FRANKFORT, Ky. (AP) - Patient advocates across Kentucky are worried that a drop in nursing home citations for serious problems under Gov. Ernie Fletcher's administration could signal a relaxation in enforcement.

Advocates say Kentucky nursing homes have not grown noticeably safer under Fletcher's administration to warrant a coinciding drop in citations from the state.

"My experience does not validate a drop of 50 percent in citations," said Ruth Morgan, an ombudsman in Bowling Green. "We've not seen that kind of improvement in quality of care, unfortunately."

Cabinet officials, however, say they are not ignoring problems and said several reasons could contribute to fewer citations.

State government conducted annual inspections and cited about one in four of approximately 300 nursing homes with serious deficiencies that caused "actual harm" or "immediate jeopardy," during the last four years of former Gov. Paul Patton's administration. Under Fletcher, that rate has fallen to about one in 10 nursing homes, the Lexington Herald-Leader reported.

Kathy Gannoe, a Lexington ombudsman, said the drop was "stunning" and could indicate that the state is giving nursing home facilities extra chances to correct their problems before issuing serious citations.

"That's a stunning drop," Gannoe said. "It's very interesting and also very troubling."

The Government Accountability Office, which is Congress' investigative arm, has said that similar drops in other states may be a sign of relaxed enforcement.

Citations for serious deficiencies could lead to daily fines of as much as $10,000, and loss of federal payments.

Cabinet officials say they are not ignoring problems that could hurt patients.

Steven Davis, the Cabinet for Health and Family Services' inspector general, said he was not aware of the drop in citations for serious deficiencies. Davis said there could be various reasons for the drop, including too few inspectors, and a focus both on complaints and fewer homes.

Davis said inspectors are focusing their attention on a smaller set of nursing homes that have the worst records. And, they're focusing on "complaint inspections" which look at specific problems that are raised in complaints, Davis said.

Davis said state officials are issuing more deficiencies than in previous years, but they're for less serious problems.

"Frankly, facilities are just doing better on their own initiative," Davis said.
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Information from: Lexington Herald-Leader, http://www.kentucky.com

(Copyright 2007 by The Associated Press. All Rights Reserved.)