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Audit of TN Nursing Home Surveys Reveals Troubling Trends

A recent audit conducted by the Tennessee Comptroller’s Office confirms what we often see in cases that we handle at the Jehl Law Group: in many cases the State of Tennessee is failing to hold nursing homes accountable for abusing or neglecting seniors. The audit examines the activities of the Board for Licensing Health Care Facilities, which is responsible for licensing, inspecting, and surveying nursing homes in the State of Tennessee. The audit relied on a random sample of 25 facilities that included, 17 nursing homes, 3 hospitals, 3 assisted-care living facilities, 1 home health agency, and 1 residential home for the aged.

Federal and state regulations require investigations into complaints received by the Office of Health Care Facilities. When complaints come into that office, they are categorized by how urgent or serious the complaint is. The audit examined the two most serious types of complaints:

  • Immediate Jeopardy (IJ)- Meaning that a nursing home’s actions or failure to comply with federal regulations has caused or is likely to cause serious injury, harm, impairment or death to a resident, and
  • Non-Immediate Jeopardy High (NIJH)- Meaning that a nursing home’s actions or failure to comply with federal regulations may cause harm to a resident.

Both types of complaints require a rapid response. IJ complaints require an onsite survey within two working days. NIJH complaints require an onsite survey with ten working days.

Even though the Comptroller’s Office admits that “untimely complaint surveys and regular health surveys of health care facilities could jeopardize the safety and welfare of persons residing in these facilities,” they found that both types of surveys were often late. In the sample of 25 facilities, there were 13 cases of an IJ (immediate Jeopardy) complaints. The findings regarding those complaints are appalling. None of the 13 cases were evaluated within the required 2 days. The shortest amount of time it took surveyors to get on-site was 8 days. The longest took an unthinkable 274 days. That means that someone complained of immediate jeopardy to the health of a resident, and it took more than 9 months for a state surveyor to get on-site to investigate. The average time that it took surveyors to get on site for an IJ complaint was 74 days.

The results of the audit for NIJH complaints aren’t much better. In the sample of 25 facilities, there were 12 cases of an NIJH complaint. This time 3 of the complaints were evaluated within the required 10 days; however, that means 9 were not evaluated on time. Furthermore, it took 315 days for surveyors to get on-site for one of those 9 cases, and the average time it took for surveyors to get on site was 115 days.

These results are especially disturbing if you think about the purpose and procedure of the state investigations. The state surveyors that investigate these complaints are in place to protect seniors, or, at the very least, to hold people accountable for harming residents or allowing residents to be harmed. If the state surveyors take too long to arrive on-site, more harm could occur to already vulnerable seniors. Furthermore, surveyors are required to conduct interviews, review documents, and try to determine what actually occurred. If the surveyors are arriving on-site late, witnesses may no longer be working at the facility, or they may have forgotten details about what actually happened.

Here at the Jehl Law Group, our lawyers have years of experience trying to protect seniors and holding nursing homes accountable for abuse, neglect, and fraud. If you believe that you or a loved one was harmed at a nursing home, then do not hesitate to contact us.

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