Report: Texas Lax In Monitoring Nursing Homes

DALLAS (AP) – Texas has heavily reduced its enforcement of rules that govern the state’s nursing homes, due in part to budget cuts, legislative changes and inspectors being discouraged from citing bad conditions, according to an analysis by a newspaper.

The analysis found Texas has all but stopped imposing the most severe penalties, such as revoking a home’s license and government contracts, or seeking a court-appointed overseer against nursing homes in violation.

Four employees who performed inspections for the state in recent months said that their superiors often resist letting them cite homes for possible life-threatening abuse and neglect, the newspaper reported.

“They’ll say, `You just don’t have it,”‘ said a highly experienced inspector, who still works for the state and asked not to be identified out of fear of retaliation. “You feel it’s to the point of immediate jeopardy, and to be told `no’ is quite mind-boggling.”

But Chris Traylor, commissioner for the Texas Department of Aging and Disability Services, said the agency’s nursing-home enforcement leaders aren’t impeding tough enforcement.

“That’s nonsense,” Traylor said in a statement. “Our message to staff consistently has been, `Call it like you see it, and do whatever is necessary to protect the health and safety of residents.”‘

Tim Graves, head of the Texas Health Care Association, which represents for-profit nursing homes, said the enforcement system is working.

“I’m at a comfort level with where we are,” said Graves, who added: “We have a regulatory structure in Texas that’s probably as tough as any state’s.”

The newspaper reported that its 2 1/2-month investigation found that:

— 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.”

In one example, the newspaper found that last year a nursing home in the Dallas suburb of Duncanville lost track of 72-year-old James Hines for more than 25 hours. He was eventually found on the lawn in the hot July sun, with cuts and severe sunburns.

A state investigation found that no one on the home’s staff noticed that Hines had been missing for more than a day, although a medication chart erroneously showed him as current on his eye drops, blood pressure pills and anti-seizure drugs.

The home, the Duncanville Healthcare and Rehabilitation Center, eventually paid a $26,000 federal fine.

A state auditor’s list last summer showed 12 serious enforcement remedies were brought against Duncanville Healthcare in a 42-month period, the most of any of the 64 nursing homes in North Texas.

The incident was “an out-of-the-ordinary and unusual event,” which the nursing home’s owner regrets, said Brian Lee, general counsel for Sykesville, Md.-based Nexion-Health, which owns the facility.

Lee noted the home received no deficiencies and was “above average” in its most recent state inspection, in April.

Amanda Fredriksen, who advocates for the elderly in AARP’s Texas office, said such incidents illustrate how Texas doesn’t act until people already have been harmed.

“These things should just simply never happen,” she said.

(Copyright 2011 by The Associated Press.  All Rights Reserved.)

Comments

One Comment

  1. NiteNurse says:

    The best monitoring will come families or guardians who visit and often to check the care the patient is receiving. From experience I know these nursing homes will do their best care if they know someone from the patient’s family will be checking on them. The visits should be unannouced and at different times of the day or night. Don’t depend on the government to do everything for you.

  2. YRofTexas says:

    *Shocker*
    The only time on record that I have agreed with NiteNurse.
    When my husband was in the hospital for 2 months last year, they threw away 2 of his underclothes, gave him an insulin shot (he is not diabetic), tried to sedate him to keep him quiet.
    Because I spent every night but one with him, the nurses and techs were on their toes. If a person had an attitude or failed to do their job. I made it known to the floor nurse, and changes took place quickly. They hated me, but I didn’t care. I cleaned up after my hubby, fed and kept his clothes clean. I made sure that his personal hygiene was to his comfort, sheets changed every day, things were recorded, and clean surroundings. They also learned to NOT ignore his requests when he buzzed the nurses station.
    He got out sooner because I was the Lion at the Gate, and I was not about to allow my husband to be harmed or to not heal quickly. I was there in the bathroom, cleaning his urinal, when a visiting nurse gave him that insulin shot. My husband was in a sleep stupor, and asked me if he was diabetic. The furr flew!
    This is why it is CRITICAL that Someone Stay with your loved one when they are in a very serious health dilemma. You MUST be Aggressive in taking care of your loved one. No compromise; take no prisoners!

  3. YRofTexas says:

    I can’t believe it!
    The only time on record that I have agreed with NiteNurse.
    When my husband was in the hospital for 2 months last year, they threw away 2 of his underclothes, gave him an insulin shot (he is not diabetic), tried to sedate him to keep him quiet.
    Because I spent every night but one with him, the nurses and techs were on their toes. If a person had an attitude or failed to do their job. I made it known to the floor nurse, and changes took place quickly. They hated me, but I didn’t care. I cleaned up after my hubby, fed and kept his clothes clean. I made sure that his personal hygiene was to his comfort, sheets changed every day, things were recorded, and clean surroundings. They also learned to NOT ignore his requests when he buzzed the nurses station.
    He got out sooner because I was the Lion at the Gate, and I was not about to allow my husband to be harmed or to not heal quickly. I was there in the bathroom, cleaning his urinal, when a visiting nurse gave him that insulin shot. My husband was in a sleep stupor, and asked me if he was diabetic. The furr flew!
    This is why it is CRITICAL that Someone Stay with your loved one when they are in a very serious health dilemma. You MUST be Aggressive in taking care of your loved one. No compromise; take no prisoners!

    1. YRofTexas says:

      Apologies! CBS did not initially appear to post my message…sorry!

  4. Lyn C. Cromwell says:

    Hey everyone did you know that one of the owners of several Nursing homes in the State of Texas is none other than State Senator John Corona. Therefore, the findings in this article should NOT come as a surprise. He sits on several of the Legislative Committees which hold hearings and control which laws make it to the Floor for voting.

  5. DallasGal says:

    Our state laws do not benefit the elderly/patients in nursing home care. Doctors cannot be employed by nursing homes, per Texas state law. If your parent is in a skilled nursing environment, not only do you have to oversee/monitor what the nursing home staff is doing, but also monitor the doctor. If the doctor that consults at the nursing home decides to take your loved one off a vital medication that they need to live and the nursing home staff follows the doctor’s orders, and your loved one dies because of being off their required medication, DADS (Dept of Aging and Disability Services) will NOT find the nursing home at fault because they ‘followed doctor’s orders”. THERE ARE NO CHECKS AND BALANCES REQUIRED!!!! This happened to our mother, who died because the doctor overseeing her care at a skilled nursing home facility basically forgot to put her back on medication she needed to live and she effectively died because she didn’t have it. DADS says that the nurses followed doctor’s orders because they did as they were told (not to give my mother the medication, even though common sense and ethics would tell you to put her back on it).

    When you file a complaint with DADS, after they have investigated your complaint, hopefully the investigator will call you with the results of their findings. All you will get at first is a verbal summary of their findings. In order to get the final investigation findings, it will take approximately 5-6 months (I filed mine in July and they are still not ready). You have to request your complaint’s findings in writing, crazy that you have to request it, and PAY for the copies of it!!

    And if you think of suing, Texas passed a law in 2003 that limits lawsuits, so my mother’s life is only worth $250K less legal and court fees. You know that the actuaries for the nursing homes calculated that the risk of being sued for being negligent is close to nil because most folks that oversee their loved ones in a nursing home is elderly and can’t handle the stress of fighting for justice (it’s painful) or can’t find a lawyer to take their case.

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