‘It’s not OK.’ Beshear cites missteps that led to backlog in nursing home inspections

Gov. Andy Beshear acknowledged on Thursday that Kentucky made mistakes contributing to a massive backlog of federally required state inspections of nursing homes, putting people at risk.

“These are our seniors. These are vulnerable individuals, and it’s our job in the state to do everything we can to protect them,” said Beshear, a Democrat, at his weekly news conference in Frankfort. “So our job has to be to do better. And in terms of when (the backlog) will be eliminated, it ought to be as soon as possible.”

The Herald-Leader reported last week that, as of June, 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 have quit the job in recent years because of comparatively 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.

In Kentucky, surveys are performed by the Office of the Inspector General at the Kentucky Cabinet for Health and Family Services.

Beshear said Kentucky initially faced the same problems as the other states. The COVID-19 pandemic temporarily shifted attention to infection control in nursing homes, creating a logjam of delayed standard surveys in 2021 and 2022, and there is a nationwide shortage of nurses, who often serve as state inspectors.

But on top of that, Kentucky has struggled to hire and retain qualified workers at many state agencies, he said. Over the past decade, the legislature eliminated traditional pensions for new hires and allowed most state workers to go without salary increases, he said.

“We lost people in every major field where we desperately needed them,” the governor said.

The state government finally is seeing a wave of job applications because of recent pay raises approved by the legislature, Beshear said. The state health cabinet this summer provided even larger raises for the nurses who work as nursing home inspectors, boosting their salaries from $53,000 on average to a range of $72,328 to $95,834.

“We hope it will have an impact and an impact soon,” Beshear said.

On a related point, the governor said, the state might have erred by prioritizing complaint surveys — a briefer, focused visit to look at a specific grievance — over the standard surveys that are intended to prevent abuse and neglect problems from happening in the first place.

“It’s not OK to have the second-largest backlog, and it probably needed to be a better balance there than what was selected,” Beshear said.

“What’s important at this moment is that we acknowledge when we had a shortcoming and we work to get it right,” he said. ”We work to make sure we have the staffing, we work to make sure we have the balance. It’s not just complaints but those regular checkups, too.”

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