The nursing home industry has failed to police themselves and the state agencies that regulate the facilities have failed to police themselves or the facilities. This lack of self-policing is causing families to come forward in increasing numbers to file lawsuits against the nursing home facilities. Large jury awards are being handed out in these cases because the jury members all have parents who may have been subjected to this type of inhumane treatment and they can identify with the victims and their families.
Nursing home abuses are becoming more widely discovered because some of the employees of these facilities are unsung heroes who step forward to tell the truth for what it is. The “whistle-blowers” law has aided in these individuals coming forward because the facilities cannot legally retaliate against an employee who “blows the whistle” on their employer. During our investigations, we find that many of these employees have worked at all of the nursing homes in the area because they keep trying to find one that isn’t as bad as the one they just left. After seeing the neglect and abuse at a nursing home, their conscious can’t take it any longer and they decide to move on to another facility.
Unfortunately, this is an industry-wide problem that stems from the owners of nursing homes trying to drain every penny of profit out of the operation. When this occurs, the focus changes from how good of care they can give to the patient to simply keeping the home running without any major problems. In their quest for profit, the owners pay their staff slightly above minimum wages and the LVN’s and RN’s receive a lower pay than their counter-parts at hospitals. Obviously, if these people are getting paid less than others in the same field, they will eventually develop poor attitudes and moral will be low. Instead of paying a higher wage and getting a better trained and qualified employee to begin with, the industry keeps on with the poor standards. People need jobs, and because they need jobs, the nursing homes will always get people who will work for the pay they provide. That doesn’t make it right.
One day, the nursing home industry will realize that they are starting to pay more for lawsuits and bad publicity and will understand a simple principal of business. If they would simply pay their employees better, they would attract a better quality of person who is better trained. If they can hire a better trained person who is making a pay level more in line with their counter-parts, their moral will be better, work will get done, the patients will be better treated and the nursing homes will not get sued. It simply comes down to the fact that they can pay more money up front or pay a lot more money when they are sued. None of the facilities seem to have caught on to this simple fact.
The general public is getting smarter and more concerned about this type of abuse and is starting to place hidden video cameras in their family’s rooms to catch the abuse. As the public gets better educated, there will be more eyes paying attention which will in turn create more opportunities for lawsuits. Almost everyone has heard about “lawsuit abuse,” and I don’t think anyone is jumping for joy by the thought of more lawsuits, but this is the remedy set aside for seeking relief for neglect and abuse. The way to stop the lawsuits is to simply stop the abuse. The way to stop the abuse is for the nursing home industry to truly police themselves.
No one likes the idea of having their mother or father treated in this fashion, and I can assure you that this is going to be more concern as the “baby-boomer” generation gets older and we have more elderly that are going to have to be dealt with. The nursing home industry actually has the opportunity to make a great deal more money in the near future because of this. However, people will begin to take relatives in more or find some other manner in which to make their parent’s last days more respectable and comfortable if the industry continues on their current course.
The State agencies that regulate the facilities are just as much to blame for this dilemma as anyone. Their job is to properly license and police the facilities. Of course, the first thing you hear from them is that they don’t have enough staff or money and they are doing everything they can. Unfortunately, neither is true. For the most part, all government agencies have more money than they need because the government’s solution to any problem is to throw more money at it. I have yet to find a nursing home that did not know in advance that they were going to have an inspection by the State. When the nursing homes know ahead of time, they begin to fill in charts, put out new linen that is just there until the State leaves and reschedule employees so that there appears to be more on duty when the State is there than normal shifts. In essence, it is like a child getting told that the parents are coming upstairs to inspect their room in an hour and giving them enough time to push things under the bed and hide things out of sight.
There is going to have to be a more aggressive approach to regulating the industry. I don’t mean more laws. We have plenty of laws, rules and restrictions. What we need is someone who has enough desire and will-power to actually make truly unannounced inspections and hand out fines that will get the attention of the administrators. Some of the ways to over-come poor inspection habits are as follows:
- Make inspections more than once a year
- Make the inspections at a time that does not coincide with the renewal of a facility’s license. They all know they have an inspection coming right before they are re-licensed.
- Create inspection “teams” consisting of more than one inspector. Even when the inspector arrives, word spreads through the home that an inspector is there and the other end of the facility has time to get their act together before the inspector can make it all the way to them. By sending at least two inspectors, one can start at one end and one at the other and cover more ground.
- Stiff fines need to be assessed for violations. The nursing home administrators understand money and that will get their attention.
- Post the inspections grades on the State’s Internet sight for the world to see. By doing this, you create bad publicity for those messing up and creates an incentive to change.
- Make sure that the inspectors have not worked at the nursing homes that they are inspecting as they form friendships that will not be broken. Many of the State inspectors worked in nursing homes before they went to work for the State and they still have contacts there.
- Increase the number of inspectors to a workable ratio between homes and inspectors
- Set guidelines for the inspectors requiring a certain number of inspections per week.
- Enact ordinances allowing nursing home records to be made available to public under the open records act.
- Require the financial statements of the nursing home facilities to be made public since public funds often pay for the patients and their treatment.
By enacting some or all of these suggestions, the industry will begin to see an improvement. Failing to do so will keep the facilities operating in a “business as usual” status which clearly is not working.
Kelly Riddle is the principal of Kelmar and Associates, formed in 1989, and conducts investigations domestically and internationally. A distinguished speaker and author of 10 books, Mr. Riddle has more than 30 years of investigative experience and earned a Bachelor of Science degree in Criminal Justice from the University of North Alabama. He was chosen as the “PI of the Year” by the National Association of Investigative Specialists and the PI Magazine named Mr. Riddle as the “#1 PI in the United States”. He has been designated an expert in surveillance, insurance investigations, nursing home abuse and computer investigations. He was chosen as “One of the Top 25 PI’s of the 20th Century.” Kelly obtained his Texas Certified Investigator designation (less than 50 in TX.) Mr. Riddle is also on the Board of Directors for the Texas Association of Licensed Investigators (TALI).