Texas can and must do better for its elderly. That became painfully clear as The Daily News delved into its project “An Uncertain Age,” which published on Thanksgiving Day and will continue in the news pages. Most striking in the reporting was the lack of oversight in an industry charged with caring for a vulnerable, sometimes voiceless population.
Most industry observers agree Texas’ weak regulation of nursing home operators allows violators of licensing requirements to escape accountability when they hurt residents or jeopardize their health, the American Association of Retired Persons found in a 2017 study.
The study found about a third of the state’s 1,200 nursing homes accounted for 94 percent of serious violations, but that regulators were hamstrung in assessing meaningful sanctions because of a law allowing nursing homes to correct violations before receiving a penalty in most cases.
After that report, Texas legislators passed House Bill 2025, giving regulators more power to discipline repeat offenders. That bill went into law Sept. 1, 2017.
Despite the new law, advocates and relatives still report being deeply dissatisfied with the care of the elderly.
Aging is a universal human experience. Everyone wants to be certain of making the right decision when it’s time to find long-term care for parents, relatives and for themselves. Such care is expensive, as The Daily News’ special report noted. But there’s still so much to explore, particularly the issue of profits over people.
Nursing homes once were largely a nonprofit endeavor. But increasingly, for-profit entities have taken over, creating chains of nursing homes. It’s true, for-profit entities can find efficiencies in economies of scale.
But we’re not talking about Big Macs here. We’re talking about human beings who, in some cases, have no voice of their own.
Older adults who live in for-profit nursing homes are nearly twice as likely to have health problems linked to poor care than those in nonprofit nursing homes and those who live in private homes, a study released in October found.
“We saw more — and more serious — diagnoses among residents of for-profit facilities that were consistent with severe clinical signs of neglect, including severe dehydration in clients with feeding tubes which should have been managed, clients with stage 3 and 4 bed sores, broken catheters and feeding tubes, and clients whose medication for chronic conditions was not being managed properly,” said study leader Lee Friedman.
Friedman, associate professor of environmental and occupational health sciences at the University of Illinois at Chicago, added that substandard care falls within the definition of elder abuse, according to news service United Press International.
The study included more than 1,100 people, aged 60 and older, who were seen in five Chicago-area hospitals between 2007 and 2011 for health problems that could be related to poor care, according to UPI.
As for-profits become more prevalent in what was traditionally non-profit sectors, the industry reports a staffing shortage crisis, generally related to overworking and underpaying nursing home workers.
“When nursing facilities do not have enough staff to give each patient adequate attention, it leads to mistakes and neglect,” according to NursingHomeAbuseGuide.org. “At the same time, when staff is extremely overworked and stressed, there is a greater risk that they will commit abusive acts out of frustration.”
What’s most disturbing is the state of Texas doesn’t require a staff-to-resident ratio for nursing homes as it does for childcare, said Misty Sullivan, a staff ombudsman for the state of Texas.
And that’s a problem in a state where nursing staff turnover is at crisis levels, Sullivan said.
“Whether it’s Galveston County or all the other 253 counties in Texas, the big problem is shortage of staff, which results in lack of care type issues for residents that live in nursing homes,” Sullivan said.
Given the cost of staffing in nursing homes, this isn’t a problem Texans should leave to the industry to solve.
For their parents, families and themselves, Texans should demand lawmakers put people over profits and demand that people who profit off the care of the elderly actually provide that care.
• Laura Elder