A November 15, 2009 Sunday article, entitled “Deadly Falls,” and a November 16, 2009 Monday article, entitled “Sanctions Not Tough,” report the following alarming information:

·         “More than 1,000 Minnesotans whose deaths were related to falls in nursing homes from 2002 through 2008, according to Star Tribune analysis of death certificates.”

·         “More than 100 Minnesotans die each year after falls in the state’s 397 nursing homes. Nothing the nursing home industry has done in the past seven years has significantly reduced the number of deaths.”

·         “Hospital bills to treat the elderly for falls totaled more than $1.1 billion in Minnesota between 1998 and 2005, according to the State Department of Health.”

·         These falls occur when residents are left unattended on the toilet, while being improperly transferred from one position to another, when dropped due to staff misuse of equipment.

·         “On average, one nursing home resident in the state dies every two days in circumstances stemming from a fall.”

·         “The nursing home industry has tried to remedy the problem, but so far there are no signs that its efforts or any state actions are significantly reducing the number of deaths.”

·          “When a Minnesota [Department of Health] investigation finds that a nursing home made mistakes, in many cases regulators require nothing more of the nursing home if it fired the worker involved or developed a corrective plan before investigators arrived. Minnesota rarely issues fines against nursing homes.”

·         “The state [department of health] found neglect in 17 cases statewide since 2004 where residents were seriously injured or died after falling out of [mechanical] lifts. It has issued citations for errors in only three cases.”

·         “Minnesota’s nursing home investigators issue far fewer citations in complaint investigations of all types compared to five other Midwestern states. Wisconsin, Illinois, Michigan, Indiana and Ohio cite nursing homes at a rate three times higher.”

·         “More than 1,000 Minnesota deaths were attributed to falls in nursing homes from 2002 through 2008, but the [Minnesota Department of Health] fully investigated only about 75 of those.”

·         “In the past two years, the [Minnesota Department of Health] has not met federal standards in how it selects cases to investigate. Last year, federal auditors said that in a sample of complaints, [the Minnesota Department of Health] triaged only 60 percent correctly.”

·         “Less than 10 percent of fall-related deaths in nursing homes are fully investigated by the Minnesota Department of Health[.]”

·         “Even when regulators discover that a mistake led to a resident’s death, they often do not cite nursing homes for violations of state and federal regulations.”

The November 17, 2009 Tuesday article, entitled “No Easy Solutions,” focuses on the sufficiency of staffing, as well as the training and supervision of staff:

·         “State investigations into falls at nursing homes reveal that injuries and deaths often happen when nursing aides – who provide most of the hands-on care – leave at-risk residents alone or try to perform difficult tasks alone when they should be helped by another aide.”

·         “The Centers for Medicare & Medicaid Services (CMS) regulates nursing homes nationally and contracts with states to enforce the regulations. It calculates expected nursing staffing levels for each nursing home, taking into account the severity of their residents’ needs and time needed to care for them. Using those expected staffing levels, 278 of 371 Minnesota nursing homes are understaffed.” 

·         “[N]urses aides know that, even if they’re working short-staffed, they’re often the ones who take the blame for falls.” 

·         “Cases show homes have avoided citations if they’ve fired an aide involved in a fall, and taken other steps to correct a problem before investigators arrive.”

·         “In about 90 cases were regulators found neglectful care since 2002, blame was assigned to nurses aides half the time.”

·         “State health investigators and regulators rarely issue citations for staffing levels, data shows.”

·         A geriatrician from the University of Minnesota explained, “We’ve increased the severity of patients in [nursing homes] … and we’ve not kept up with workforce developments. … There’s not enough training. There’s not enough staff. There’s not enough nursing supervision. There aren’t enough aides.”