LOUISVILLE -- Several Kentucky nursing homes, including one in Paducah, have been named in a U.S. Senate report on nursing homes with a "persistent record of poor care."

Pennsylvania's U.S. Sens. Pat Toomey, a Republican, and Bob Casey, a Democrat, released the names of nearly 400 nursing homes nationwide with poor safety records that, until last week, had not been publicly identified.

Complaints at the Kentucky nursing homes include residents not receiving their medication on time, a staff member allegedly sexually assaulting a patient, and unlocked medication carts sitting unattended in hallways.

River Haven Nursing and Rehabilitation Center in Paducah and Twin Rivers Nursing and Rehabilitation Center in Owensboro were on the list. Others in Kentucky included: Klondike Center, Louisville; Springhurst Health and Rehab, Louisville; Woodcrest Nursing and Rehabilitation Center, Elsmere; and Mountain Manor of Paintsville.

Toomey and Casey released the names after questioning why the Centers for Medicare and Medicaid Services only publicly shares a smaller list of about 80 nursing homes that investigators frequently check on to resolve documented issues.

Those facilities are designated as "Special Focus Facilities" and identified on the federal Nursing Home Compare website with a small yellow triangle. They can be cut off from Medicare and Medicaid if they fail to make improvements.

Owensboro's Twin Rivers Nursing and Rehabilitation Center is the only Kentucky facility designated as one of "Special Focus Facilities," according to the report that was shared with the Senate Special Committee on Aging.

The expanded list of about 400 nursing homes that Toomey and Casey revealed last week includes "Special Focus Facility candidates" that have a "persistent record of poor care."

These additional facilities, however, are not deemed "Special Focus Facilities" because of limited resources at the Centers for Medicare and Medicaid Services, according to the report.

Federal budget cuts in 2014 limited the number of nursing homes the agency can put in the oversight program, Medicaid Services Administrator Seema Verma said in a May letter to Casey.

But Toomey and Casey described the "SFF" candidates as "nearly indistinguishable" from the smaller group of about 80 nursing homes.

According to the report, the only parties that know if a nursing home is a SFF candidate are Centers for Medicare and Medicaid Services, the state in which the candidate is based and the facility itself.

SFF candidates do not face additional oversight and are not "subject to more rigorous enforcement actions, additional disclosure or reporting requirements," the report states.

In addition, CMS does not have a way to add a candidate to the more rigorous SFF program "if a particularly egregious incident occurs," according to the report.

The senators' report also found the Centers for Medicare and Medicaid Services has failed to consistently update the Nursing Home Compare site and include "detailed information or context" on the SFF program.

"There is no information on Nursing Home Compare explaining the reason for a facility's participation in the program, the length of time it has been in the program or whether it has improved," the report stated.

About 1.3 million Americans are nursing home residents, cared for in 15,600 facilities, according to the Centers for Disease Control and Prevention.

In April, CMS identified about 3% of them as problematic in one of two categories, according to the report, after Casey and Toomey requested the list of problematic nursing homes one month before.

"When a family makes the hard decision to seek nursing home services for a loved one, they deserve to know if a facility under consideration suffers from systemic shortcomings," Toomey said.

River Haven Nursing and Rehabilitation Center in Paducah was mentioned among cases of nursing home neglect and abuse in the Senate report.

One resident at the facility who suffered from a burn wound and was receiving treatment that included a skin graft did not have their "dressing changed or showers administered as ordered," according to the report.

State investigators at the Paducah facility found the individual "lying in bed with a large amount of green drainage on (their clothing) and a pool of green drainage on the bed sheets," the Senate report said.

The resident told investigators they were not sure the last time their clothing had been changed.

"As evidenced by this report, oversight of America's poorest quality nursing homes falls short of what taxpayers should expect," the senators concluded.

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