A Toledo nursing home is again facing the loss of its license from state regulators for the same problem it was cited for a few months ago - an alleged failure to protect residents and respond properly when faced with an incident of alleged sexual abuse.
The Ohio Department of Health is proposing to revoke the license of Liberty Nursing Center of Toledo, 2005 Ashland Ave.
If a facility’s license is revoked, it can no longer operate.
A woman who answered the phone at the facility Monday declined to comment, as did the company's corporate office. License revocations are fairly rare. The state moved three times this year to take licenses from Ohio nursing homes; it had not revoked any licenses for the previous five years.
A Nov. 8 survey from the Department of Health noted facility staff "failed to report an allegation of resident-to-resident sexual abuse to the administrator, take action to protect residents after an allegation of abuse was made and immediately iniatiate an investigation into the incident."
State documents further note, "Although the real and present danger was removed, the facility remained out of compliance as the facility had not demonstrated ongoing self-monitoring and evaluation over time to prevent occurrence."
In a previous incident, which took place in July and triggered another potential license revocation, a male resident diagnosed with schizoaffective disorder, delusions, and sexually aggressive behaviors entered the room of a partially paralyzed female patient. Nurses found him lying on top of the woman with his pants removed and her incontinence brief pushed aside.
Nurses notified the man’s psychiatrist and transferred him out of the facility, but after Liberty staff determined the man had no sexual contact with the victim, an administrator ordered them to “clean up” the woman, and she did not undergo a doctor’s examination. Liberty did not notify her guardians, file an official report with the Toledo Police Department, or notify the health department.
A hearing was scheduled in Columbus for this week in regards to the July incident; in light of the more recent survey, the state has canceled that hearing and issued a new order to revoke the home's license. Liberty has 30 days to appeal the state's Nov. 23 action. If it does not appeal, the license will be revoked and the facility will have to close.
The facility has a history of problems and was designated a Special Focus Facility by Centers for Medicare & Medicaid Services, indicating a history of poor care that warrants stricter monitoring.
Many residents at Liberty are there due to severe mental illness, a trend that is becoming more common at nursing home facilities, according to David Grabowski, a professor of health care policy at Harvard Medical School.
More than 500,000 people with mental illness (excluding dementia) reside in U.S. nursing homes, greatly exceeding the number in all other health care institutions combined, according to a 2009 paper co-authored by Mr. Grabowski.
"Nursing homes have become the de facto mental health care institution as a result of the dramatic downsizing and closure of state psychiatric hospitals, spurred on by the de-institutionalization movement. However, it is questionable whether nursing homes are equipped to serve the unique needs of residents with chronic mental illnesses," according to the study.
Mr. Grabowksi noted nursing homes must have appropriate staff and training to care for people with severe mental illness and noted Medicaid, the dominant payer of nursing home services, doesn't reward nursing homes with increased compensation commensurate with the increased amount of care that group of residents needs.
Liberty’s parent company, Liberty Health Care Corp., operates more than a dozen other nursing homes across Ohio, including Liberty West Nursing Center of Toledo, 2051 Collingwood Blvd., and Liberty Nursing Center of Fremont, 1865 Countryside Dr.
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