Who should be contacted about bad nursing-home operators?
January 22, 2018 1:31 PM   Subscribe

Asking for a friend: family-run nursing home that had been providing excellent care has been taken over by a company that immediately started laying off people with seniority, cutting staffing, etc. There are still good people working there, but things are deteriorating weekly. Can't complain to the company, because the people running the place won't provide contact information; where would be the most productive place to apply pressure: state rep? US rep? senator? some board/committee/institution that supervises nursing homes? This is in Massachusetts, if that makes a difference.
posted by languagehat to Law & Government (14 answers total)
 
Technically, the facility, then the regional omsbudperson, but realistically, the Dept of Health. Here's the Mass.gov page.

If it's anything like CT - and it likely is, since in the end it's mostly Medicare money in these places - this could conceivably prompt a complaints inspection (which is different than the annual inspection) especially if there are issues like legal understaffing, problems with the building itself, and especially any specifics like patients witnessed in their beds in urine or increased pressure sores.
posted by cobaltnine at 1:38 PM on January 22, 2018 [2 favorites]


Try the Massachusetts Department of Public Health Division of Health Care Facility Licensure and Certification, on mobile so having a hard time pasting a link, but give that a try. I have no insight into their responsiveness.
posted by teragram at 1:38 PM on January 22, 2018 [2 favorites]


You can file a complaint here: Mass Nursing Home Consumer Information

Also, given that it sounds like there haven't been any clear violations of law/regulation yet, I would also post reviews wherever possible.
posted by mercredi at 1:39 PM on January 22, 2018 [1 favorite]


Go on your state government’s website first, it’s probably licensed, inspected, and regulated by Health & Human Services or similar.
posted by kapers at 1:39 PM on January 22, 2018 [1 favorite]


The state of Massachusetts says you should complain to the Division of Health Care Facility Licensure and Certification, as per this page.

There's also a Long Term Care Ombudsman you should be able to contact -- see list here.
posted by ourobouros at 1:39 PM on January 22, 2018 [1 favorite]


If your Attorney General's office is strong with consumer protection, you can try them, as well.

Also, contact a beat reporter in the town, telling them that vulnerable seniors are at risk.
posted by crush at 1:57 PM on January 22, 2018 [2 favorites]


My company is in the senior care industry and your question as posted reads a bit vague and misdirected to me.


1) The problems you've listed are all about staffing and operations and that's not something you can really complain about, nor is it really anybody's business. I assume your actual problem is the quality of care? If yes, it would help to know what are the specific issues, e.g. is it failure to administer meds on time, wait times after a button is pressed, cleanliness, elder abuse, something else?

2) Are you sure this is a nursing home? A nursing home is essentially a hospital that provides long-term care and it is unlikely that it would be family-owned, as you say. This is important because different types of long term care facilities have different lines of oversight.


3) Do you have access to a residential lease agreement? Are there specific lease violations?
posted by rada at 2:27 PM on January 22, 2018 [2 favorites]


> The problems you've listed are all about staffing and operations and that's not something you can really complain about, nor is it really anybody's business.

That's a very odd thing to say. If there's nobody supervising dementia patients, it's damn well something you can complain about.

> Are you sure this is a nursing home? A nursing home is essentially a hospital that provides long-term care and it is unlikely that it would be family-owned, as you say.

I don't know if there's a technical definition of "nursing home"; this place comes up if you google the phrase, and it provides assisted living, long-term care, nursing services, and dementia care. And whatever the likelihood might be, it was definitely family-owned for many years.
posted by languagehat at 3:33 PM on January 22, 2018 [4 favorites]


[One comment deleted; let's not get into "maybe your friend is wrong" type objections here... If you have info about who to contact about different types of facility, just go ahead and give that info.]
posted by LobsterMitten (staff) at 4:31 PM on January 22, 2018 [2 favorites]


Teragram has it. The ratio of staff to clients/residents may be regulated by statute. Even if they are technically compliant with statute with regard to staff-to-resident ratios, there should be some regulatory provision that addresses a facility ensuring the health and safety of clients. It's the job of the Department of Public Health to ensure that consumers have a path to file a complaint if there is reason to believe that a facility is noncompliant.

To determine compliance, you'll need to file a complaint with the Department of Public Health to trigger an investigation. You do that through DPH's Licensure and Certification division for nursing homes here. The link brings you to consumer information, but there is also a button to file a complaint. Be as detailed as you can when you file.

In the meantime, you can also search for the nursing home in question here. You may be able to search for past complaints, investigations and findings.

the people running the place won't provide contact information
Are they allowed to withhold contact information in the event of a complaint or grievance? I might check with the advocacy organization, or a lawyer who specializes in elderly care.

You can also call the State Ombudsman. Looks like Massachusetts has an Executive Office of Elder Affairs. The link to the Long-Term Care Ombudsman is here.

What you are describing is what advocacy organizations are for. They can help you determine the proper channels to go through (specific to Massachusetts - each state is different), give you specific information about the complaint process and inform you of your rights as a consumer. MANHR (Massachusetts Advocates for Nursing Home Reform) is a good place to start. Your complaint may be part of a larger statewide problem. Either way, you have rights and should have your concerns addressed.

Good luck!
posted by onecircleaday at 5:04 PM on January 22, 2018 [2 favorites]


the people running the place won't provide contact information
I find it very unlikely that this is legal, but that doesn't mean they will change their behavior. In my state, it's required to post a (massive, hideous) poster with contact information for both ombudsman services and our licensing entity.

Nthing all the recommendations to contact both the Long Term Care ombudsman and whatever the licensing authority is. If it's an assisted living, that may be a different authority than the Department of Public Health--it may be Social Services. MANHR is an excellent place to start--they will likely know or be able to look up what agency licenses this facility. The ombudsman and licensing are a both/and, not either/or--the ombudsman is a resident advocate and is supposed to work from the inside WITH the facility to make things better; licensing is the regulator and will be the only one who can mete out any punishment, if that's what it comes to.

Staffing ratios do vary by state and by type of facility, but the regulations are an attempt to safeguard the residents and make sure they're well taken care of. It is NOT your job or your friend's job to know the regulations. This is one of those "see something, say something" scenarios, there is no reason not to complain if you're really concerned.
posted by assenav at 6:27 PM on January 22, 2018 [1 favorite]


When you waste making your report to your local heath department, concrete details are king. Things you can complain and should if present:

Apperence of bedsores
Falls
Lack of turning for bedbound patients
Decreased bathing, grooming and meal quality for patients
Slow response times for toileting needs, cleaning beds
Any outright physical, or sexual abuse or major neglect(of course )
Lack of medical follow up (not calling EMS when appropriate, missing outpatient appointments, prescription issues and such, issues with Foley's, ventilators, ostomy bags, other medical equipment)
Not managing resident conflicts especially if residents hurt each other

There is more but that's a pretty good list of some stuff to look out for.
posted by AlexiaSky at 10:52 PM on January 22, 2018 [1 favorite]


Waste in that sentence should be are, sorry about that.
posted by AlexiaSky at 12:56 AM on January 23, 2018


Just to provide an interim update: the Attorney General's office was notified, but weren't especially helpful ("all complaints are looked into, try the board of health"). My friend was able to meet with health inspectors and gave them an earful; they are awaiting results. Meanwhile, the situation has not improved (too few aides to take care of inmates, unattended inmates are having accidents).

This Washington Post article has helpful context (content warning for link: appalling description of death of woman in nursing home):
“You must consider that the reimbursement rate from CMS [Centers for Medicare and Medicaid Services] continues to fail to keep up with rising costs that’s associated with care,” said Prieto, who focuses on nursing-home litigation. “The only variable that’s available for these for-profit facilities to ensure they continue to maximize their opportunity for profiting is staffing. Purposefully understaff facilities in an attempt to ensure maximum profit.”

Avi Mukherjee, a professor at Marshall University who focuses on health-care management, said high staff turnovers, diminishing morale, and meager pay and benefits often result in low quality of care.

“The key is to understand that low service quality and negative outcomes for patients and residents is not in the interest of the long-term survival of these companies,” Mukherjee said.
posted by languagehat at 6:49 AM on May 2, 2018


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