New Tool Reveals Nursing Home Violations

Searchable database allows families of patients to check up on long-term care facilities.

Taking care of aging parents can be a very difficult situation for families, especially if a nursing home is a major consideration. Now, there is a new and easy way to check up on long-term care facilities in Connecticut that allows families to look at 2,138 nursing home histories and incidents online in a convenient, searchable database.

Over the summer, the federal government posted nursing home inspection reports online for the first time. Among the violations the NBC Connecticut Troubleshooters found, were a nursing home resident found wandering outside in the dead of winter, another resident went missing for 32 hours , misuse of anti-psychotic drugs and even a crack pipe found inside a resident’s room.

To find out how and why these incidents are happening in Connecticut nursing homes, the NBC Connecticut Troubleshooters went to the state Department of Health and the Department of Social Services for answers. Nancy Shaffer sees thousands of residents’ complaints every year and advocates for their families as the state’s ombudswoman.
"I think those [problems] really do stem back to the supervision and the education of the staff, the direct care-giving staff,” Shaffer told NBC Connecticut.

Indeed the unsettling part of these incidents was just how they happened. The resident who disappeared for 32 hours – in what the industry calls an “elopement” – gave clear warning signs before leaving his Park Place nursing home in Hartford.

According to federal reports, the resident declared he would be “leaving today and will knock out the window screen and hitchhike to Florida.”
The next morning, the resident escaped from the secure dementia unit, despite a high level of anti-elopement technology. 

When we visited Park Place, the director declined to speak with us. Our repeated phone calls and messages to their corporate owner, Spectrum, went unreturned. 

In the federal report, the facility said it would conduct more security checks.
Spectrum also did not comment on another elopement at its Torrington Health and Rehabilitation Center. In February 2011, a resident was found wandering half a block away in the cold.
Although the resident wore a Wanderguard device, which alerts staff if the resident goes beyond a secure area, the resident still "exited the building through the facility’s lower level” and nobody noticed. 

After the government cited the home, Torrington resolved to closely monitor the patient.

In Norwich, we found another potentially dangerous elopement. A resident of Regency Heights was found walking one mile away from the nursing home in the middle of December. According to the federal government report, the resident was last seen at a “supervised smoking session.”

In order to fix the situation, the report said the staff would be held accountable for the elopement.

The director of Regency Heights said it does not comment on specific cases but did respond in an email.
"With respect to a December 2010 elopement, corrective actions were taken at the facility that were approved and verified by the Department of Public Health. Currently, Regency Heights of Norwich is in compliance with regulatory requirements and has no outstanding cited deficiencies.”

Since the nursing homes declined to go on camera, we went to Paul Wiistrom, the president of the Connecticut Association of Health Care Facilities (CAHCF), for answers. He coordinates a group of 170 non-profit and for-profit nursing homes in Connecticut. 

"It's not a chronic ongoing problem,” Wiistrom said. “But one has to remember that we have 28,000 residents in our facilities in 230 facilities that are in the state of Connecticut and that's a lot of people to watch 24 hours a day seven days a week, 365 days. But it's our responsibility as an industry and as a specific facility...”
When these elopements do happen, the state Department of Health requires homes to devise a plan of corrective action. Branch chief Wendy Furniss said nursing homes must prove they abide by not only the state’s standards but also prove that they are giving consistent, good quality care.  

“Our expectation is a care facility is as good on midnight on Saturday as it is on Monday at noontime,” Furniss said.

"The Department of Public Health has a very rigorous inspection program,” Furniss said. “It brings us into nursing homes about 5 or 6 times a year…the Department's stance is obviously elopements should not happen." 

Furniss recommends frequent unannounced personal visits by families to prevent elopements, injuries and other problems.
"We can't be there every day, so if family are able to visit and be a presence in the nursing home with the loved one, it helps ensure good care for the resident,” said Furniss.
However, Shaffer, Connecticut’s nursing home advocate-in-chief, said families and residents are often concerned about how staff caregivers will react to complaints or feedback.
“It's an issue families and residents being concerned, taking a complaint to the nursing home staff because they don't know [what will happen],” Shaffer said. “And sometimes, it's a perception, just a perception they may be retaliated against. Sometimes, it's retaliation."

Families can also check up on Connecticut facilities now by sifting through inspection reports made public by the federal government. ProPublica, an independent and non-profit news organization, has built a tool that makes these reports searchable by nursing home, city, and specific keywords or problems.
Health care reporter Charles Ornstein, who helped build the search tool, says staffing at nursing homes is critical.

"Time and again it all points back to staffing, whether it’s they have enough staff but the staff doesn't know what they're doing or they have enough staff but the staff aren't properly allocated within the nursing home,” Ornstein said.
Limitations of Medicare funding also play a factor.
"We need more money in the system, there's no doubt about it,” Wiistrom said.
Ultimately however, Wiistrom promised the nursing home industry will work as fast as it can to respond to problems large and small.
"We had a couple of incidents of choking and the industry at large, with the help of the Department of Health, has been all over it like a lawnmower on grass,” Wiistrom told NBC Connecticut.
When we asked the State whether they believe Connecticut standards are high enough to maintain a consistently good quality of care for all residents, ombudswoman Nancy Shaffer said, "I think we can always do a better job. I think we're trying. There are some very good people who are really trying and collaborating to make things better.”

To access the ProPublica nursing home inspection, click here.

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