Journalist Robert Garrett wrote a great article for the Dallas News about the failure of Texas to penalize nursing homes that neglect and abuse residents. Current and former inspectors say that they’re being discouraged from reporting bad care and unsafe conditions. Experts fear that elderly and frail residents are at risk of abuse and neglect as some operators routinely cut corners and understaff facilities.
The state has stopped imposing the most severe penalties, such as revoking a home’s license and government contracts, or seeking a court-appointed overseer. Four employees who performed inspections for the state in recent months told The News that their superiors often resist letting them cite homes for possible life-threatening abuse and neglect. Without that implicit threat, corporate owners will treat minimal fines as a cost of doing business instead of correcting the problem.
The Dallas News investigated and found:
State regulators whose job is to keep shoddy operators from owning or running homes have done cursory, and at times inaccurate, background checks that in at least one case failed to keep out a federally banned health-care provider.
State budget cuts have reduced staff by about one-fourth since 2001, even as the number of nursing homes in Texas is virtually unchanged, at about 1,200.
Legislative changes, especially limits on lawsuit damages passed in 2003, have virtually eliminated trial lawyers as de facto watchdogs of nursing homes. Other changes limited the state’s ability to fine nursing homes and have created an industry-friendly cadre of “quality monitors.”
After inspectors discovered practices endangering the lives of elderly and disabled residents, the state regulatory agency hasn’t gone after the homes’ licenses.
AARP said the state’s relatively infrequent use of harsh sanctions “raises serious concerns about the agency’s commitment to quality.” AARP , a leading advocacy group for seniors, recently gave Texas poor marks for quality care. Using data from the federal government, it ranked Texas 34th among states in avoiding bedsores for high-risk nursing home residents and 42nd in preventing hospital readmissions.
In 2001 (the nursing home industry spent as much as $575,000 during the 2001 session),
Republican lawmakers removed about 45 of the 557 inspector positions and converted them to “quality monitors” who try to help operators solve persistent problems, such as bedsores. Today, the inspector force has dwindled to about 400. And the quality of care has suffered. Budget documents show that state nursing-home enforcement has remained on tight rations. For the last several years, inspection teams have had fewer people and spent less time at a home during annual visits than in previous years.
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