Complaints of abuse in nursing homes on the rise

Thursday, Aug. 2, 2001 | 9:10 a.m.

CARSON CITY -- Complaints concerning abuse of elderly patients in Nevada nursing homes are on the rise, but state officials say the problem here is not as alarming as it is nationally.

A national report released Monday covering the past two years said elderly people were abused in nearly a third of the nation's nursing homes. And many of them suffered serious injury.

Rep. Henry Waxman, D-Calif., who released the statistics, said there were nearly 9,000 abuse violations from January 1999 to January 2001. He said examples were discovered of residents being punched, choked or kicked by staff members or other residents.

In Nevada, in the fiscal year ending June 30, the state Division of Aging reported it investigated 606 complaints arising out of the state's 50 nursing homes. The division said 158 complaints -- 26 percent -- were substantiated.

"We don't see what we're seeing nationwide on a grand scale" said Gilda Johnstone, who supervises eight ombudsmen who investigate complaints coming from the elderly.

Johnstone and Charles Perry, executive director of the Nevada Healthcare Association that represents nursing homes, said substantiated complaints are not high in this state because a law passed in 1999 requires that those working in nursing homes undergo criminal background checks.

They also said the industry is tightly regulated in Nevada, with supervision by the state Bureau of Licensure and Certification and by the aging division.

"There is an awful lot of oversight," Perry said.

Figures compiled by the aging division said the number of complaints of senior abuse in nursing homes has risen in the past three fiscal years from 418 to 606.

Division director Mary Liveratti said the division did not break down the number of substantiated complaints before the 2000-2001 fiscal year.

Liveratti and Johnstone said one reason for the rising number of complaints is a better reporting system.

Liveratti said nursing home workers are required to report any incident, including accidents, which contributed to the higher number being reported.

For instance, she said, an elderly patient with fragile skin may suffer a bruise or a cut when being moved from a bed to a wheelchair. This is not really abuse. But the ombudsmen examine each case to determine if there was adequate staff available to transfer that patient or if there was neglect on the part of the worker.

In the past, there have been cases of deliberate abuse by staff of a patient, said Johnstone. "But we don't see that lately."

Perry said, "I don't believe you will find the abuse or neglect in Nevada nursing homes," that is detailed in the national report. He said there have been some citations by the state that resulted in fines.

The national report found that in 1,601 nursing homes there were citations issued because of incidents that put residents in great risk of harm, injured them or killed them. It said more than twice as many nursing homes were cited for abuse in 2000 than in 1996.

The Licensure and Certification bureau is compiling data for a new report, but a study released in July 2000 found that 42 of the 50 nursing homes were not in substantial compliance with all the regulations on patient care.

The bureau said, however, that only one home -- Washoe Care Center in Sparks -- provided substandard care to its patients. And that home improved conditions after the report, the bureau noted.

The bureau makes unannounced visits to each home, which are graded on their compliance with 522 federal regulations.

One problem, not only in Nevada but nationwide, is finding nurses, Perry and Johnstone said.

And some nursing homes have experienced financial problems. Perry said five have closed in the last year, the most recent the Fallon Convalescent Center on July 29. He said the payment schedule from Medicaid has been too low to provide the money to make a profit.

He said Gov. Kenny Guinn and the 2001 Legislature "made a huge step in the right direction" in raising the rates Medicaid will pay the homes for their patients. The payments to the homes will rise by 21.6 percent this fiscal year and another 4.3 percent next fiscal year.

That will cost Medicaid an additional $38.5 million over the biennium. Medicaid funds are split between the federal and state governments.

"We know it will not cure the entire problem," said Perry. "But we're working on a new method of paying for Medicaid patients and hope it will be ready shortly after the first of the year."