As detailed in a special report recently by CNHI News Indiana, the state’s oversight of nursing homes was lax in the months and years before the pandemic hit.
Once COVID-19 set in, general monitoring of the homes ground to a halt as the state was directed by the Centers for Medicare and Medicaid Services to focus on containing outbreaks. Residents and their families were left in the dark about whether nursing homes were conforming to federal patient safety standards.
Hoosiers deserve better. State inspections and complaint investigations should be frequent, thorough and timely.
But that’s not the way it’s been in Indiana.
Among the six Midwest region states, ours ranked worst over the summer for conducting federal surveys on time, records show. In September, 44 of the state’s 535 nursing homes hadn’t undergone the rigorous federal inspection for a year and a half or longer. Included in that group were two facilities with past abuse allegations and several facilities with 1-star ratings, the lowest level possible.
Overall, 92 nursing homes in Indiana are saddled with that rating. Because of extensive histories of poor resident care, 18 are candidates for a federal program of intense state oversight.
After the pandemic’s onset, CMS directed states to continue investigating “immediate jeopardy” complaints — ones requiring prompt on-site investigation because of potential for further harm. But federal statistics show Indiana rarely categorizes complaints as that serious.
In 2015, according to an inspector general report, our state rated just 1% of complaint cases as immediate jeopardy and 35% as high priority, the next level down. Nationwide, half of all nursing home complaints were rated in those categories.
By its own analysis in 2018, Indiana also fails to utilize fully its Indiana Long-Term Care Ombudsman Program, in which the state contracts with agencies to serve as nursing home resident advocates by responding to and investigating resident complaints.
The state’s failure to inspect nursing homes regularly and to investigate serious complaints quickly can have profound consequences in communities across Indiana.
Over 18 months beginning in 2018 at Golden Living Center Muncie, a series of complaints shed light on inadequate staffing and supervision, leaving the home’s memory care patients at risk of wandering away, suffering dangerous falls and being sexually assaulted.
The health, safety and dignity of Indiana’s nursing home residents should be paramount. The pandemic has heightened anxiety, and the state’s response has brought mixed results.
According to statistics from the Centers for Disease Control and Prevention, Indiana had the highest rate of resident deaths from COVID-19 (60.6 per 1,000) through Oct. 11, compared to neighboring states Michigan, Ohio, Kentucky and Illinois.
While the pandemic has slowed nursing home inspections and complaint investigations across the country, Indiana’s sluggish oversight is largely to blame for creating the state’s backlog of hundreds of inspections.
Hoosier nursing home residents deserve the very best care. The governor and the state health department should work diligently together to make sure they get it.
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