The Government Accountability Office (GAO) has finally concluded what we all knew to be true:  Nursing homes go unpunished for the abuse and neglect suffered by residents. See story here

Federal health officials impose only minimal penalties on nursing homes repeatedly cited for mistreatment of patients.  As a result, nursing homes cycle in and out of compliance with federal standards and pose a continued threat to the health and safety of patients.

”Some of these homes repeatedly harmed residents over a six-year period and yet remain in the Medicare and Medicaid programs,” said the report, to be issued this week by the Government Accountability Office, an investigative arm of Congress.

The Department of Health and Human Services ”fails to hold homes with a long history of harming residents accountable for the poor care provided,” the investigators said.

Congress established stringent standards for nursing homes in 1987. In 1998, the GAO reported that ”homes can repeatedly harm residents without facing sanctions.”  About 1.5 million people live in the nation’s 16,400 nursing homes on any given day.

The GAO said federal health officials hesitated to impose fines of more than $200 a day, in part because they believed that larger penalties ”could bankrupt some homes.” Fines are generally so small that nursing homes view them as a ”cost of doing business,” with ”no more effect than a slap on the wrist,” the report said.

Here is a good example where a nursing home was fined for overmedicating a resident and then officials withdrew the fine!

Many residents are totally reliant on staff for care, and rely on the federal Medicare program to pay the bills. The problem at nursing homes is poor staffing.  I just read an article that discusses the issue and explains how and why it is a system wide problem.

The article talks about an investigation that found the staffing shortage wasn’t an oversight.  The homes and their upper management were "padding their balance sheets on the backs of helpless residents in their care".

“They were all trying to make a buck,” said Alan Peak, an FBI agent in the white collar crimes unit. The probe revealed criminal conditions at the nursing homes—residents suffering from bed sores, malnutrition, beatings, neglect—all the result of their management company’s directives to cut costs. Meanwhile, managers rewarded themselves handsomely for their efficiency.

The fraud prosecution is one of the first of its kind. While systematically cutting back on service at the nursing homes, management continued to collect money from Medicare and Medicaid for services they knew were inadequate, or in some cases not performed at all.

The management company and its CEO, as well as the nursing homes, pled guilty last fall to fraud conspiracy charges. In February, the CEO was sentenced to 18 months in prison, and the nursing homes were each fined $180,000. The company president was sentenced April 20 to two months in prison for his role.


The Michigan AG is trying to stop the abuse and neglect of nursing home residents.  A Metron’s Greenville Nursing Home is facing a $100,00 fine for what the Michigan Attorney General calls "quality of care deficiencies."

The penalty was imposed against Metron for bed rail issues involving several residents earlier this year. This incident follows criminal charges the Attorney General brought in February 2006 against eight employees of the Metron facility in Big Rapids. The charges stemmed from the death of Sarah Comer in January 2005.

See more information here

A new report shows that Medicaid programs are failing to deliver adequate medical services to the low-income populations they were designed to serve including nursing home residents.  The non-profit consumer advocacy organization Public Citizen issued a report ranking Medicaid programs by how they met and surpassed federal mandates in four categories: eligibility, scope of services, quality of care and provider reimbursement.

Fifty-five million, mostly low-income Americans get their health care coverage through their state Medicaid program. The worst Medicaid programs in the country, according to Public Citizen, are those in Alabama, Colorado, Idaho, Indiana, Mississippi, Missouri, Oklahoma, South Carolina, South Dakota and Texas.

Public Citizen ranked states by the optional health care services that states provide beyond legally mandated services.
"Medicaid desperately needs nationwide uniform standards of quality of care and an effective means of monitoring and upholding those standards," said Ms. Ramirez de Arellano.

See story here

Georgetown police could not find any physical evidence to corroborate one of the recent complaints filed against Georgetown Healthcare and Rehab in Maryville. In March, police were called to the facility after a resident said he was choked by a nurse.

The incident happened in December but he waited to report it because he was “in fear of possible retribution.”  The nurse denied the charges but was placed on suspension during the investigation. 

The resident was shown pictures of 12 women who work at that facility and was asked to show the investigators the one who choked him. The photo selected was not the nurse he accused of the abuse. There was a inconsistency in part of his allegations.

“Based on this investigation, there is no physical evidence or witnesses to support this allegation,” Investigator Johnell Sparkman wrote in his report. “At this time this case is unfounded.”

Helluva an investigation.

No polygraph examination of the accused? Prior complaints? Interview other residents?

See story here

The nursing home industry and insurance lobbyists have fought (and continue to fight) to limit the duties of nursing homes in conducting background checks on employees.  It is ridiculous. Background checks are cheap and quick in the computer age even with the high turnover rate of employees.  Look at this story where a nursing home aide raped 90-year-old resident.. It could have been prevented if they did a background check.

William Morrison, a former aide at the Rome Memorial Hospital Residential Health Care Facility,  was convicted last month of raping and sexually assaulting a 90-year-old resident of the nursing home.

Morrison was an employee at Rome Memorial Hospital for several months before being transferred to the hospital’s affiliated 80-bed nursing home. Rome Memorial Hospital Residential Health Care Facility intended to perform a criminal background check when Morrison was hired, but it was not completed before he raped the elderly resident.

The background check would have revealed that Morrison was previously convicted for one felony and several misdemeanors in the 1990s. His last conviction was for a misdemeanor drug offense in 1999

See story here

This is an incredible story.  A nursing home employee was jailed for allegedly using a cigarette lighter to set fire to an elderly patient’s bed over the weekend.

Tina Louise Spencer was booked into the county jail on charges of first-degree arson and attempted murder. Spencer is accused of setting fire to the bed of Ann Hudson, 88, at Carlton Cove nursing home.  The resident sustained first- and second-degree burns on her scalp and forehead.

Investigators said Hudson wasn’t a regular patient of Spencer’s but that Spencer checked on her from time to time. Firefighters were called to Carlton Cove shortly after 7:30 a.m. Saturday. Firefighters determined the fire wasn’t accidental, which led to a probe by investigators with the police’s Arson Task Force and the fire marshal’s office.

Johns Hopkins has recently released a study that indicates that patients that resided in long term care facilities within the last six months are more likely to be infected with drug resistant superbugs.    There was no definitive explanation for the increased risk, but researchers believe that underlying illnesses and weakened immune systems in nursing home residents are a factor.  Those residents who are wheelchair or bed -bound have an even higher risk of superbug infection – 22 times higher than patients who hadn’t resided in long-term care facilities.  The problem with superbugs is that they can lead to dangerous bloodstream infections.

The result of this study, at least immediately for Johns Hopkins, is that all patients who have been in the long-term care stetting will be tested for superbugs, and will be treated as infected until the test results are in.  In terms of nursing homes, this study shows how wide spread drug resistant bacterial infection has become, and indicates the need for better infection control in long term care facilities.

To read more about this study, click here.

In past years, the bill came close to passing but failed because of lack of support in the House of Representatives. Therefore, it is extremely important to get members of the House to co-sponsor and support the bill this year.

Please contact your U.S. Representative’s office and ask for him or her to co-sponsor the Elder Justice Act, H.R. 1783. Ask them to support this bill because:

  • Abuse and neglect of the elderly in long-term care settings are serious problems. (If you can, give a local example that shows this.)
  • Abuse and neglect are under-reported; but even so, long-term care ombudsmen across the country receive over 16,000 complaints a year about abuse, gross neglect, and exploitation. (If you have one, substitute a statistic from your state or area that shows the amount of abuse or neglect in your local facilities.)
  • The Elder Justice Act will help public agencies combat abuse against all elderly. It is the strongest legislation introduced to protect nursing home residents in the past 20 years.
  • There are several ways to contact your Representative:
    Call the U.S. Congress switchboard at 202/224-3121. They will put you through to the Representative’s office, and you can give your message to the person who answers the phone.
  • The Elder Justice Act provides for a wide range of programs and grants to improve detection and handling of elder abuse. A number of provisions are directly related to protecting residents in nursing homes and/or other long-term care facilities. These would:
  • Improve forensic investigation of elder abuse.
  • Require the number of adjudicated criminal violations by facilities or their staffs to be published on Nursing Home Compare.
  • Provide for a consumer rights information page on Nursing Home Compare.
  • Authorize new funding to improve ombudsman capacity and training.
  • Authorize a national training insitute for long-term care surveyors.
  • Require operators and empoyees of any long-term care facility that receives federal funds to report "any reasonable suspicion of a crime" to law enforcement; establish fines for those who fail to report and protection from retaliation for those who do.
  • Require nursing homes that are voluntarily closing to give 60 days notice to the state survey agency and provide a plan to relocate residents.
  • Authorize a report to recommend legislation or administrative action to establish a national criminal background check system for nursing home workers.
  • Authorize a study on establishing a national nurse aide registry.