On Your Side Investigation: State Lags Behind in Nursing Home Surveys

(Memphis)  From unexplained injuries to ignored concerns, local families turned to the On Your Side Investigators about what they call at lack of quality care at area nursing homes.

WREG found state rules and regulations may be at the root of the problem.

Putting a loved one in a nursing home can be a difficult decision for anyone, and the families who spoke with WREG say their relatives’ conditions only got worse.

The On Your Side Investigators found nursing homes with poor ratings, high deficiencies, and even fines.

What’s worse though, is the lack of staff to catch potential problems and state inspectors who violate their own policies, putting your loved ones lives’ at risk.

NOTE: We want to warn viewers and readers, you may find some of the video disturbing.

“Somebody dropped the ball,” says Thea Herndon.

A busted lip, bed sores, deep wounds on her feet, is how Herndon says her sister, Toni, suffered while at Poplar Point Health and Rehabilitation.

“She began to have multiple falls, cuts and bruises that were unanswered for, or unexplainable,” Herndon added.

It all came to a head when Herndon says her sister fell again in late September. The family happened to be at the nursing home meeting about her care.

“I found my sister face down in a puddle of blood. Her ear was almost severed from the fall.”

Medicare’s Nursing Home Compare website gives Poplar Point a one star overall rating, which is the lowest possible.

The facility was cited with 17 deficiencies in its last, regular survey.

It’s the same place police arrested a patient for allegedly raping another.  The victim was 101-years-old.

Herndon’s family called the On Your Side Investigators, concerned these weren’t isolated incidents.

“I think the public should be aware of what’s going on in the nursing home, that one in particular,” Herndon said.

Kay Fowler shared similar concerns about her brother Jimmy’s care at Gallaway Healthcare.  She told WREG, “He fell eight times.”

“Before he went to Gallaway, he could walk, talk, do anything like that, now he just sleeps,” Fowler explained.

Fowler says Gallaway officials seemed uncooperative when she decided to move her brother. Plus, she noticed another problem.

“This nursing home had not been inspected since April of last year,” says Fowler.

That was on April 19, 2012, when the facility was cited for 20 deficiencies and fined $3200.

Katie Earnest is the District Long Term Care Ombudsman. They serve as advocates for nursing home patients. She says late surveys are an ongoing problem.

Read more about the Ombudsman Program here.

“There is a survey window, a nine to 15 month window that nursing homes should be inspected and in the state, we have been running behind on those surveys,” says Earnest.

Those late, regular surveys means the state is breaking both state and federal regulations.

Of the 36 nursing homes in our area, we found 16 with surveys that have gone past the mandated window.

Seven haven’t had inspections since 2011, including Poplar Point.

“The annual survey is not the only time we’re in the facility,” says Vincent Davis, the Director of the Division of Health Care Facilities, which is the agency in charge of surveys.

He points out inspectors also visit nursing homes to investigate complaints.

We ask, “But why would you all be behind at all?”

“There are staffing issues, for sure,” Davis replied.

Davis says they often lose inspectors to better paying jobs in the private sector, contributing to a staffing shortage.

The division also closed its Nashville office several years ago, forcing surveyors from East and West Tennessee to cover the entire state.

It’s a trend Davis says they’re trying to reverse.

“We’ve begun to fill positions just by the virtue of the fact that our salary base has risen.”

While late surveys are one problem, Earnest is really concerned about the lack of time patients get with nursing home staff.

“Staffing levels, and making sure the nursing home is appropriately staffed to meet residents’ needs a lot of times can be at the heart of why residents aren’t receiving quality of care,” says Earnest.

Currently, there is no federal requirement for nursing home staffing, only recommendations.
In order for nursing homes to get five stars in staffing, Medicare recommends patients get 4.4 hours of direct care a day.

In Tennessee, the minimum requirement is half that at two hours, with only 24 minutes coming from a licensed practitioner, like a nurse.

“So that’s your medicine administration, and things like that, wound care,” explains Earnest.

Advocates like Earnest want state legislators to consider increasing the minimum requirement.

Until that happens, it’s up to families like the Herndons and Fowlers, to assure their loved ones get quality care.

“Go, talk to residents, talk to families, find out what it’s like day to day in that home,” Earnest recommends.

Herndon’s family splits visits between brothers and sisters. They also keep journal entries related to Toni’s care. “Because she can’t speak for herself, we’re her voice,” says Herndon.

“The person I am now is because of him.  He gave up his childhood to help raise me.  It’s my place now to take care of him,” said Fowler of her brother Jimmy.

Neither Gallaway or Poplar Point would comment on the families’ accusations.

As far as stafffing standards, Mississippi has slightly higher minimum requirement and Arkansas has a ratio.

Officials with the Division of Health Care Facilities says families who have concerns should contact them at (615) 741-7221.

Visit their website, to find out more information about nursing homes, or check out Nursing Home Compare.

To get in touch with Earnest’s office, call 901-527-0208 ext. 215.

Here’s a copy of the Nursing Home Residents Bill of Rights

See map of area nursing homes with survey details here:

List of Area Nursing Homes: