Before the COVID-19 pandemic hit in 2020, New York’s Health Department managed to close its investigations into about 87% of nursing home complaints during the previous two years.
But since then, the closure rate plummeted to about 51% as the coronavirus ravaged the facilities, leaving thousands of families in the dark about their claims of unhealthy and unsafe conditions inside nursing homes.
That newly reported detail on the drop in timely investigations — uncovered in state documents obtained via public records request — deepened concerns about a backlog of unresolved nursing home complaints filed amid the pandemic.
The information also built upon findings of the USA TODAY Network New York investigation last month, which detailed the outcomes of more than 35,600 nursing home complaints during the pandemic’s first two years.
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Now, state records offered the first glimpse of how the pandemic-era nursing home complaint process compared to prior years, according to an analysis of complaints from Jan. 1, 2018 to Dec. 31, 2019.
Among the findings:
- A total of 15,572 complaints were filed in 2018 and 2019, or less than half of the total during the pandemic’s first two years.
- Health officials determined only about 5% of complaint cases were “substantiated,” or violated health and safety standards, in 2018 and 2019.
- Another 82% of complaint cases were deemed “unsubstantiated,” while 13% remained unresolved as ongoing investigations at the end of 2019
- By contrast, during the pandemic’s first two years, about 4% of cases were substantiated and 49% went unresolved as ongoing investigations.
One of those unresolved complaints in 2018 came from Jean Harris. It asserted her 100-year-old mother suffering from dementia had been neglected at a nursing home in Dutchess County.
Harris recently responded to a community feedback request tied to the initial USA TODAY Network New York investigation, saying she wanted to share her story to drive nursing home accountability and transparency.
“That’s the only thing that can help: When people are made aware of what’s going on,” said Harris, a 68-year-old former Poughkeepsie Journal advertising and marketing employee.
“And it’s important to warn people so that, hopefully, if they have a loved one that they’re having to find a (nursing home) for, they know that it can be a scary situation.”
A nursing home nightmare
While Harris’ complaint in 2018 against the Thompson House in Rhinebeck seemingly vanished in the system, grievous memories of the case still torture her today.
During one visit, an awful smell struck Harris the moment she arrived. Her shock quickly turned to sorrow and anger upon discovering its source: Her mother sitting alone in a wheelchair in the hallway with a soiled diaper.
As Harris yelled for a nurse to help, she realized her mother was shivering and desperately pulling down on her shirt’s short-sleeves to shield her frail arms from the air conditioning.
Between frantic calls for help, Harris held her mother close to share warmth while repeatedly saying: “We’ll get somebody to help you. we will get somebody; Just hold on.”
Harris’ mother, Florence Hite, was promptly transferred to Northern Dutchess Hospital and diagnosed with aspiration pneumonia, a kidney injury, dehydration, and sepsis, she said.
About a month later, Hite died in a hospice unit of another area nursing home, just 12 days shy of her 101st birthday.
Harris described the decision to move Hite to hospice care as one of the hardest of her life. It stemmed, she said, from seeing other nursing home residents wasting away in a geriatric chair, semi-reclined and being woken for spoon-feedings.
“They’re not given the interaction or the care that they should be given,” Harris said. “She would have ended up in one of those chairs in a hallway; treated like a vegetable, and it’s sickening.”
After Hite’s death in 2018, Harris hounded state health officials for updates on the complaint. But as months turned into years without answers, Harris has focused more on remembering her mother’s life rather than its tragic end.
She recounted Hite’s time working as the Hyde Park town clerk and a 20-year stint selling Avon, as well as a life-time membership in the Fairview Fire Company’s Ladies Auxiliary.
“She was a widow from the time she was 42 years old and had four children,” Harris said. “She was a hard-working woman.”
Hite also maintained her health and independence until moving into assisted living at 99, which made her rapid decline mentally and physically in a nursing home all the harsher, Harris added.
Still, Harris found some solace knowing her family was spared the horrors that unfolded as COVID-19 devastated nursing homes.
“At least she didn’t have to go through that,” Harris said. “She went through enough.”
Nuvance Health, the current parent network of the Thompson House, declined to comment on Harris’ claims, citing privacy reasons.
“We fully comply and cooperate when there is a (Department of Health) survey, investigation or request for information,” Nuvance spokesperson Sarah Colomello wrote in an email statement, responding to questions about the case.
NY nursing home questions, legislation
The initial USA TODAY Network investigation prompted two lawmakers to call for legislative oversight hearings on the findings, as well as numerous reader responses to a request for public input on the investigation.
Some readers sought further details about how health officials investigate nursing home complaints.
Indeed, state Health Department inspectors use varying tools to investigate complaints, spanning from on-site visits, phone calls, medical record reviews, as well as in-person interviews with staff, administrators and residents, state records show.
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But the fact a strikingly high percentage of complaints had been deemed unsubstantiated or remained unresolved between 2018 and early 2022 has raised new concerns about the overall investigative process.
As a result, advocates, family members and nursing home workers have been rallying this year to demand authorities release more details about nursing home complaints and improve conditions at the facilities.
One advocacy push has focused on the state’s long-term care ombudsman program, which has historically been another method of nursing home oversight, although it lacked the authority and resources of the Health Department.
State lawmakers recently passed legislation requiring the ombudsman program to publicize annual reports on the kinds and patterns of nursing home complaints received by its regional offices. It would also report the number of ombudsman visits to each long-term care facility.
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Meanwhile, a group of about 80 nursing homes filed a lawsuit recently seeking to overturn New York’s law that established staffing minimums and resident-care spending levels for nursing homes.
State officials have asserted, in part, the case should be rejected as an improper attempt to “legislate through the courts” in violation of the doctrine of separation of powers, court records show.
‘Staff is overworked’
Amid the legal battles and reform push, Marge Donhauser, of Springville, Erie County, voiced concerns about staffing levels at the nursing home caring for her 97-year-old mother, Norie.
Donhauser, a 73-year-old former hospice nurse, said she has noticed some issues with the care her mom receives at the Jennie B. Richmond Nursing Home in Springville. But overall, she appreciates all the workers’ efforts.
“We love Jennie B — it’s very family oriented,” Donhauser said. “It’s not just Jennie B; this is happening at nursing homes all over. Morale is down and staff is overworked.”
“They just don’t have enough people,” she added. “I’m prepared for my mom to go, but I want it to be God’s choice; not that she didn’t receive fresh water or got medicine she didn’t need.”
Soiled linens and other belongings do not appear to be taken care of promptly because of the shortage of staff, Donhauser said.
Medicine carts also sit unattended in hallways, she added, noting a passerby could disturb the medications.
Carole Francis, the facility’s administrator, said the staff works very hard despite the home losing about 20% of its workforce due to the state’s COVID-19 vaccine mandate for health care workers.
As a result of the loss of workers who refused to get vaccinated, the facility shuttered its entire short-term unit to concentrate on the needs of its long-term care residents, Francis said. It also started staff morale-boosting events like pizza parties and cookouts.
Francis noted medicine carts in hallways are required to be locked when unattended. And the facility conducts training for certified nursing assistants onsite, while slowly filling job opening caused by the mandate.
An extra patient care assistant has also recently been added to all shifts for jobs like delivering fresh water and folding linens, she added.
“I feel we are still maintaining good patient-to-staff ratios and I don’t believe short staffing is leading to any problems,” Francis said.
Ron Donhauser, Marge’s brother, said he visits their mother nearly every day and hasn’t noticed the issues Marge sees.
“I am amazed at the job they all do,” he said. “They mop the floors every day and I give the food a 10. My mother is always dressed when I get there and there are always a lot of staff in the hallways. I’ve never heard my mother complain about anything.”
Marge Donhauser said she called the state Department of Health hotline with her concerns earlier this year. She said the agency official asserted it could be 90 days before someone could respond to the nursing home, citing a backlog of cases.
“I told them to meet me at the cemetery then, since it was going to take so long to get any action,” she said.
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David Robinson is the state health care reporter for the USA TODAY Network New York. He can be reached firstname.lastname@example.org and followed on Twitter:@DrobinsonLoHud†