Crisis management
12/6/2012The Ohio Department of Health did the right thing in moving to revoke the license of Toledo’s Liberty Nursing Center for its failures to protect the safety of patients, many of whom are mentally ill.
The action shows the state is serious about enforcing critical safety standards for some of the state’s most vulnerable residents. Liberty may appeal, but some of its 100 residents have moved out.
Given Liberty’s history, the state had little choice. Going forward, however, it must do a better job of monitoring and overseeing the 966 nursing homes it licenses to prevent similar abuses and closures. The state shouldn’t wait for a crisis before it acts.
Liberty’s repeated problems are inexcusable, by the nursing center and the state. A Nov. 8 survey noted that the nursing center’s staff failed to report an allegation of resident-to-resident sexual abuse, act to protect residents after an allegation of abuse, and immediately initiate an investigation.
Last July, a male resident diagnosed with schizo-affective disorder, delusions, and sexually aggressive behavior entered the room of a partially paralyzed female patient. 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. But the center failed to provide a doctor’s examination, nor did it notify the victim’s guardians or the Health Department.
State regulators ought to review their monitoring and oversight procedures, including whether the state has sufficient nursing home surveyors and frequent enough inspections. Surveyors now inspect the centers about once every 18 months. They also investigate individual complaints by residents, family members, and others.
The state needs to improve not only how it detects problems, but also how it sanctions and corrects failures. Fines aren’t always a remedy.
In many cases, temporary third-party management contracts to help nursing homes improve operations could better serve patients and the public. Nursing homes with problems should pay for those contracts.
Ohio has done a good job of helping consumers make educated choices about nursing homes, especially with information on the Internet. It must do an equally good job of educating nursing home residents and their families about how to use complaint channels to assert their rights.
Ultimately, safeguarding nursing home patients is the state’s duty. Meeting that responsibility calls for more aggressive oversight and earlier intervention.