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Abstract: 

Residents of nursing homes and related institutions have always been at high risk of physical and emotional abuse, financial exploitation, and especially of neglect. In recent years, the risks have only increased as the nursing home population shifts toward the “old old” with multiple serious impairments. Especially in for-profit facilities, staffing levels are at or below those required to provide even minimally adequate care. There has been a persistent enforcement problem in coordinating federal and state inspections—and financial problems, especially at the state level, have limited the frequency and thoroughness of inspections. There are seldom better facilities available to which to transfer residents of poor-performing nursing homes. As a result, some nursing homes remain in business, and even retain their Medicare and/or Medicaid certification, despite an ongoing history of violations, including persistent violations that are not corrected. This article surveys recent attempts at federal, state and county levels to audit nursing home performance, enforce standards, and prosecute criminal abuse. Features national initiatives as well as regulatory and civil litigation efforts in Ohio, Colorado, South Carolina, West Virginia, and New Mexico.

Keywords: Institutional abuse; inspection reports; National Consumer Voice for Quality Long-Term Care; unfair agreements; dual eligibles

Affiliations:  1: Co-Editor.