Retirement News : Seniors : Nursing homes' silent pain

Nursing homes' silent pain

Date Added: 15-03-2005

If you are considering a nursing home in North Carolina for an elderly relative, you might never learn about certain serious injuries and deaths that may have occurred there.

Federal and state rules require nursing homes to be vigilant in reporting suspected abuse, neglect or mistreatment, and injuries when the cause is unknown.

However, injuries can escape reporting when nursing home officials know how the injuries occurred and they don't suspect abuse, neglect or mistreatment.

When such cases are not reported, there is no state investigation into how the incident occurred and how to prevent it from happening again. That means no state official looks for larger patterns of safety problems or checks to see whether nursing home staff is properly trained. If the state has no record of such incidents, neither do families vetting nursing homes.

When nursing homes don't report serious incidents to their state oversight agency, "then you just have the facility investigating itself," said Alice Hedt, executive director of the National Citizens' Coalition for Nursing Home Reform in Washington.

After an Observer inquiry, a U.S. senator is pushing to close this "reporting loophole" in the federal regulations. But those regulations affect only nursing homes that accept Medicare and Medicaid patients, which is the majority. N.C. licensing rules would have to change to make sure every nursing home in the state reported such incidents.

No N.C. official is actively working to change those rules.

Nursing home advocacy groups and the federal Centers for Medicare & Medicaid Services say they do not know how many states have reporting requirements that are more detailed or stricter than the federal rules.

In South Carolina, nursing homes must report many categories of serious injuries and unexpected deaths, no matter whether the cause is known. If the report leads to an investigation that cites violations, the home must take corrective action.

In the past five years, N.C. officials received 8,457 reports from nursing homes and other sources about problems such as abuse, neglect and injuries where the cause was unknown. They investigated 1,933 and substantiated 634. But since injuries where the cause is known are not reported in North Carolina, nobody knows how often they occur.

In one case two years ago, 89-year-old Cora Elliott slipped from a mechanized lift administered by Statesville nursing home assistants and later died. Since Autumn Care of Statesville knew how her fatal injuries occurred, and they did not involve abuse, neglect or mistreatment in the home's judgment, Elliott's case was not reported to or investigated by the state.

Officials at Autumn Care and parent company Autumn Corp. of Rocky Mount declined comment. In October, Autumn Corp. settled a wrongful death suit in Iredell County Superior Court with Elliott's son, Johnny Elliott of Cornelius, for $300,000.

"There needs to be something to protect the other people," Elliott said. "It's not going to help my mom."

In lawmakers' hands

Last month, after the Observer contacted Sen. Charles Grassley, R-Iowa, the finance committee chairman asked the administrator for the Centers for Medicare & Medicaid Services to survey which states require reporting of nursing home injuries when the cause is known.Grassley, who has for years pushed to improve nursing home accountability and increase consumer access to such information, requested a plan of action for closing the loophole by March 22.

In North Carolina, the General Assembly sets licensing and reporting requirements for nursing homes. The Division of Facility Services within the N.C. Department of Health and Human Services enforces both the state and federal rules.

The licensure and certification chief for Facility Services says it's the legislature's responsibility, not his department's, to set policy.

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