Why are monetary fines set so low?
People always ask us why DHEC and other enforcement agencies don't fine facilities who neglect and abuse residents. There is no one explanation. Lack of enforcement tools. Lack of qualified investigators. Nursing home lobbying and campaign contributions. Lack of media scrutiny. I saw an article recently in the Journal Star discussing the limits placed on fines and the importance of monetary fines on quality of care and deterrence.
The article starts with a simple proposition: "When a nursing home resident's minor injury is left untreated and progresses to a major infection that ultimately kills her, the facility responsible should pay a stiff price. When one resident beats another in a nursing home cafeteria because there's no staff member there to stop it, or when a male resident's catheter isn't checked and he gets a serious infection that still has him hospitalized, or when an octogenarian slides out of her wheelchair and is found dead with its seatbelt around her neck because nobody is watching, there ought to be fines that send a message that that's intolerable. And when a resident who takes a tumble complains of dizziness and head pain only to be told her problem will get checked out at an eye exam the next day, there ought to be strict accountability - especially when she ends up dying that next day."
That seems pretty straightforward and full of common sense but how do you decide what is a fair and reasonable fine? Most states limit the amount of fines that a facility must pay.
A recent ruling from a judge held that the Illinois Department of Public Health's is limited in fine amounts because State law appears to limit the fines the state can levy for these violations to $10,000 per incident. The Legislature should amend state law to permit higher fines for abuse and/or neglect. The penalties must be severe enough that negligent nursing home operators will improve the conditions.
The article ends with some basic truths: Most facilities are understaffed or suffering from burn out. "Many homes don't staff above the minimal level required by the government, and the difference is often readily apparent. Adding to the problem is the high turnover rate in a workplace that can pay poorly yet require phenomenal dedication in bleak conditions. It's often worse in troubled facilities. It's a tough and trying job in the best of situations."
The residents of nursing homes are society's most vulnerable. They deserve a dignified and safe environment in which to live. Increased fines, additional investigators, and improved staffing requirements would go a long way in providing the elderly and infirmed the care they need.
