Report finds that lack of enforcement allowed for neglect at state nursing homes

Auditor General Eugene DePasquale says Pennsylvania’s Department of Health needs to do more to ensure quality care in Pennsylvania nursing homes.

DePasquale released his 91-page audit on Tuesday, with 13 findings and 23 recommendations.

The report says the Department of Health’s lack of documentation, standard protocols, and enforcement allowed problems like neglect and unsanitary conditions in nursing homes to slip through the cracks.

“What this tells me is the Department of Health was not looking,” DePasquale said during a press conference. “And when you don’t look, there’s no way to discover problems.”

DePasquale gave several examples of situations in which he feels the Department of Health did not impose sufficient penalties on nursing homes.

“[Someone] complained a family member was dirty, frail, and unresponsive,” DePasquale said. “The resident was found to be malnourished and dehydrated, was admitted to the hospital, and later passed away.”

“The resident was also receiving too much anti-psychotic medication,” DePasquale continued. “The DOH action – they cited the facility, issued a $3,000 fine, and put the facility on a provisional license.”

DePasquale later acknowledged that these kinds of measures do not make much of an impact on large, for-profit nursing home companies.

The audit also highlighted issues with evaluating state staffing requirements. Pennsylvania regulations require nursing homes to provide at least 2.7 hours of direct nursing care per resident, per day. The federal recommendations are for 4.1 hours.

DePasquale says nursing homes failing to meet state standards were often not cited during Department of Health inspections.

He also noted that, for three years during the previous administration, the Department of Health stopped taking anonymous complaints about nursing homes.

“That decision is breathtaking,” DePasquale said. “Absolutely breathtaking.”

The Auditor General praised currently Department of Health Secretary Dr. Karen Murphy. He says she requested the audit following media reports of issues in nursing homes, and he commended her department for cooperating fully with the audit.

“Sometimes you can say you want the independent review, then we start asking for box A, B, and C, and they start getting queasy,” DePasquale said. “That did not happen here.”

Dr. Murphy says the Department of Health has already started making changes. Anonymous complaints are now accepted, there has been an increase in staff for nursing home investigations, and the department has increased fines and other penalties.

“We have a very dedicated staff in the Department of Health that works very hard each day to ensure the safety of nursing home residents,” Dr. Murphy said. “It is incumbent upon us to give them the tools they need to do their job well.”

The Department of Health formulated a task force last summer to take a broader look at nursing home issues and potential solutions in Pennsylvania. Dr. Murphy says the task force will release its findings later summer, which will include recommendations about Pennsylvania’s laws related to minimum-staffing requirements in nursing homes.

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