Monday, September 9, 1996

Since Its '93 Birth, Board Has Disciplined No One

By Associated Press

AUSTIN (AP) - A state board created in 1993 to improve the regulation of nursing homes has not disciplined a single nursing-home administrator, despite receiving hundreds of complaints, the Austin American-Statesman reported Sunday.

A review of disciplinary files at the Texas Board of Nursing Facility Administrators showed that the board's complaints committee has dismissed most cases.

Even among the 23 worst nursing homes in Texas since 1993, including those with problems so severe the state got trustees to take them over, administrators have escaped sanctions.

An administrator who resigned from one of those homes went on to another, where alleged problems have led to two more efforts to sanction her this year, the American-Statesman reported.
The board consists of six nursing home administrators and three three public members appointed by the governor. It has authority to fine remiss administrators or revoke or restrict their licenses.

The newspaper reported that records from the administrators board and the Texas Department of Human Services show the board's persistent failure to punish administrators can be traced to four problems:

- The state Department of Human Services, which inspects and regulates nursing homes, has not consistently referred administrators to the board for possible discipline, even though federal law requires it to do so.

- Three years after the board was created, and despite the urging of state lawyers, board members have not adopted stringent rules needed to act against administrators operating substandard homes.

- The board routinely clears administrators accused of wrongdoing because board rules do not clearly define wrongdoing. In one case last month, board members deliberated over whether to punish an administrator who failed to promptly call police about the sexual abuse of six female residents by a male resident. State and federal nursing home regulations demand immediate reporting of such cases.

- Shoddy staff paperwork and incomplete investigations have delayed most of the 30 cases of proposed discipline against nursing home administrators in the past three years. None of the cases have been finalized. Nine of the proposed disciplinary cases were closed after the board's litigator questioned the soundness of the cases.

"I think that we've made very little progress in weeding out the nursing home administrators that are a detriment to the system," said board member Johnnie Lou Avery of Big Spring, a public member of the board.

Some of Avery's colleagues on the board dispute that.

"I think the nursing home residents are being protected," said Merril Grey, a board member and nursing home administrator in the Dallas suburb of Lancaster. "I would be surprised that licenses have not been either suspended or revoked in the last three years."

The author of 1993 legislation that set up the current board, state Sen. Mike Moncrief, D-Fort Worth, said lawmakers need to take another look at regulating nursing home administrators.

"It certainly doesn't appear that people responsible for abuse and neglect in long-term care facilities are being held accountable," Moncrief said.

Michael Sims of Waco, chairman of the administrators board, began efforts to improve the board after learning of the American-Statesman's investigation. Sims wants the board to sign a cooperation agreement with the Department of Human Services, conduct in-depth investigations and write enforceable standards of conduct for the 2,700 nursing home administrators licensed in Texas.

"Something in this system is not right," Sims said. "We need to begin to recognize the things we need to do."