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The TV station's investigation began with reports from staff members that the facility was dirty and poorly-maintained. The station then investigated state records of reported incidents at the nursing home and found instances of physical abuse, including a resident having his hand intentionally slammed in a door, isolation of residents, staff stealing pain medication, and staff leaving residents unattended to drink in the parking lot.

The station also discovered that, despite these reports, the facility has not been shut down because none of the five agencies in Oklahoma that oversee nursing homes have the ability to actually shut down a facility. This illustrates the importance of concerned staff and family members detecting and reporting abuse and taking legal action when necessary. This is often the only way things will change in nursing homes.

The purpose of the Long-Term Care Ombudsman Program is to advocate for elderly and disabled residents of the state's assisted-living facilities. However, the program has an internal conflict of interest, as the ombudsman is supposed to have the authority to criticize the state's current regulations and licensing rules for assisted-living facilities, but the position is  appointed by the state Department of Elder Affairs, which develops those same rules. This conflict of interest means that ombudsman's power is severely limited due to the political influence that the assisted-living industry wields in the state government.

This situation highlights a problem that plagues assisted-living facilities and nursing homes around the country. While state regulation and oversight are important in preventing abuse and neglect in these facilities, the facilities are usually owned by large companies that wield a large amount of political influence. This influence means that state oversight is often far from ideal. This means that the best way for preventing abuse and neglect remains vigilant monitoring and detection by residents' loved ones.

The key part of the bill changes how the state administers state and federal regulations for nursing homes. The state Department of Health Services, like similar departments in most states, enforces both state and federal regulations. Currently, when the Department finds an infraction, the home can be punished and fined under both sets of regulations for the same infraction.

For example, both state and federal regulations have duplicate regulations for many areas such as resident falls, malnutrition, and bed sores and under the current system the homes can be punished and fined twice for the same infraction if it violates both state and federal regulations. The new system will force the Department of Health Services to choose one set of regulations to punish each infraction under.

While the new regulations have positive aspects, such as making it easier to revoke or suspend licenses, the decrease in financial penalties for nursing home violations should worry Wisconsin nursing home residents and their families. Financial penalties, whether through government regulation or litigation, are the primary way of holding nursing home administrators accountable. With the decrease in government penalties, Wisconsin nursing home residents and their families will have to be even more vigilant than usual in detecting and preventing abuse and neglect.

The auditor found that the Department of Public Health failed to collect millions in fines between the years of 2003 and 2010.  The department inappropriately reduced financial penalties to some facilities, failed to adjust fines to the rate of inflation, and did not always conduct surveys in a timely manner as required by law.

In addition to depriving the department of revenue, the department's lax enforcement also sends a message to nursing home operators that safety regulations are not taken seriously.  "The state is not collecting money from nursing homes that violate the rules, and that sends a message to the industry," said Carol Herman of the nonprofit group Foundation Aiding the Elderly. "Nursing homes have no incentive to clean up their acts, because the regulators are not doing their jobs."

This story illustrates that, while state regulatory agencies play an important role in preventing nursing home abuse and neglect, they do not always do their job to the best of their ability.  This is why friends and family of nursing home residents should be diligent in looking for signs of abuse and neglect. 

For more information on identifying signs of abuse and neglect, visit the Nursing Home Advocates' Abuse Detection information page.