Careless: How the Pennsylvania Department of Health Has Risked the Lives of Elderly and Disabled Nursing Home Residents

The Pennsylvania Department of Health (DOH) has been failing in its job to protect nursing home residents.  Over the past several years, DOH has significantly decreased the issuance of sanctions against nursing homes and has adopted and employed an investigatory strategy that dismisses 92% of the complaints against nursing homes.  Additionally, when DOH finds that there is harm to patients, it is mischaracterizing and minimizing the severity and the breadth of the harm.  As a result, current nursing home residents are at a greater risk of having their rights violated and/or their wellbeing threatened.  The lack of enforcement action by DOH also means that prospective nursing home residents will not be accurately informed about problems with nursing homes, and will be forced to make decisions based on incomplete and inadequate information.

Pennsylvania ranks fourth in the United States in the percentage of residents 65 and older. [i]   By 2030, Pennsylvania’s aging population, residents over 60, will reach 4 million.[ii] Research shows that roughly 70% of individuals over 65 will require some kind of long-term care[iii].  For many Pennsylvanians, this care will be provided in a nursing home.  As of 2013, Pennsylvania had 88,000 nursing home beds, with an average occupancy statewide of 80,000.[iv]  For individuals entering a nursing home, or for families looking for care for a loved one, deciding on a nursing home is a complicated and often difficult decision.

In Pennsylvania, the Pennsylvania Department of Health is charged with enforcing the various federal and state regulations that are in place to protect residents and their rights.  DOH conducts yearly inspections of nursing homes, which the agency calls surveys, and also investigates complaints filed by residents or other individuals.  DOH’s enforcement powers range from requiring nursing home staff training, to civil monetary penalties, to the closure of a facility.

In an in-depth review of data available from DOH concerning Philadelphia nursing homes, Community Legal Services (CLS) has found that from 2012 through 2014 DOH:

• Dismissed 92% of complaints filed by residents or other individuals as unfounded.
• Routinely mischaracterized the severity and breadth of violations, which, in addition to harming nursing home residents, misinformed members of the general public who were looking for safe nursing homes.
• Conducted 161 follow-up visits after finding a violation, and never once found that a violation persisted, despite the unlikelihood that every violation was remedied immediately.