Kentucky. Over the last decade, the nursing home industry made political contributions amounting at least $1.8 million to Kentucky politicians while lobbying against bills that would require nursing home owners and corporations to hire more direct-care employees, face higher fines for violations, and abide by stronger precautions against elder abuse. After having examined the industry’s campaign donations, and following stories earlier this summer, the investigative report revealed systemic gaps in the state’s handling of abuse and neglect cases at nursing homes.
Also in response to those stories, Gov. Steve Beshear — who has taken at least $58,500 in industry donations, and whose brother, David Beshear, helps care for patients at a nursing home in Dawson Springs — announced a review of how his administration handles reports of abuse and neglect of residents. “The governor is very concerned about the issues that have been raised concerning abuse and neglect of the elderly in nursing homes,” according to Beshear spokesperson, Kerri Richardson. “While he welcomes campaign contributions from those who support him, they never have and never will have any impact on the decisions he makes as governor.” Understandably, reform advocates are pessimistic.
Founder of Kentuckians for Nursing Home Reform, Bernie Vonderheide, stated: “We’re David up against Goliath. They obviously have the money, they give so much, and we are just so overwhelmed.” Every winter, Vonderheide’s group lobbies the General Assembly for bills sponsored by the same two or three lawmakers. Chief among the proposals is one to establish minimum staffing requirements for nursing homes based on the number of residents and the level of care they need. Residents are neglected when profit-focused companies put too few employees on duty, Vonderheide said. And every winter, the reform bills die without receiving a committee vote.
“I’ll keep trying. One of these times, I might get through,” said Rep. Carl Rollins, D-Midway, who sponsors the lion’s share of the reform bills. “I’m talking about having adequate staffing. My Lord! You would have thought I wanted to put a stake through their hearts.” Rollins said he sponsors the bills because of his late mother-in-law’s experience in a Kentucky nursing home with too few employees to respond to residents’ needs. “We had to hire someone, a personal aide, who went in on weekends when they were particularly understaffed to make sure she was fed and cleaned and cared for,” Rollins said. “I worry about any nursing home resident who doesn’t have someone looking out for them.” Vonderheide and Rollins said it’s their understanding, from talking with lawmakers, that House Democratic leaders don’t want the reform bills called for a vote.
Since 2005, the nursing home industry has given at least $74,850 to the Kentucky House Democratic Caucus, which distributes campaign money at leadership’s discretion to House Democrats in contested races. Overall, the industry gave at least $203,421 to state legislative campaigns in the past decade. In a prepared statement, House Speaker Greg Stumbo said he isn’t blocking the reform legislation. “In fact, I don’t recall this particular issue being brought up to me by any member during the legislative session,” said Stumbo, D-Prestonsburg. “Personally, I favor reasonable guidelines on nursing homes, just as I support law enforcement and inspectors cracking down hard on those who do not follow the law.”
Nursing home reform bills usually are assigned to the House Health and Welfare Committee, where they perish. Committee chairman Tom Burch, D-Louisville, is invested in a real estate trust that includes nursing homes. Burch’s former House aide, Eric Clark, now is chief lobbyist for the Kentucky Association of Health Care Facilities, the group representing for-profit nursing homes, and runs its political action committee, which has given at least $90,750 in campaign donations since 2005. Last week, Burch said House Democratic leaders don’t seem receptive to the reform bills advancing to the House floor. “As chairman, I never get told directly, but I do get the feeling that it’s not a good idea to bring the bills forward,” Burch said. “I don’t know exactly what they’re thinking. It’s like any time your boss lets you know indirectly what his preference is.” However, Burch added, he has his own objections to the reform bills. For example, Burch said, his research suggests that setting minimum staff-to-patient ratios at nursing homes could cost hundreds of millions of dollars in additional payroll. It also could set a precedent by which other institutions — such as schools or prisons — are pressured to have more employees on duty to handle those in their care, he said. “We don’t have that kind of money,” Burch said.
According to Burch, “the problem with nursing homes is bad management.” Burch adds: “I spent my career with General Electric. If you had those sorts of management problems at G.E., you would go out on your ear.”
Burch said it’s not a conflict of interest for him to control nursing home bills while invested in a medical-properties real estate trust that includes nursing homes as well as doctors’ offices and hospitals. “It’s not that much money,” Burch said. “I’ve got, like, $100,000 in there that used to be G.E. stock. If I had $1 million in there, I’d say I might have a conflict.”
Unfortunately, it appears that what should be a priority, that is, nursing homes should properly and adequately tend to their residents daily as they are entrusted and paid to by families throughout the Commonwealth and across the nation – instead of spending time and monies into relaxing regulations and standards on the care they are expected to provide by paying lobbyists and politicians.
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