Des Moines Register has a great article on Senator Grassley’s comments and complaints about how states investigate nursing home abuse and neglect.  He is calling for a federal investigation into the way states respond to complaints of poor nursing home care.

"I have an obligation to protect Iowans, and all Americans, from substandard nursing care," the Republican senator from Iowa said in a letter Thursday.  Grassley criticized Iowa’s nursing home inspectors for failing to thoroughly investigate a complaint involving Waterloo’s Ravenwood Nursing and Rehabilitation Center.

In August 2006, Maizie Bickley was an 89-year-old resident at Ravenwood. Nurse aide Connie Rust called Bickley’s daughter, Sandra Bickley, one night to report concerns that Maizie Bickley was very ill and wasn’t being properly evaluated or treated by the nurses.  Within hours of Maizie Bickley’s arrival at the hospital, she was diagnosed with a bowel obstruction, an infection and dehydration.

The facility fired Rust, the aide that told the family the truth citing a company policy that prohibits conduct "that results in serious negative public relations." I guess being caught providing substandard care is considered bad for "public relations" but it is worse for the neglected resident!

Sandra Bickley was furious, particularly when the Iowa Department of Inspections and Appeals looked into Ravenwood’s care for her mother and found no problems. She complained to Iowa Citizens’ Aide Ombudsman William Angrick and to Grassley. 

Dean Lerner, who heads the state inspections department, asked the federal Centers for Medicaid and Medicare Services to do its own review of his agency’s work on the case.  That federal review concluded that state inspectors didn’t conduct a thorough investigation of the Bickley case and didn’t interview nurses, ambulance workers or the hospital’s emergency room staff.

Grassley is asking the GAO to examine the nation’s state-run nursing home inspection agencies and the manner in which they respond to complaints. He is also asking the Centers for Medicaid and Medicare Services to give him four years’ worth of investigative reports dealing with state inspections. He wants to know whether the Bickley case is an indicator of a widespread problem.

Although certified nurse aides have relatively little training compared with registered nurses, it’s the aides who provide most of the hands-on care in nursing homes. But they typically are prohibited from sharing concerns about quality of care with residents’ family members.

"But the problems with nursing homes are widespread," she said. "We’re basically just warehousing our senior citizens in this country. Too many homes are owned by corporations, and for them the bottom line is profit."

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