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| Minnesota Health Commissioner Dr. Ed Ehlinger |
The abrupt firing of a
senior regulator at the Minnesota Department of Health is unleashing a
torrent of complaints by employees who describe dysfunction and disarray
at the state agency responsible for protecting vulnerable adults at
senior care facilities.
In
interviews with the Star Tribune, employees described an office so
overwhelmed by backlogged cases that workers dumped dozens of
maltreatment complaints into recycling bins without reading them. Others
said unread complaint forms piled up into stacks 2 feet high and went
unexamined for months.
At one
point, employees said, they were ordered to stop making phone calls to
elderly victims and other individuals who reported nursing home abuse
because it was too time-consuming. But that only angered families,
hindered investigations and subverted office morale, they said.
“Day after
day, people here are put in an impossible situation,” said Jessie
Saavedra, who has worked at the Health Department for 23 years,
including the past three years at its Office of Health Facility
Complaints (OHFC).
Workers
contacted the Star Tribune after learning that Nancy A. Omondi was
terminated last month as director of the agency’s health regulation
division. Her firing came just weeks after
the Star Tribune published a five-part series
documenting that hundreds of residents at senior care centers across
Minnesota are beaten, sexually assaulted or robbed each year.
The
employees’ accounts help explain why the Health Department suffered
chronic breakdowns in investigating maltreatment complaints, holding
facilities accountable and addressing the alarm and anxiety of worried
families.
In an
interview, Health Commissioner Dr. Ed Ehlinger said he was “really
disturbed” by reports that employees may have destroyed complaint
records and said he has already launched an investigation into those
claims. He and other agency officials also emphasized that OHFC staff
are expected to call individuals who report complaints, and that such
calls are vital to families and the investigative process. An agency
spokesman said any contrary guidance by a supervisor “would be
unacceptable.”
“I admit
that we have some dysfunction in OHFC,” Ehlinger said. “We acknowledge
that we are not doing as good a job as we should. If we are going to be a
resource that people can trust and come to, then we need to do a better
job.”
More investigators
Agency
officials acknowledge they were caught off guard by a massive surge in
abuse complaints in recent years, and they are now taking steps to
reduce the backlog and streamline investigations. This includes a plan
to double the OHFC’s investigative staff over the next four years by
adding 27 investigators. The surge in complaints partly stemmed from the
July 2015 launch and promotion of a new, centralized hot line for
maltreatment reporting, which made it easier for seniors to report
abuse.
The agency
is also modernizing its computers so it can collect and share more
information about abuse investigations electronically. Starting in
January, agency staff will begin scanning maltreatment complaints into
its computer system, an important step toward reducing the agency’s
reliance on paper.
The number
of maltreatment allegations received by the OHFC has swelled from about
4,000 in 2010 to more than 25,000 in 2016. Yet the unit has failed to
keep pace with this surge, and last year it only investigated 3 percent
of these cases on site, state records show.
“We were not ready for that kind of onslaught,” Ehlinger said.
However,
former and current employees at OHFC say the problems in the unit are
deep-rooted and unlikely to be solved through more funding or additional
staff.
“The
system is broken and it’s been broken so long that the people in charge
can no longer see it,” Omondi said in an interview shortly after her
termination.
OHFC
employees said many of the unit’s problems stem from an archaic,
paper-based reporting system. Even when complaints are sent
electronically by other state and county agencies, staff must still
create a special paper file. At times, the complaints are written out by
hand and stuffed in the complaint files, workers said.
“You could
fill up a whole baseball diamond with the tons of paper files waiting
to be processed,” Saavedra said. “With that volume of paper, the chances
of things getting lost and important things going missing is really,
really high.”
Employees said files would
sometimes go missing for months at a time or get permanently lost. The
delays frustrated relatives who reported abuse because they couldn’t
learn why their cases were not being investigated, workers said.
Enforcement breakdown
The
result, as documented by the Star Tribune investigation, is that the
vast majority of abuse allegations from senior care homes in Minnesota
are never resolved and perpetrators are never punished.
Two former
OHFC employees, who spoke on the condition of anonymity, said they
recall written complaints being tossed in recycling bins, without being
reviewed, because of pressure to reduce the backlog of unresolved cases.
The practice, they said, contradicted the agency’s claim that it
reviews every complaint.
Diane
Konecny, a former complaint intake specialist, said she left the unit in
2013 after 16 years, partly because of guilt over not being able to
respond to abuse complaints in a timely manner.
“People
were in tears because we felt so bad for these families and these
vulnerable adults,” said Konecny, who is retired. “We wanted to get
these cases resolved. But obstacles were being thrown our way that made
it impossible to do quality work.”
Mixed messages
One of
these obstacles, say former and current employees, was conflicting
messages on whether to communicate with abuse victims and others who
report abuse.
These
interviews were often vital to determining exactly what happened in an
incident and whether the allegation warranted a deeper investigation.
The regular calls also put victims and their relatives at ease,
indicating that the state took their allegations seriously, employees
said.
But OHFC
staff said they were told by administrators — at various points since
2013 — to stop calling individuals reporting abuse, as a way of speeding
up investigations and reducing the backlog of unresolved cases. At
other times, employees said they were encouraged to make such calls.
“I remember thinking, ‘Why
are they putting a roadblock in front of us?’ ” Saavedra said. “People
file these complaints because they have a serious concern, and we should
be responding to [them] in a timely fashion.”
Crying in their cubicles
Omondi
said she became concerned about a “dysfunctional work environment” at
the OHFC soon after joining the agency in September 2016. She said she
was told that some staff were “crying in their cubicles” because of the
backlog of unresolved cases. The unit also suffered from high turnover,
with more than a third of the staff leaving each year, she said.
“I walked
into a lot of chaos,” she said. “People desperately wanted to do a good
job, but their plate was overflowing. So how could they catch up?”
A number
of OHFC staff said they have shared their concerns with top department
administrators and the Minnesota Office of the Legislative Auditor. The
auditor’s office is
conducting an evaluation, expected for release in February.
Responding to the Star Tribune series, Gov. Mark Dayton has
appointed a special work group led by a handful of consumer groups, which will make recommendations to the 2018 Legislature.
State
legislators also have expressed concern. Last week Sen. Karin Housley,
chairwoman of the Senate Aging and Long-Term Care Policy Committee, and
two other lawmakers called for an investigation into management
practices at the Health Department after receiving reports of bullying
at the agency. Housley, a Republican from St. Marys Point near Afton, is
also working with advocacy groups to craft legislation that would
improve the speed and transparency of senior home investigations.
“We need
to remember that elder abuse is a life-or-death issue,” said Sen. Jim
Abeler, R-Anoka, chairman of the Senate Human Services Finance and
Reform Committee. “If I ran the [Health] Department, I would be working
overtime … to solve this problem.”
Full Article & Source:
State employees say elder-abuse reports tossed in trash due to backlog of cases
