The Senate Committee on Finance held a hearing March, 6 2019 addressing the ongoing concern over nursing home abuse and neglect.
Committee Chairman Sen. Chuck Grassley of Iowa said in his opening statement, “Hardly a week goes by without seeing something about nursing home abuse or neglect in the national news. Every family has a loved one — a mother, a father, or a grandparent — who may someday need nursing home care. That makes this a topic of enormous concern to every American.”
Grassley said the Inspector General reported one-third of nursing home residents experience harm during their time under care at federally-funded facilities, and more than half of those instances were preventable. He said a high percentage of the cases involved “sexual abuse, substandard care, and neglect.”
The hearing also focused on the Centers for Medicare and Medicaid Services’ (CMS) rating system, where those searching for a nursing home facility can supposedly learn about the quality of care those nursing homes provide.
But ranking member Ron Wyden of Oregon said, “Too much of the information that goes into the rating system is self-reported. It is not a reliable indicator of quality.”
Witnesses Share Stories of Nursing Home Abuse
Wyden referenced how one of the day’s witnesses — Patricia Blank of Iowa — attended the hearing to share of how her mother passed away from neglect at her nursing home.
Blank’s mother, Virginia Olthoff, passed away in February 2018 after experiencing dehydration and severe pain.
Blank said her mother, who experienced dementia, had lived at Timely Mission Nursing Home in Buffalo Center, Iowa for 15 years, and Blank believed she had been receiving proper care. She said she would frequently hear from administrators about when her mother’s medication was changed and was updated about her mother’s yearly evaluation.
But on February 28, 2018, the overnight registered nurse called and said her mother was moaning and in pain and she believed she should be taken to the hospital.
“The emergency room doctor … said my mother was extremely dehydrated and had sodium levels that were so elevated she likely had suffered a stroke,” Blank said.
“He also said, quote, ‘This did not just happen. I believe she’s been without water or any type of fluid for four or five days, maybe for as long as two weeks.’”
The emergency room doctor filed a report to the department of human services, which Blank said “read like a horror story.”
“According to numerous staff members, my mother had been eating very little and drinking almost nothing for two weeks,” Blanks said. “Where was my phone call then?”
Maya Fischer also shared the testimony of her mother’s abuse, which she said occurred at Walker Methodist Health Center in Minneapolis, Minnesota. She said a nurse walked into her mother’s room and witnessed a male nurse raping her mother.
“And just like that, my mother became another statistic in the shocking reality of nursing home abuse,” Fischer said.
She said other residents had complained about the nurse and “the department of health investigated these prior complaints, did nothing, and then kept them hidden.”
“I still feel the guilt of not being able to take care of her myself and having to entrust her care to others, only to have her subjected to this unthinkable assault,” Fischer said.
Experts Weigh in on Nursing Home Abuse
The conversation shifted to solutions for increasing the quality of nursing home care. Dr. David Grabowsi, a Harvard Medical School professor, referenced a New York Times article about the rate of nursing home closures in rural areas. He said there’s been more than 400 closures, and the problems in nursing homes across the country are magnified in rural areas.
“I would hope that we could think of some different policy levers here like Medicaid payment changes for rural areas,” Grabowski said. “Could we think about additional regulatory oversight. … Can we think about payments and regulations as a way to maybe spur better quality in those rural markets?”
David Gifford, the senior vice president of quality and regulatory affairs for the American Health Care Association, said other challenges faced by rural nursing homes are workforce-related.
“Many people are moving from rural areas into urban areas, and there just aren’t enough people there, and we need incentives to get high-quality healthcare workers to come in there,” Gifford said.
He proposed changes like a student loan forgiveness program that could attract nursing school graduates.
Changes to Nursing Home Quality Ratings
Discussion also centered on criticism of the Nursing Home Compare and Five-Star Quality Rating Systems by the CMS. These criticisms have led the centers to initiate changes, which are set to take place in April 2019.
The systems were designed to help in the selection of nursing homes, and provide a rating of one to five stars for nursing homes. While five-star nursing homes are considered to provide above-average care, and one-star ratings indicate below-average care, nursing homes are also given a separate rating for the following areas:
- Health inspections: indicate compliance with Medicare and Medicaid health and safety standards
- Staffing levels: high staffing levels are generally an indicator of quality and measure the number of nurses that are available to provide patient care at a given time
- Quality measures: measured based on assessments from residents and Medicare claims data
One example of a change in the rating system deals with registered nurses on site. Previously, a facility with seven or more days in a three-month period with no registered nurse onsite would automatically be given a one-star staffing rating. Beginning this month, it will be reduced from seven days to four.
Caring for Victims of Abuse
Dansky | Katz | Ringold | York is committed to standing up for the rights of nursing home residents who have experienced abuse and neglect. We have expert understanding of nursing home laws and regulations and have helped hold nursing homes accountable and earned compensation for victims and their families.
If you believe a loved one has been a victim of elder abuse, contact DKRY today for a consultation, where we’ll learn about your case and share ways we can advocate for you.