The United States Department of Health and Human Resources is in charge of overseeing the administration of health care in the U.S. It distributes funds for patient care to healthcare facilities, including Nursing Homes through Medicare payments (the Centers for Medicare & Medicaid Services, otherwise known as “CMS”). As part of its oversight, it monitors complaints at those Nursing Homes, as reported to the Health Departments of the individual states. Since 2015, the DHHS Office of the Inspector General has been reviewing reporting data from each state compiled from 2011-2015, tracking the rates of complaints about patient safety and the responses from inspectors to complaints that nursing patients were in jeopardy. The full report is available here.
The full report from the OIG is available here.
An interactive Map was created as part of the OIG’s report and can be seen here. The Map allows users to click on different states and observe the trends in each state in complaints and responsiveness between 2011-2015. Initially, it is notable that nationwide, the number of nursing home complaints made to State Agencies increased by 33%. Nationwide, the number was 44.9 reports of abuse per 1,000 nursing home residents. As the Report details, that means that there are higher instances of physical and medical abuse reported to officials. It could be because the number of instances is increasing, or that the number of people coming forth to report it themselves or on behalf of a family member is increasing. It is likely that both factors are at play.
Looking at the data, the US DHHS has noted in the OIG’s report that Illinois is struggling in its response to such complaints. CMS requires that States investigate all “high priority” nursing home complaints onsite within 10 days of reporting (See Page 12 of the Report). Illinois saw its number of complaints rise from 2,687 to 4,792 between 2011 and 2015. In 2015, a full 64% of these were Prioritized as “High Priority.” This is a substantial burden on the Illinois Department of Public Health to send out investigators to the field, gather data, gather reports, conduct interviews and investigations, and to then create reports and possibly initiate enforcement or intervention actions against nursing homes and on behalf of the patients.
For patients, this means that they are relying upon a reporting system that appears to be stretched very thin. Administrators and investigators with the best intentions have limited time and resources. This means that residents will often have to turn to private resources to investigate instances of nursing home abuse and neglect. At Coogan Gallagher, we have dedicated our practice to working to investigate the root causes of injuries to people such as nursing home residents who have suffered injuries or had to be sent to the hospital from a nursing home because of poor treatment. Each resident deserves compassionate and dedicated care. Nursing staffs are often filled with many compassionate and dedicated people. But those resources are also often stretched very thin. If you feel that you or a loved one have not received adequate treatment, or if you or a loved one had to be taken to the hospital as a result of an incident at a nursing home, it may be time to consult with our attorneys about what happened.