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Published: Sunday, 12/2/2012

Shameful care

In improving its oversight of nursing homes, the state should aim to fix problems before they become crises

A Toledo nursing home’s appeal of state censure for the sexual abuse of a partially paralyzed patient raises troubling questions about the ability of the Ohio Department of Health to monitor and regulate the care of some of our state’s most vulnerable residents. The state must do more to prevent problems in the 966 nursing homes it licenses.

Citing continued failure to protect residents from abuse, the state notified Liberty Nursing Center of Toledo in August that, barring major changes, it would lose its license. State regulators said the facility’s staff had failed to respond properly to an incident of sexual abuse.

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A license revocation would close the nursing home. The Health Department will hold a hearing on the matter in Columbus this week, but such revocations are rare. Before this year, the state had revoked no licenses for five years; this year, it has taken steps to revoke three.

Considering its impact on patients and families, closing a nursing home should happen, as state officials say, only as a last resort. Even so, putting elderly and mentally ill patients at risk because of negligence or incompetence is just as serious.

In improving its oversight of nursing homes, the state should aim not to revoke more licenses, but instead to fix problems before they become crises. Persistent problems such as those at Liberty Nursing Center are inexcusable.

The Blade reported that the nursing home has a history of problems, and was designated a “special focus facility” by the federal Centers for Medicare and Medicaid Services. In December, 2011, a motorist found a resident wandering without a coat two miles from the center. In 2009, two patients left the building and allegedly used cocaine and marijuana. In two other incidents, patients injured themselves by jumping out of a window.

Last July, a male resident diagnosed with schizoaffective disorder, delusions, and sexually aggressive behavior entered the room of a partially paralyzed female. Nurses found him on top of the woman with his pants removed and her incontinence brief pushed aside.

Staff members determined the man had no sexual contact with the woman. The woman did not get a doctor’s examination. Liberty did not notify her guardians or the Health Department. Nor did it file an official police report.

Ohio must do better at monitoring and regulating nursing homes. Surveyors now inspect nursing homes about once every 18 months. They also investigate individual complaints by residents, family members, and others.

The state ought to determine whether it has enough surveyors. But more important, it needs to improve how it monitors problems, sanctions failures, and provides ways to administer care more efficiently and humanely. When necessary, the state should contract for temporary third-party management, with fees paid by the offending facility.

Consumers must do their part by making educated choices about nursing homes. To its credit, the state is helping citizens make better choices by posting information about homes online.

State government is ultimately responsible for making sure that Ohio’s most vulnerable citizens are not abused and neglected. That’s especially true when taxpayers support that care through programs such as Medicare and Medicaid.

Negligence and incompetence may force the state to revoke Liberty’s license. Some of its 100 residents have already moved out. In the future, the state must keep Ohio’s nursing homes running effectively and humanely with more-aggressive oversight and intervention.



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