Due to the sorry state of nursing homes in Indiana, Attorney General
Greg Zoeller is pushing for several new initiatives in an attempt to
arrest the problem. Zoeller is seeking the creation of a watchdog panel
to keep an eye on the state board that regulates nursing home
administrators, which could lead to greater punishment for
administrators who run bad nursing homes. He is also pushing for new
laws to ensure that nursing home wrongdoings are uncovered.
The federal government has identified Indiana as a state with a
disproportionate number of poorly performing nursing homes. The Centers
for Medicare and Medicaid Services reported in 2009 that Indiana ranks
among the 10 worst states in the U.S. for nursing home care.
Experts have supported Zoeller's recent moves, believing that holding
administrators more accountable will improve nursing homes in the state.
In the last five years, the Department of Health has given about 300
inspection reports to the attorney general, according to the federal
legal requirement that health inspectors report major problems to
licensing officials. According to Indianapolis Star news sources, only
six of these complaints were presented to Indiana's Health Facility
Administrators (HFA) board. Zoeller has, however, filed 150 licensing
complaints against nurses since 2009. The Star also reported that poorly
run nursing homes are seldom punished.
Zoeller wishes to change current laws that allow him to refer cases to
the HFA board only when the administrator is directly responsible for
the problem. He has complained about the difficulty in making timely
licensing actions stick.
Part of Zoeller's plan involves the creation of a seven person Regulated
Occupations Evaluation Committee early next year. The committee, created
by a law passed in April and set to begin reviews in January, includes
public officials and gubernatorial appointees. This committee will
review the state's licensing board's role. "States all seek to ensure
the highest quality of health care to our most vulnerable population,"
Zoeller wrote in a letter to the Regulated Occupations Evaluation
Committee members. "Indiana has an opportunity, through our work on this
committee, to study and develop stronger methods of licensing
oversight."
The state Attorney General also wants stronger oversight of the Health
Facility Administrations, so that poorly performing administrators can
be identified and brought up to state and federal standards for care.
Another part of Zoeller's plan involves better whistleblower protections
for nurses and administrators who report misconduct. He has also
recommended that laws be enacted to require insurance companies to
report any payouts involving nursing home negligence to the state.
"The (Health Facility Administrators) board writes the licensing rules
for nursing home administrators, and the board acts as judge and jury to
decide whether or not those rules were violated," Zoeller said in a
press release. "We have an opportunity through this evaluation committee
to thoroughly examine the rule-enforcing process . . . to determine if
it is adequate to hold these licensees accountable for violations within
the facility that occur on their watch."
A potential outcome of these changes is a dramatic increase in the
number of cases brought against bad administrators. Indiana residents,
however, remain doubtful that these changes of Zoeller's will be
effective. There is a significant history of mistrustful actions for
Indiana residents to overcome. Some have pushed for a stronger handed
approach than Zoeller recommends. Robyn Grant, a member of the advocacy
group United Senior Action, has suggested that the state make such
negligence public: a contentious action because of patient
confidentiality rules.