Failure to Investigate Patient Abuse in a Timely Manner Hampers Care in Tennessee

A shocking, disheartening new report out from the Tennessee State Comptroller’s Office details the multiple failures of the Tennessee Board for Licensing Health Care Facilities in investigating nursing home, long-term care facility, and hospital complaints in a reasonable timeframe. Not only are investigations taking much too long to begin, even reports of abuse that are required to have a 48-hour turnaround for on-site follow-ups are often not completed. These failures of the board to complete their duties have likely put countless patients and residents at risk over the past several years.

Among other problems, the 24-page performance audit found the following:

• The average response time for a case marked as finding a patient in immediate danger was 74 days.
• For annual surveys of facilities, which are supposed to be conducted every 15 months, instead the time passing between reviews fell between 17 and 24 months.
• Listing abusive health care workers in an online registry, which facilities are required to check before making any new hires, moves so slowly that in one case, it took 10 months for an abuser’s name to go into the registry.
• In many situations, unlicensed staff members have been allowed to dispense medication in assisted living facilities.
• Fire sprinkler requirements are not met at many facilities. This has caused at least eight deaths in a 2003 Nashville fire.

Undoubtedly the staff at the Office of Health Care Facilities and the 18 board members have a lot to oversee. Tennessee has 160 hospitals, 321 nursing homes, 291 assisted living facilities, 128 residential homes for the aged, 153 care facilities for people with intellectual disabilities, and 39 psychiatric residential treatment centers, in addition to dozens of other types of centers. Officials from the Office of Health Care Facilities initially cited a lack of staff and a 50% increase in complaints since 2012 for the backlog. But as Brian Lee, executive director of Families for Better Care and a long-term care advocate says, that is an unacceptable excuse. “People die, I mean, they are neglected to death” in the timeframes in which the office has been operating, he says.

In response to the audit, officials said that they have filled half of their 12 vacant positions and are going to move to an electronic planning system to improve their speed and accuracy when handling complaints. They are also putting into place new procedures for handling the abuse registry, both in terms of reporting it and in terms of the regulations involved. They have plans to review the rules about medication administration too. All of these efforts should result in better care for the thousands of people living in Tennessee’s facilities and hospitals if they are implemented immediately. After all, it is the duty of society to protect its older and sicker members as it protects everyone else. The elderly, sick, and disabled deserve more from the state than they have been getting. Now that the results of this audit are public knowledge, hopefully the future of patient care in our state will improve significantly.