Texas has all but stopped imposing the most severe penalties, such as revoking a home's license and government contracts, or seeking a court-appointed overseer against nursing homes in violation, the Dallas Morning News reported.
Four employees who performed inspections for the state in recent months said that their superiors often resist letting them cite homes for possible life-threatening abuse and neglect, the newspaper reported.
"They'll say, 'You just don't have it,'" said a highly experienced inspector, who still works for the state and asked not to be identified out of fear of retaliation. "You feel it's to the point of immediate jeopardy, and to be told 'no' is quite mind-boggling."
But Chris Traylor, commissioner for the Texas Department of Aging and Disability Services, said the agency's nursing-home enforcement leaders aren't impeding tough enforcement.
"That's nonsense," Traylor said in a statement. "Our message to staff consistently has been, 'Call it like you see it, and do whatever is necessary to protect the health and safety of residents.'"
Tim Graves, head of the Texas Health Care Association, which represents for-profit nursing homes, said the enforcement system is working.
"I'm at a comfort level with where we are," said Graves, who added: "We have a regulatory structure in Texas that's probably as tough as any state's."
Findings of report
The newspaper reported that its 2½-month investigation found that:
- State regulators whose job is to keep shoddy operators from owning or running homes have done cursory, and at times inaccurate, background checks that in at least one case failed to keep out a federally banned health-care provider.
- State budget cuts have reduced staff by about one-fourth since 2001, even as the number of nursing homes in Texas is virtually unchanged, at about 1,200.
- Legislative changes, especially limits on lawsuit damages passed in 2003, have virtually eliminated trial lawyers as de facto watchdogs of nursing homes. Other changes limited the state's ability to fine nursing homes and have created an industry-friendly cadre of "quality monitors."
source: Houston Chronicle (AP, 11/14)
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