Texas and San Angelo Nursing Homes Fall Short for Standards of Care

SAN ANGELO, TX - Taking care of the elderly is a priority for most communities; however, according to a report by the American Association of Retired Persons (AARP) office out of Austin, Texas is falling behind when it comes to providing quality care for elderly citizens living in nursing homes.

Amanda Fredriksen, a representative with AARP in Austin, talked about some of the problems facing Texas nursing homes, and gave insight into the condition of the facilities in San Angelo. Reading from the Quality Reporting System (QRS) report of state fiscal year 2015, she noted that multiple nursing homes in San Angelo had issues needing to be addressed.

Some of these violations were reported as level two, which she noted are bad in their own right. However, there was one location that received various level four violations, which is worse.

Senior Care of Meadow Creek in San Angelo was highlighted for these discrepancies. This report showed there were five level four violations, which, Fredriksen explained, call for immediate jeopardy. This meaning at least one or more individuals living in the facility were in danger due to life-threatening conditions.

There were also more reported violations during a second visit in April of 2015. These were recorded as two level three violations, meaning notable problems with residential care.

“What I think is most concerning was these instances were reported on separate visits,” Fredriksen said. She added that consistent violations are alarming and they need to be addressed immediately.

In both visits, the staff's treatment of residents was one of the violations cited on the report. Fredriksen noted these violations can account for various issues; however, she said more serious reports can be an indication of abuse or neglect towards patients. 

Overall, Medicare Nursing Home Compare showed 7 percent of long-stay residents at Senior Care of Meadow Creek had experienced one or more falls causing serious injury. This is compared to the state average of 3.6 percent and the national average of 3.3 percent.

Since receiving these violations, the nursing home was penalized with federal fines. These penalties are also listed on Medicare.gov. The first fine totaled $12,155, and the second fine for the visit in 2015 was $30,518. If a violation is not appealed, the cost of the fine is automatically discounted 35 percent, Fredriksen added. The first fine pre-discount was closer to $18,000, and the second fine would have been closer to $45,000.

The Director of Communications for the corporate branch of Senior Care Centers, Michelle Metzger, responded to the QRS report.

“We strive to take the best possible care of our patients and residents, and our caregivers take this work very seriously,” Metzger said. “When deficiencies are found or self-reported, we work in partnership with the Texas Department of Aging and Disability Services (DADS) to develop a plan of correction to help address the concerns cited.”

She explained that these reports are taken seriously, and they welcome regulatory oversight to help keep the patients and residents in the highest care possible.  

“Our patients and residents are our highest priority,” Mertzger said.

The Importance of Researching Nursing Homes

All in all, when it comes to consistency in the reported violations, issues tend to occur at nursing homes across Texas. The AARP report showed that one in four nursing homes in Texas will have repeated reports of serious violations.

For this reason, Fredriksen insisted on the importance of researching nursing homes before admitting any loved ones into their care. She noted the DADS and Medicare compare websites are useful resources for this research.

“I think it’s important for people to take a deeper look into nursing homes,” Fredriksen said.

She also noted some of the important criteria, which includes nursing homes with low-staff turnover rates. Texas has a 72 percent staff-turnover rate, according to AARP data, meaning the quality of care is negatively affected.

“Look for facilities that really invest in their staff and train them for a variety of needs,” Fredriksen said.

She added it’s also important to visit nursing homes before hand to test the atmosphere. This includes the cleanliness, absence of off-putting smells, and observing the interaction between staff and residents.  

“To see repeat violations for staff treatment of residents is certainly something that is alarming, and draws attention to the safety of these nursing homes,” Fredriksen added.

Need for Legislative Action 

The AARP report showed that in fiscal year 2014, state authorities identified 18,879 licensing violations in Texas, and only took 39 enforcement actions, according to AARP data. Also listed, the Sunset Advisory Commission found that in fiscal year 2013, DADS enforcement action responded to less that one percent of almost 19,000 state nursing home violations. 

In addition to these violations, Texas ranks 41st for inappropriate use of Antipsychotic medication, which is used to manage psychosis for symptoms of delusion, hallucinations, and paranoia.  

Looking Towards Future Improvement

AARP Texas Director Bob Jackson said this report offers a solid case for reform that will improve Texas nursing homes.

“When making the difficult decision to place a loved one in a nursing home, family members deserve to know that the facility is adequately regulated to ensure their loved one is safe and well cared for,” Jackson said. “In Texas today, those assurances do not exist.”

The Texas legislators are being pushed into adopting a “common-sense" reform outlined to the data shown in the report. It is to be considered a serious matter as it will improve the lives of 93,000 plus residents of nearly 1,200 plus nursing homes in Texas, noted the AARP case study.

The case study highlights the need for reform by supporting a statewide effort to provide a framework for challenging those facilities in Texas that do not meet health standards.

“The state [legislature] is where the action is,” Fredriksen said. She noted two state representatives who are supporting these reforms are being considered by the 85th Regular Session of the Texas Legislator.    

Charles Perry, Texas State Senator for District 28, has been one of the candidates to speak for Senate Bill 932. The aim of the bill will address the responsibility for assigning penalties to certain long-term care facilities by the commissioner of the Health and Human Services Commission. The bill is scheduled for an open hearing on March 27.

Toni Rose is a Texas House Member for district 110, and is the author of House Bill 3968. This bill, if passed, will increase penalties against certain long-term care facilities. It was filed on March 10. Rep. Rose is also a Committee Member for the Health and Human Services Transition in the Texas Legislature.

AARP is a non-partisan, non-profit advocacy organization with a membership of more than 38 million, including 2.3 million Texans.