistently provided high-quality care to the residents of Kenton County and looks forward to doing so in the future." (Read more)

Legislature passed few health-related bills; took small steps on child obesity, diabetes, elder abuse

There were proposals to combat childhood obesity, fight methamphetamine production, impose a statewide smoking ban and protect nursing home residents, but Kentucky lawmakers were reluctant to make changes through health-related legislation this year, with one big exception. Some small strides were made, but in large part much-heralded bills did not get much farther than committees.

The major exception was Senate Bill 110, sponsored by Senate Republican Floor Leader Robert Stivers of Manchester, left, which flew through the General Assembly at eyebrow-raising speed. The bill greatly expands the scope of care optometrists can provide to their patients, including a corrective laser procedure that optometrists can now do only in Oklahoma. Normally, that procedure can only be performed by ophthalmologists, who are trained medical doctors. The bill also allows optometrists to prescribe certain drugs and lets the state Board of Optometric Examiners define what procedures optometrists can legally perform, a more fundamental policy change.

The bill was cause for controversy also because of the amount of campaign contributions, totaling almost $400,000, that optometrists made to all but one legislator and Gov. Steve Beshear in the past two years.

One of the first bills to make headlines was House Bill 193, a proposal by state Rep. Susan Westrom, D-Lexington, left, to ban smoking statewide in public spaces and workplaces. Though hopes were never high it would pass, advocates said the time was right to introduce the idea to the General Assembly and educate legislators about the importance of a comprehensive law that would protect all employees, including restaurant and nightclub workers, from second-hand smoke. "Here's what's important: We don't want to settle for a half-baked law," said Amy Barkley, a director for the Campaign for Tobacco-Free Kids.

At the dawn of the session, state Rep. Addia Wuchner, R-Florence, right, introduced a pack of bills designed to fight childhood obesity. One would have required the assessment of elementary school children's body mass indices, or weight-to-height ratios. Another would have required that elementary school children receive 30 minutes of physical education a day. Neither of these proposals were able to gain traction, but Wuchner did win passage of House Concurrent Resolution 13 creating a legislative task force on childhood obesity. By examining child-care facilities, before-and after-school programs, physical education in schools and higher school nutrition standards, members will come up with strategies to get children eating more healthily and exercising more frequently.

Diabetes, which is often preceded by obesity, was also addressed in the form of Senate Bill 63, which charges several state offices, including the Department for Public Health, to try to reduce the incidence of the disease in the state and improve diabetes care, and Senate Bill 71, which establishes the Kentucky Board of Licensed Diabetes Educators and defines diabetes education.

The "meds-for-meth" bill, which would have required prescriptions for three popular decongestants used to make methamphetamine, drew a lot of attention — and pro and con advertising dollars — this year, but was not able to make headway after clearing the Senate Judiciary Committee 6-4 on Feb. 3. The sponsor, Sen. Tom Jensen, R-London, right, promised to broach the issue again next year. "We're waiting for something very terrible to happen by not acting on this," he said. "A tragedy's gonna happen here and then we're all really gonna feel bad."

After several stories about elder abuse and nursing home neglect ran in the Lexington Herald-Leader and The Courier-Journal late last year, two bills were on the table to provide protection for those potentially in harm's way. But neither — whether that be requiring coroners to investigate nursing home deaths or making nursing home workers be subject to a background check — made any headway. House Bill 52, intended to prevent elder abuse by prohibiting a convicted adult abuser from inheriting from the victim after he or she dies, did pass.

Other health-related bills that passed:

• House Bill 121, which bans methylenedioxypyrovalerone, the primary ingredient on products marketed as "bath salts." The product is sold in stores and online under names like Cloud Nine, Red Dove, Blue Silk and Ivory Wave, and, if used inappropriately, can cause paranoia, hallucinations and violent behavior.

• House Bill 311, which allows physicians to submit electronic or faxed prescriptions for methamphetamine and Schedule II controlled substances. Previously, the prescriptions could only be written.

• House Bill 12, which allows mental health professionals to perform an examination using telehealth services. One of its amendments requires health care facilities to report data on health-facility acquired infections and to implement infection prevention programs.

• House Bill 362, which establishes licensing requirements for ginseng dealers.

• Senate Bill 40, which allows pharmacists to give flu shots to children 9 to 13.

• House Concurrent Resolution 138, which urges Congress to provide more resources to treating veterans and military personnel for post-traumatic stress disorder.

• Senate Bill 112, which limits the amount of a copayment or coinsurance that must be paid for services rendered by a physical therapist or occupational therapist to 20 percent of the total charge of the service.

Two bills aim to establish registry for abusers of adults

Identical bills have been filed in the House and Senate to establish a state registry of people who have abused or neglected adults.

Senate Bill 38, sponsored by Sen. Julie Denton, R-Louisville, left, and House Bill 101, filed by Rep. Ruth Ann Palumbo, D-Lexington, right, have advance in their respective committees.

The Courier-Journal's Deborah Yetter, who wrote a series of stories that examined elder abuse in December, reports that advocates including the Council on Developmental Disabilities are working to advance the bill. Council officials feel "a registry would help protect disabled or elderly adults by giving potential employers a place to check the backgrounds of people they hire to provide personal care at home such as housekeeping or bathing or grooming," Yetter reports.

Some state officials have expressed concerns about the cost of such a registry. (Read more)

Beshear backs bills to protect seniors from abuse but doesn't endorse minimum staffing for nursing homes

Gov. Steve Beshear today endorsed a package of previously introduced bills that he said would give the elderly and other adults more protection against abuse and exploitation, but it did not include a bill to set minimum staffing standards for nursing homes, the major measure sought by reformers. The legislation would:

• Prevent people who abuse or neglect vulnerable or elderly adults from benefiting from their deaths (House Bill 52)
• Keep a person convicted of felony abuse or exploitation of an adult from serving as that victim's guardian, executor or power of attorney (HB 54)
• Make it easier and more efficient for adults and seniors needing a guardian when more than one state is involved. (HB 164)
• Require annual criminal background checks of staff at personal care agencies, a step beyond the pre-hiring check. (Senate Bill 23)
• Require criminal background checks for all employees of nursing homes and assisted living homes, including custodians and food service workers (SB44)
• Create an adult abuse registry (HB101 and SB 38)

Beshear noted that last year he implemented recommendations from a Cabinet for Health and Family Services report investigation of nursing home neglect and abuse and said “This legislation further strengthens safety standards and will make a significant difference in the lives of Kentucky’s elderly citizens and the people who care for them.” Beshear recently received the Better Life Government Involvement Award from the main nursing-home lobby, the Kentucky Association of Health Care Facilities.

Bernie Vonderheide of Kentuckians for Nursing Home Reform told Kentucky Health News, "We think Gov. Beshear is to be applauded for reacting decisively to reports by advocates and the media of abuse and neglect of our state's senior citizens. We hope he will continue giving his attention to these serious matters. For example, he should also support legislation before the General Assembly that would set minimum staffing standards for nursing homes, one of the big causes of abuse and neglect among our seniors."

Bill would keep abusers of elderly from inheriting from them

Someone who abuses an elderly person would no longer be able to inherit the departed's assets. That is the aim of House Bill 52, which unanimously passed a House committee Thursday and is expected to pass the full House.

Rep. Joni Jenkins, D-Shively, right, said the bill is meant to close a gap in the existing law. "A law known as the 'slayer statute' already bars a person convicted of killing someone from inheriting from the victim," The Courier-Journal's Deborah Yetter reports. "But as things stand now, people convicted of abusing, neglecting or financially exploiting an elderly person still can benefit financially after their death."

One instance involved John Jackson Robbins of Louisville, who was sent to prison for 10 years after being found guilty of neglecting, abusing and financially exploiting his mother. He inherited her $1.1 million estate upon her death.

Jefferson District Judge David Bowles, right (C-J photo), oversaw the probate case. Despite efforts to keep the money from Robbins, "there was no law to prevent that," he said.

If no other heirs can be found after an heir-caused death, the proposed law would give the estate to a trust fund for protection of the elderly. (Read more)