Kentucky is next to last in currency of nursing-home inspections, and it may not have hit bottom yet, health officials tell legislators

by Kentucky Health News

Kentucky is farther behind on nursing-home inspections than only one other state, and the huge backlog might last a long time, Beshear administration officials state officials warned a legislative committee Tuesday. That could leave health and safety problems undiscovered, reports John Cheves of the Lexington Herald-Leader.

“We’re waaay behind,” Health and Family Services Secretary Eric Friedlander told the Health and Human Services Delivery Task Force. “It’s gonna take us, if we’re lucky, a year to dig out of this.”

There are many reasons, he said, including the pandemic, but the main one is a lack of registered nurses, who “form the backbone of the health cabinet’s inspection teams,” Cheves reports. Adam Mather, the cabinet’s inspector general, said only 30 of the 83 nurse inspector positions are filled.

“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.”

The task force co-chair, Sen. Stephen Meredith, R-Leitchfield, said “We’ve got a very serious issue that kind of caught us by surprise.”

Cheves notes, “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.” The figures come from the federal Centers for Medicare and Medicaid Services, which requires states to inspect nursing homes each year.

“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,” Cheves reports. “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.”

But Friedlander still isn’t sure what they’re doing will work. “I’m hoping we are at the nadir,” he 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.”


Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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