Twin Rivers Nursing and Rehabilitation Center is one of nearly 90 nursing homes nationwide to be named a Special Focus Facility, which means it is enrolled in a federal oversight program for facilities with a history of serious health and safety violations.

It is the only nursing home in Kentucky currently in the SFF program. Five other facilities in the state are candidates, but have not been placed in SFF. State officials decide which nursing homes will participate. The federal program only accepts about 90 facilities nationwide at any time due to budget constraints.

SFF nursing homes are subject to increased oversight, penalties and the threat of losing Medicaid and Medicare reimbursements.

Twin Rivers -- a 132-bed facility -- has been part of the SFF program 22 months, according to information published by the Centers for Medicare & Medicaid Services.

"SFFs are expected to graduate from the program within 12-18 months," Seema Verma, administrator of the U.S. Department of Health & Human Services, wrote last month in a letter to members of the U.S. Senate. "To graduate from the program, the facility needs (to) have two standard surveys without serious deficiencies identified, at least (six) months apart. If facilities are unable to graduate, they are subject to increased enforcement actions or termination."

In the past five years, Twin Rivers has failed or received poor marks during three inspections, according to Steve Davis, Kentucky Inspector General.

On May 20, 2016, Twin Rivers received "the most serious classification for a violation in the Level 4 range denoting 'immediate jeopardy' to a resident's health, safety or well-being," Davis said.

State officials last inspected the nursing home in late March. Level 2 deficiencies were cited, denoting no actual harm with the potential for more than minimal harm, but not immediate jeopardy, he said.

According to Nursing Home Compare, a federal website that provides inspection reports and other information, Twin Rivers has been assessed more than $524,000 in federal fines since May 2016.

Twin Rivers' last inspection report on the website is dated September 2018. At that time, inspectors cited 15 deficiencies. The average number for Kentucky nursing homes is about five, the report said.

Inspectors noted problems in these categories: freedom from abuse, neglect and exploitation (2); quality of life and care (4); resident assessment and care planning (5); resident rights (1); nutrition and dietary (1); pharmacy service (1) and environmental (1). All of the deficiencies were listed under the "minimum harm or potential for actual harm" level, an improvement over earlier 2018 inspection reports that had several citations in the "immediate jeopardy" category.

For example, a July 2018 survey determined the nursing home "failed to notify the Physician of a significant change in the resident's physical status or possible need to alter treatment for two (2) of twenty-one (21) sampled residents."

The report also showed a resident had been prescribed chest percussion treatments every six hours for 20 minutes, but no documented evidence proved staff completed all the treatments.

One resident's tracheal secretions "increased, thickened and went white to green," the report said. "However, the facility failed to follow its policy and did not notify the Physician of the change in condition ... ."

Fifty percent of nursing homes with SFF status improve and graduate from the program, federal records show. About 16% are terminated from Medicaid and Medicare.

The Messenger-Inquirer contacted Twin Rivers, but a nursing home official declined to comment.

On Monday, Sen. Bob Casey, D-Pennsylvania, and Sen. Pat Toomey, R-Pennsylvania, released a report titled "Families' and Residents' Right to Know: Uncovering Poor Care in America's Nursing Homes." Their report included a list of about 400 nursing homes nationwide that struggle to meet standards for quality of care. The list included SFF candidates and participants.

The senators said the names of nearly 90 SFF facilities are public; however, about 400 or so nursing homes have documented issues and qualify for the program. Yet, federal officials have not released their names in the past.

"Senators Casey and Toomey believe that the list of SFF candidates is information that must be publicly available to individuals and families seeking nursing care for their loved ones," the report said. "For that reason, the Senators are releasing the April 2019 list of SFF candidates and are continuing to work with (Centers for Medicaid & Medicare Services) to make future lists public."

To view the Senate report and list, go to and scroll down to Minority News.

Renee Beasley Jones, 270-228-2835,

(0) comments

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.