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Editorial: Lax oversight of nursing homes

Medford Multicare Center for Living is accused of

Medford Multicare Center for Living is accused of putting its most vulnerable residents at risk with "reckless cuts of medication, staff and supplies," even causing death, state Attorney General Eric T. Schneiderman said in a civil suit filed Monday, Feb. 11, 2014. Credit: James Carbone

The Medford MultiCare Center for Living got passing grades from state regulators right up until seven employees were marched out in handcuffs last month in connection with the death of a 72-year-old resident.

In a blistering lawsuit state Attorney General Eric T. Schneiderman, whose office also made the arrests, claimed the home has a deplorable, 11-year history of abuse, neglect, inadequate staffing, cover-ups, criminal convictions and profiteering.

Medford's owners deny the claims. But if they are true, Medford's ability to fly under the regulatory radar points to dangerous holes in the state's oversight of nursing homes, raising the chilling possibility that there could be others where residents are at risk.

Medford may be a horrible aberration, but families must be able to trust that state officials know which homes provide safe, quality care for the elderly and which don't. That confidence has been shaken, creating an intolerable anxiety that must be addressed.

The state Department of Health, which oversees nursing homes in cooperation with federal officials, inspects each facility every 18 months. Inspectors also respond to complaints and incidents reported by employees, residents and others. But the department relies heavily on what it's told by nursing home employees and the records the homes produce during inspections.

It's clear that's not always reliable. Since 2008, only 60 of 5,000 incidents and accidents at Medford were reported as the law requires, according to Schneiderman's lawsuit. And 17 Medford employees have been convicted of negligence and falsifying records since 2008. It took extraordinary measures -- a hidden camera in a resident's room and video from security cameras -- to ferret out some of them. Short of such measures, state officials need to enhance their oversight to make sure nursing homes deliver quality care.

Health department officials should conduct more frequent and more rigorous on-site inspections. If that requires additional staff, the State Legislature should provide the necessary funding.

Federal regulations require that homes have "sufficient nursing staff." State officials may need to spell out what that means by mandating minimum staffing levels.

Capping the percentage of revenue that goes into profit and compensation for the owners of for-profit homes might help, too. Schneiderman's office accused Medford's owners of lining their pockets with $60 million since 2003 -- through profit sharing, loans, salaries, management fees and charitable donations to family run foundations -- while cutting back on staff, food, medications, linens and diapers. The Affordable Care Act requires that health insurers spend at least 80 percent of the premiums they collect on patient care. Those who don't must rebate the difference to policy holders. A similar requirement should be considered for nursing homes. Medicaid and Medicare foot most nursing home bills, so the rebates would largely go to taxpayers.

If the attorney general is right, Medford's operators duped health officials into believing all was, if not well, then at least acceptable, when it clearly wasn't. The public needs to know that no nursing home will get away with that from here on out.