A state audit found Kentucky neglected nursing home oversight, delaying inspections for years and failing to catch inaccurate Medicaid eligibility data.
The Cabinet for Health and Family Services (CHFS) in Kentucky did not properly manage Medicaid eligibility or payments nor complete health and safety inspections for nursing homes within mandated time frames, the state auditor’s report released this week suggests.
Of 190 nursing inspections reviewed, 162 were late, some by as much as 51 months, far exceeding the federal requirement of no more than 15 months between surveys.
In terms of inaccurate Medicaid eligibility data for nursing homes, some 358 people who had already died were still listed as eligible for Medicaid, the audit reveals.
Auditor Allison Ball said the lack of timely inspections posed risks to residents’ health and safety, but also noted that changes were underway.
“CHFS has finally taken steps to rectify the backlog of long-term care facility inspections it had allowed to linger,” Ball said in a news release. “This shows that all of the problems uncovered in our report can be fixed by following our recommendations.”
State officials said they have since taken steps to address the problem. As of March 2026, all 268 nursing home facilities in Kentucky have received compliance surveys within the required time frame after the state worked to clear the backlog of overdue inspections.
Ball said lingering issues could potentially jeopardize federal funding tied to Medicaid, as well as grants that support program oversight, patient safety investigations and other services.
However, Gov. Andy Beshear’s administration strongly disputed those claims. A spokesperson said that some of the issues stem from limited access to federal data needed to verify eligibility across state lines.
“The Beshear administration worked hard to access this necessary data, and after months of waiting, the Centers for Medicare and Medicaid Services (CMS) finally provided states with the information requested to determine Medicaid eligibility for individuals who may be enrolled in more than one state program at one time,” Scottie Ellis, Gov. Beshear’s communications director, said in a statement to a local media outlet. “As the federal government has acknowledged in the past, no state has access to the data necessary to identify when beneficiaries are concurrently enrolled in a Medicaid Managed Care program in another state.”
State officials said corrective measures included reviewing thousands of records flagged for eligibility concerns. Overall, CMS flagged 21,330 people for verification, with the state resolving most cases, reviewing the remaining 7,026, and confirming 872 as eligible, Ellis said. About 5,200 were removed, but Ellis noted that disenrollment did not necessarily mean prior ineligibility.
The audit identified nearly $1 million in duplicate Medicaid payments, totaling 844 instances.
