Kentucky Fights Nursing Home Staffing Rule
In a move that prioritizes industry interests over resident safety, Kentucky is challenging a new federal rule designed to improve nursing home care by mandating minimum staffing levels. This opposition comes despite the state’s own documented evidence of the severe consequences of understaffing in these facilities.
Lyndon Woods: A Case Study in Neglect
A stark example of the dangers of understaffing is Lyndon Woods Care & Rehabilitation, a Louisville nursing home. Kentucky state health inspectors uncovered a shocking pattern of neglect during five visits in 2023. Residents were subjected to:
- Physical altercations: Elderly residents, lacking proper supervision, resorted to punching, kicking, and slapping each other.
- Falls and injuries: Residents repeatedly fell, sustaining injuries including bedsores and broken bones, some of which proved fatal.
- Unsanitary conditions: Residents were left lying in their own urine and feces, their calls for help going unanswered.
Inspectors identified understaffing as the root cause of these problems. Overwhelmed caregivers struggled to provide basic care, including changing soiled briefs and helping residents out of bed.
“Very Dangerous for the Residents”
Employees themselves voiced concerns about the dangerous conditions created by chronic understaffing. According to Murray Ledger & Times, one nursing assistant reported being responsible for 60 residents with just one colleague. Another employee stated that management was aware of the critical staffing shortages but failed to provide assistance.
The High Cost of Understaffing
Brent L. Moss, an attorney with Marks Balette Young & Moss, with experience on both sides of nursing home litigation, is suing Lyndon Woods on behalf of the estate of Wayne E. Moore, an 81-year-old resident who died after months of neglect due to understaffing. “In my experience, negative experiences in nursing homes are always tied to staffing,” Moss asserts.
A New Rule for Safer Care
To address the dangers of inadequate staffing, the U.S. Centers for Medicare and Medicaid Services (CMS) announced a new rule in April 2022. Starting in May 2026, nursing homes will be required to provide a minimum of 3.48 hours of direct care per resident daily, including specific requirements for registered nurses and nursing assistants.
While limited exemptions will be allowed for facilities facing genuine workforce shortages, the federal government is investing $75 million in training programs to help nursing homes comply.
Kentucky Sides with Industry, Ignoring Resident Needs
Despite the clear evidence of harm caused by understaffing, Kentucky has joined 19 other states in a lawsuit seeking to block the CMS rule. Attorney General Daniel Cameron argues that most Kentucky nursing homes cannot meet the new staffing standards and will be forced to close.
This stance aligns with the interests of the nursing home industry, which claims the rule is an unreasonable financial burden. However, critics argue that many nursing home chains prioritize profits over resident care, diverting funds through complex financial structures.
The Real Cost of Inaction
Kentucky’s Long-Term Care Ombudsman, Sherry Culp, confirms that understaffing is a major concern for residents and their families. Her office receives numerous complaints about delayed responses to calls for help, neglect, preventable injuries, and inadequate hygiene care, all of which are linked to staffing shortages.
Experts emphasize that understaffing is at the heart of most serious deficiencies found in nursing homes. Toby Edelman, senior policy attorney with the Center for Medicare Advocacy, points out that research consistently demonstrates a direct correlation between staffing levels and the quality of care.
Profit Over People
Edelman criticizes the industry’s claims of financial hardship, highlighting the substantial profits generated by many nursing home chains. “If there’s no money in nursing homes, then why do these companies keep buying them?” she asks.
Competing for Scarce Resources
The Kentucky Association of Health Care Facilities (KAHCF), the state’s nursing home lobbying group, argues that Kentucky’s shortage of registered nurses makes it difficult to meet the new staffing requirements. However, critics point out that nursing homes often offer lower wages than hospitals and medical practices, exacerbating the staffing challenges.
Political Influence and Industry Interests
KAHCF has been actively lobbying against staffing mandates and has made significant campaign contributions to Kentucky politicians, including Attorney General Daniel Cameron. This raises concerns about the influence of industry interests on the state’s opposition to the CMS rule.
A Call for Prioritizing Resident Welfare
The Kentucky case highlights the urgent need to prioritize the well-being of nursing home residents over industry profits. The CMS staffing rule offers a crucial step towards ensuring safer and more compassionate care for this vulnerable population. It is imperative that states like Kentucky recognize the importance of adequate staffing and support policies that protect the rights and dignity of nursing home residents.