SYRACUSE, N.Y. -- A Jamesville nursing home has been fined by the state for failing to protect residents from sexual abuse by other residents, which experts say is part of a growing national problem at nursing homes.
A state Health Department inspection conducted last April found Iroquois Nursing Home did not properly manage two male residents with histories of being aggressive and sexually abusing other residents in the dementia unit of the 160-bed facility at 4600 Southwood Heights Drive.
The health department recently fined Iroquois $16,000 as part of a settlement agreement posted on the department's website. It's the third largest fine imposed on an Onondaga County nursing home in 10 years, health department records show.
An inspection report shows the two men at Iroquois, who suffered from dementia and other health problems, abused other residents and staff.
A sizable and growing problem
Sexually inappropriate and hostile behavior among nursing home residents is a sizable and growing problem, according to a 2014 Cornell University study.
The study of 10 New York nursing homes with more than 2,000 residents found one in five residents were involved in at least one negative and aggressive encounter with one or more fellow residents in the previous four weeks.
The state Health Department said there were six substantiated cases of nursing home resident-on-resident sexual abuse statewide between Oct. 1, 2013 and Sept. 30, 2016.
The study found sexual abuse is just one of many types of inappropriate behaviors that occurs among nursing home residents.
The long term care ombudsman program, a national volunteer watchdog group that investigates complaints by nursing home residents nationwide, compiles statistics on resident-on-resident physical and sexual abuse. It does not keep separate data on sexual abuse.
Those statistics show the combined number of physical and sexual abuse cases investigated grew from 1,903 in 2012 to 2,987 in 2015, a 57 percent increase.
Abuse jeopardized health of 40 residents
The state cited Iroquois for "immediate jeopardy," the most severe type of deficiency that causes, or may cause, serious injury, harm, impairment or death to the residents. The problem jeopardized the health and safety of 40 nursing home residents who lived near the two men, according to the state.
One of the abusive men put his genitals in the mouth of a female resident, exposed himself in front of someone's room, inappropriately touched other residents and grabbed a female member "in a forceful manner," according to the report. In one 30-day period, the man engaged in aggressive, sexually abusive and inappropriate behavior at least 10 times, the report shows.
The other abuser, who had Alzheimer's disease, put his hands under the shirt of a female resident lying in her bed, squeezed an employee's breasts and grabbed, scratched, pinched, hit and kicked other staff members.
Some of the incidents were captured on the nursing home's video cameras.
Iroquois said in a prepared statement it reported a serious, resident-to-resident incident on its secured unit for residents with severe dementia that triggered the state Health Department investigation. The home said it cooperated with the state to correct the problem.
Nursing home residents who engage in this type of behavior tend to be mentally disabled, but physically capable of moving around the facility, the study found.
"I think this is a fast growing trend that needs to be addressed," said Brian Lee of Families for Better Care, a national nonprofit advocacy group for nursing home residents.
Understaffing can lead to abuse
Sexual abuse among residents is almost always a symptom of nursing home understaffing, according to Lee. "There often is not enough staff to supervise residents and not enough training," he said.
Residents with dementia who sexually abuse other residents rarely face criminal prosecution because they lack the mental ability to have criminal intent, Lee said.
Not all cases of sexual abuse among residents are reported.
A mentally impaired male resident of a Schenectady nursing home had sexual contact many times with female residents in 2014, but the facility did not flag the incidents as sexual abuse, a state Health Department inspection report shows.
The state cited Ellis Residential & Rehabilitation Center for failing to identify the incidents as sexual abuse, thoroughly investigate them or increase supervision.
In a signed settlement with the state, Iroquois admitted there was substantial evidence of the violations cited by the health department.
Victims often the most vulnerable nursing home residents
The inspection report faulted the nursing home for not doing a better job of managing the abusive residents' behavior. Even though a small dose of antipsychotic medication seemed to improve one of the men's behavior, the nursing home discontinued it without providing an alternative treatment, the report says.
The home also failed to complete thorough investigations of the incidents and take enough steps to protect residents, according to the report.
The nursing home corrected the problem by having staff provide one-to-one monitoring of each of the men and developing interventions to use when residents engage in sexually inappropriate behavior.
State regulations require nursing homes to identify residents whose personal histories put them at risk of abusing other residents. The health department said nursing homes must monitor these individuals to prevent abuse.
Sexual assault is one of the the least acknowledged, detected and reported types of assault against nursing home residents, according to a report in The Gerontologist.
Victims are often females with mental or physical impairments -- the most vulnerable nursing home residents, the report says.
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Syracuse nursing home fined for sex abuse among residents, growing national problem