However, PennLive discovered that the Health Department has no internal policies to determine what “safe care” is.Īlthough the department does ask applicants whether any of their other nursing homes have been charged with fraud or have faced state or federal penalties, it doesn’t appear to assess staffing levels, citation numbers or other quality metrics that would help it truly determine whether a new operator has a track record of good care.
Pennsylvania’s Health Department says it only approves nursing home licenses to operators that can prove they can provide safe care. Some advocates also suggest more innovative penalties: if a nursing home is part of a chain or larger company, perhaps the agency should directly fine the chain organization or its parent company. Without tougher penalties, advocates say, there is no discentive for unscrupulous nursing home operators to provide low quality care. In one case, PennLive found the department fined a Tunkhannock home $15,000 following a medication error that caused a terminally-ill resident to have a narcotic overdose and become unconscious. In order to ensure that nursing homes are appropriately penalized for serious errors, researchers and advocates say, Pennsylvania’s Department of Health needs to appropriately grade serious violations.Īlthough the severity of a violation is one of the biggest determinants of the penalty, even when Pennsylvania appropriately grades citations the resulting penalty is often far too small or non-existent.įor instance, PennLive found that of the 104 inspections that led to citations for Golden Living’s former nursing homes in 2017, the state issued penalties in response to 10.īeyond the small number of sanctions, some sanctions appear unusually lenient. North Carolina, for instance, issued 151 immediate jeopardy violations in 2017 despite having nearly a third fewer nursing homes. Because there’s little reason to believe Pennsylvania’s nursing homes are better than those in other states, that discrepancy is likely a result of weak oversight. A PennLive analysis found that Pennsylvania issued the severest grade of violation, called “immediate jeopardy”, only 35 times in 2017 – still one of the lowest rates in the nation. Since that reporting, Pennsylvania has issued tougher violation grades but advocates say there’s reason to believe the department is still falling short.
A 2016 PennLive investigation found that Pennsylvania routinely understated the severity of problems that caused resident deaths, meaning the Health Department rarely penalized homes or only fined them a few thousand dollars – a pittance for a major nursing home chain. That’s a problem because under federal regulations the severity of a violation dictates the severity of the resulting punishment. They say that when inspectors visit nursing homes and find problems, such as a medication mistake that causes resident’s death, too often inspectors don’t grade that violation as a severe error. That 4.1 hours should consist of an average of at least 45 minutes of registered nurse care, 33 minutes of licensed practical nurse care and 168 minutes of certified nurse care.Ī key problem, advocates and researchers say, is that state regulators in too many states, including Pennsylvania, understate the severity of nursing home violations. The single biggest thing that Pennsylvania can do to improve nursing home care, experts say, is to require nursing homes to provide at least 4.1 hours of care per resident per day. Given the intense medical needs of most nursing home residents, facilities that are providing anything less than 3.5 are often providing dangerously low levels of care, experts say. In Pennsylvania however, the recommended minimum is only 2.7 hours of care per resident per day.
This doesn’t mean every resident necessarily needs that much care – some patients will need barely any help and some may need a lot of help – but 4.1 is the recommended average across a home. The facility is part of the Priority Healthcare Group.ĭo you want to improve nursing home care in Pennsylvania? Advocates and researchers say these are the eight key solutions Pennsylvania could undertake to protect the elderly from dangerous care.Įxperts recommend that nursing home residents receive a minimum of 4.1 hours of care per resident per day from direct care staff. The Gardens at Blue Ridge rehabilitation and nursing facility, at 3625 N.
The days of journalism’s one-way street of simply producing stories for the public have long been over.
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