The Minnesota Health Department performed on-site investigations of just 10 percent of the 3,400 complaint allegations it received from the public about nursing home and home-care treatment last year, according to the agency’s statistics.
And when nursing homes or other facilities self report allegations, the numbers from fiscal year 2016 were even lower. The agency only did on-site inspections of 102 allegations — less than 1 percent — of the nearly 21,000 allegations it received from providers’ reports.
“This is one of the worst performance reports I’ve heard in my 18 years,” Sen. Jim Abeler, R-Anoka told state officials. “As a state we are failing with this….I don’t often get shocked anymore but you caught my attention.”
|MN Commissioner of Health Dr. Ed Ehlinger|
“It is a high priority. This is an issue that we’ve had to deal with,” Health Commissioner Ed Ehlinger told the Pioneer Press.
The number of vulnerable adults receiving care and the ease of lodging complaints have both grown in recent years, resulting in an exponential increase in the number of complaints the department takes in.
In 2010, the state’s Office of Health Facility Complaints received fewer than 500 maltreatment complaints from the public. Last year, that number was nearly 3,500. Six years ago, providers reported 3,100 possible issues. Last year, they reported almost 20,800.
The influx has prompted the agency to triage the complaints that come in. Complaints of actual harm, potential for harm or widespread problems which could lead to immediate jeopardy quickly rise to the top, said Assistant Health Department Commissioner Gil Acevedo.
But that leaves the department unable to immediately attend to other issues.
“Thousands of complaints are not investigated so maltreatment continues, and less severe issues may escalate to more serious harm,” the agency said in a budget request this year. Those uninvestigated complaints in the last year included more than 4,000 falls, nearly 2,000 complaints of emotional or physical abuse by staff and nearly 3,000 “unexplained injuries,” the department said.
“We know that this is not acceptable,” Acevedo told a senate committee. “The volume of complaints that are coming in pretty much overwhelms our staff.”
Even when the agency does an on-site investigation, the process takes a while.
“Because of the time it takes to complete investigations, the public does not know about complaints occurring in facilities where their loved ones live,” the agency said in its budget request.
Acevedo highlighted for a senate committee a case the state looked into last year, from a Gracewood senior living facility in Hugo.
From the investigative report on the incident: “A white powdered substance was spread under the client’s nose and the same white powdered substance was on the table placed in three straight lines. Client #2 was experiencing arm tremors. The song ‘Cocaine’ by Eric Clapton was playing in the background.” The white powder, it was discovered, was powdered sugar.
That resident was suffering from Alzheimer’s disease and “was unable to report maltreatment due to severe memory impairment,” the investigative report said. But a staffer at the facility recorded the incident and shared the video.
In another incident, a client was recorded on the toilet and yelling “you guys are going to hell” at a staffer, and a staffer yelled back “we’ll see you there.” In a third recorded and shared incident, a client was videotaped holding an empty alcohol bottle “while another unidentified staff member was pushing the client’s wheelchair, with ‘rock music’ playing the background.”
“The facility was aware about this but did nothing to correct it,” Acevedo told senators.
But the report raised questions.
|Sen. Karin Housley, R-St. Marys Point|
“Yes, ma’am,” Acevedo replied.
“And the report was just posted yesterday?” Housley asked on Feb. 1.
“Yes, ma’am,” he said.
According to the health department, the initial complaint was received May 9 and considered serious enough to warrant a site visit. That two-day visit occurred in mid-June. The investigation continued until Aug. 24. The investigator informed Hugo Graceland that it found a violation of state statute in early October. While the investigation became public information on Dec. 20, it wasn’t posted onto the state’s website until Jan. 31, 2017, because of a backlog in web postings.
Although the state took months to publicly post the report, Hugo Graceland did not wait for action, according to Kari Bina, regional director for the group that operates a dozen Minnesota assisted living facilities, including Hugo Gracewood.
“We didn’t find out about this incident until the state walked through our door,” she said. Once the state officials arrived in June, the facility conducted its own investigation and “staff members that were involved were terminated immediately.”
As the number of complaints rose and the percentage of state officials who could investigate declined, the state took steps to address some of the issues.
The state changed the leadership of the office overseeing investigations, began work to streamline the investigation process and adopted new methods to help prevent problems.
“We recognize that we have not been able to meet the needs that are there in the community. We recognized it several years ago and, actually, it has led to some major changes,” said Ehlinger, the health commissioner.
The governor’s budget also proposes a state increase in funding for the health facility complaint office over the next four years, accompanied by a request for more federal funding for investigations and higher fees paid by nursing home and home care providers.
Patti Cullen, president and CEO of Care Providers of Minnesota, which represents nursing homes and other care and housing providers, said the providers see the need to increase the state complaint-investigation work.
“We’re supportive of that, even if there are going to be increased fees on our people,” she said.
|Sen. Jim Abeler, R-Anoka|
Abeler, the state senator from Anoka and a longtime expert in health and human services, said he was not sure that increasing the budget would solve the problems.
“I don’t think they use the money they have well,” he said.
Meanwhile, the state will continue to work to improve.
“We are far from where we need to be,” Ehlinger told senators. “We are far from where we want to be.”
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Lawmakers outraged over lack of investigation in nursing home complaints