U.S. Senator Charles Grassley (R-Iowa) recently requested a federal investigation of the way states investigate nursing home complaints. Grassley made his request after an investigation of the care received by Maizie Bickley, an 89-year-old nursing home patient. Bickley was found in poor condition at the facility by her daughter. The nursing home had not obtained any medical attention for Bickley when her condition worsened. Doctors later diagnosed Bickley with a bowel obstruction, infection, and dehydration that required life-saving surgery. The nursing home fired an aide as a result of Bickley's poor care.
Bickley's daughter complained to a state agency, which investigated and found no problems with the nursing home's care. Bickley's daughter then complained to an ombudsman and Senator Grassley. Shortly thereafter, the Centers for Medicaid and Medicare Services (CMS) investigated the quality of the state agency's investigation. CMS determined state inspectors didn't conduct a thorough investigation of the Bickley case.
Grassley has asked the Government Accountability Office (GAO), the investigative arm of Congress, to investigate state nursing home inspection agencies and the way they respond to complaints. He has also asked CMS for four years' worth of nursing home inspection reports in several states to determine if the inadequate investigation Bickley received is isolated or part of a larger problem. Read more about Senator Grassley's investigation of the investigators.
As a result of their investigations, I suspect the GAO, CMS, and Senator Grassley will find that state agencies are as understaffed and underfunded as the nursing homes and assisted living facilities they investigate. We can't expect more oversight and better investigations of these facilities until we commit more resources (money and people) to police them. I'm reminded of a quote by Abraham Heschel: "A test of a people is how it behaves toward the old. It is easy to love children. Even tyrants and dictators make a point of being fond of children. But the affection and care for the old, the incurable, the helpless are the true gold mines of a culture."
We also need to ensure that offending nursing homes are hit with significant fines and monetary penalties to deter further neglect and abuse. As Bickley's daughter correctly observed, "problems with nursing homes are widespread . . . Too many homes are owned by corporations, and for them the bottom line is profit." Until nursing home profits are threatened by meaningful and thorough inspections and complaint investigations, the owners of these facilities will never learn.
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.
Posted on Mon, January 28, 2008
by Robert Carter