Beshear ordered the Cabinet for Health and Family Services to conduct the review after the Lexington Herald-Leader examined 107 citations issued by the agency over a three-year period in instances where a resident's life or safety has been endangered.
The newspaper found that only seven of the 107 cases of nursing home deaths or abuse were prosecuted as crimes and that police and coroners are rarely notified of nursing home deaths or serious injuries.
“This review will be an essential document to guide the many groups that have an interest in maintaining safe nursing homes, and to ensure that proper procedures and accountability are maintained when investigations are required for suspected cases of neglect or abuse,” Beshear said in a statement.
The citations reviewed included 18 deaths, 30 hospitalizations, five broken bones and two amputations that resulted from violations of state regulations, the newspaper reported. Thirteen residents were injured because of lapses by staff members, according to the citations.
Beshear asked cabinet Secretary Janie Miller to review state agencies' coordination with local prosecutors and law enforcement to handle the reports, the newspaper reported.
Representatives from the industry, law enforcement and victim advocates were involved in the review.
Miller said the review found, for example, that law enforcement officials sometimes weren't certain who to contact at the cabinet regarding abuse and neglect cases.
She said one of the recommendations to be implemented is the creation of regional Adult Protective Services teams, which will have more clear guidelines in working with law enforcement.“That was identified as a significant improvement from the voices of law enforcement,” she said in an interview. “They get better at it, and we get better at communicating with them if we have just one or two people involved, rather than 10.”
“We think that it's about time the governor of the commonwealth start making elder care a top priority,” he said.
Vonderheide, who said he had not reviewed the report, said he is glad to see a recommendation to revitalize an Elder Abuse Committee that is inactive.
Miller acknowledged the committee rarely meets and has done little to monitor nursing home abuse investigations, which it is charged with doing under state statute.
She said she doesn't know why the committee has been inactive since before she became cabinet secretary.
“This will be an important place where a lot of stakeholders can be involved in how those recommendations are implemented,” she said.
Miller said the review is the beginning of the process of reforming the way nursing home abuse and neglect cases are handled.
Attorney General Jack Conway, who participated in the process, recommended stiffer penalties for nursing home abuse and neglect and for failure to report abuse and neglect.
“We appreciate Gov. Beshear leading efforts to ensure the Cabinet for Health and Family Services is communicating and coordinating with other state agencies in order to more efficiently and effectively investigate elder abuse and neglect cases,” Conway said in a statement.
Although the state sends reports of the most serious nursing home regulatory violations to the attorney general's office, that office can prosecute only with the permission of local prosecutors.
And local prosecutors say they seldom hear about the cases.
Miller said the final report did not include Conway's recommendations because the legislature would have to amend state law. The report, she said, made recommendations that the cabinet could implement immediately.
“We're assuming that continued work will happen,” she said. “I don't know where that will take us at this point.
Tim Veno, president of the Kentucky Association of Homes and Services for the Aging, said in a statement that, “While instances of abuse and neglect in Kentucky's Long Term Care facilities are not the norm, even one instance of abuse is one too many.”Reporter Stephenie Steitzer can be reached at (502) 875-5136.
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