Kentucky nursing care facilities face fines from "flawed inspection system"

09/16/2015 05:30 PM

FRANKFORT – Kentucky’s long-term care nursing facility operators say they are paying five times more fines than the national average because of a flawed inspection system which results in hefty fines for, what in many cases, they say can be minor issues.

Mary Haynes, CEO of Nazareth Home, a long-term care nursing facility in Louisville, told members of the Interim Joint Committee on Health and Welfare on Wednesday the states long-term care nursing facilities are facing growing pressures from state inspections which has resulted in fines which are far above the national average.

Haynes told the committee that Kentucky’s 288 facilities are close or better than the national average in a number of categories including staffing and quality measures. Kentucky had 20 percent fewer deficiencies than the national average.

However, even though the state ranks well in those key categories, Kentucky nursing care facilities pay an average of $24,523, five times over the national average, per facility in “civil money penalties” because of the result of heath inspections in which inspectors are called in for, in some cases, very minor infractions and facilities have heavy fines levied by sometimes overzealous inspectors.

The fines are the result of an “immediate jeopardy” designation, which is the highest level in the deficiency category. This sometimes can be the result of a patient saying a comb was stolen or other minor incidents which may or may not have happened.

Sen. Ralph Alvarado, R-Winchester, is a physician who has headed several nursing care facilities, said that he’s seen examples of how minor things have led to hefty fines for Kentucky facilities.

“A diabetic was due insulin and they ran out of strips to check their sugar prior to that insulin administration,” Alvarado said. “The staff went out of their way, one of them was a diabetic who went home and got her own supply to bring into the facility and the patient was given the insulin and everything was fine and the patient did well.

“A disgruntled employee, who was later let go, decided to call the state and report them for not checking that sugar prior to giving that insulin dose,” Alvarado continued. “It resulted in a $100,000 fine for the facility.”

Haynes notes that while the health inspection should be part of the equation, new criteria needs to established to keep good healthcare facilities from unjustly receiving poor ratings and being unjustly fined which could hamper their ability to care for their patients, and in some cases, stay in business.

“Looking at these other performance measures and making that balance with the health inspection is very important for the public to be able to determine the performance of the long-term care center,” Haynes said.

Haynes notes that the goal of talking with the legislators was to prove that a new balanced inspection system needs to be put into place to protect the nursing care facilities from, in some cases, unjust scrutiny compared to other states.

“When you look at how we stack up, how is it that in most of these performance measures, we are right at the national average, but as it relates to “immediate jeopardy” citations, we’re 500 percent more cited more often,” Haynes said.

There are 23,000 residents in Kentucky’s nursing care facilities. There is at least one facility in each of the state’s 120 counties.


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