‘We’re way behind.’ KY nursing home inspections won’t be fixed quickly, officials say
Kentucky’s massive backlog of overdue nursing home inspections — one of the nation’s worst — might not be eliminated for a long time, leaving health and safety problems undiscovered, state officials warned a legislative panel on Tuesday.
“We need to be clear: We’re way behind. We’re waaay behind,” Health and Family Services Secretary Eric Friedlander testified. “We’ve got a long way to go to catch up. There’s no quick fix on this. It’s gonna take us, if we’re lucky, a year to dig out of this.”
The Herald-Leader reported in July that 73 percent of Kentucky’s 277 nursing homes were listed as going more than two years without a so-called “annual” inspection. According to federal data, only Maryland had a larger backlog, at 75 percent. The national backlog average is 11 percent.
Fewer than one in five of Kentucky’s nursing home inspector positions were filled as of last fall, the nation’s worst vacancy rate, the newspaper reported. Many inspectors, including registered nurses, said they quit the job in recent years because of low pay, long hours and frequent travel demands.
The U.S. Centers for Medicare and Medicaid Services requires the states to conduct standard surveys of nursing homes every year to uncover deficiencies in care before they become serious enough to cause harm.
Members of the Kentucky Health and Human Services Delivery Task Force said Tuesday that they were dismayed to learn Kentucky has fallen so far behind.
“We’ve got a very serious issue that kind of caught us by surprise,” said state Sen. Stephen Meredith, R-Leitchfield, who is co-chairman of the task force.
Friedlander and his cabinet’s inspector general, Adam Mather, told lawmakers that several factors contributed to Kentucky’s backlog.
Every state fell behind on standard surveys during the COVID-19 pandemic when they temporarily diverted their attention to infection control, the officials said. But Kentucky has struggled more than most to catch up because it keeps losing registered nurses from its state health cabinet to the far more lucrative private sector.
Registered nurses form the backbone of the health cabinet’s inspection teams.
As of this week, Mather said, there are 53 vacancies for nurses among the inspector positions out of 83 total positions for nurses. The state managed to hire only six so-called “nurse consultant/inspectors” in the first seven months of 2023, with a 20 percent turnover rate overall, he said.
Almost nobody can hire enough nurses right now, Mather said.
“As a nurse myself, I’ve never seen a more challenging environment for the profession,” Mather said. “We’re just unfortunately, nationally, we’re not educating enough nurses to provide the care that’s needed in the country.”
Gov. Andy Beshear’s administration is trying a variety of possible solutions, including pay raises that have bumped the nurse positions from about $50,000 a year in 2020 to a salary range of $72,328 to $95,834. It’s also using private contractors to recruit nurses to the health cabinet and even to perform some facility inspections.
And it’s creating a new career ladder at the health cabinet to allow licensed practical nurses, with less formal education than registered nurses, to be hired and advance while on the job, the officials said.
In the meantime, as it works to reduce the inspection backlog, the cabinet will prioritize nursing homes that have a history of more serious citations or complaints, Mather said.
However, this problem isn’t going away soon, Friedlander told the task force.
“I’m hoping we are at the nadir,” the health secretary said. “I’m hoping we’re at the bottom. But I cannot swear it to you all. It has been a tremendous challenge retaining and hiring nurses, and that’s exactly where we are.”
‘Do they not care?’ Kentucky faces huge backlog of nursing home inspections
How safe are Kentucky nursing homes? There are hardly any inspectors left to tell us
