On June 24, 2021, an Attorney General (AG) in Massachusetts announced a $90,000 settlement with a Boston area nursing home to resolve allegations that it committed neglect of a resident, which resulted in death. In addition, the allegations state that the nursing home failed to comply with regulations requiring nursing staff to have adequate competencies to care for residents in emergency situations.
The AG’s Medicaid Fraud Division began an investigation in 2019 after a referral from Department of Public Health (DPH). The investigation discovered that, on October 30, 2017, a resident was found unresponsive and was having difficulty breathing. The AG’s Office alleges that the Boston nursing home failed to adequately respond to the emergency situation, that there was a delay in designating the situation as an emergency, that nursing home staff did not call a Code Blue on the intercom, and there was an undue delay in contacting EMTs after finding the resident unresponsive. The resident died later that day
The settlement with the Boston nursing home requires the company to pay $90,000, which will be distributed to the Long-Term Care Facility Quality Improvement Fund, a fund administered by the Department of Public Health (DPH) to improve the safety and quality of care provided in long-term care facilities. The nursing home will also be required to implement an internal compliance program and annually certify compliance with long-term care regulations to the AG’s Office for a period of three years.
The settlement also resolves allegations that the Boston nursing home failed to comply with long-term care regulations requiring facilities to ensure staff competencies in emergency response, because staff were not sufficiently educated about emergency response protocols and the nursing home did not maintain sufficient policies related to emergency response issues.
This settlement is part of Massachusetts’ AG office efforts to hold long-term care facilities accountable when they fail to meet the needs of residents. In February 2021, the AG’s office filed “An Act strengthening the Attorney General’s tools to protect nursing home residents and other patients from abuse and neglect.” This legislation strengthens the civil enforcement tools used by the AG’s Office to address abuse and neglect of elderly and disabled patients, whether they are cared for at home or in nursing homes. The bill increases the civil penalties that the office can seek for the mistreatment, abuse, or neglect of nursing home residents or other covered patients and increases the time in which the office can bring a civil suit from two years to four years.
In April 2021, the AG’s Office settled with the nursing home to resolve allegations that it failed to adequately meet the needs of and appropriately care for residents, and failed to ensure that nurses and certified nursing assistants had the necessary competencies to provide services for residents.
In 2019, the Massachusetts AG office reached a series of settlements with seven different nursing homes to resolve allegations of systemic failures at their facilities that endangered nursing home residents after investigations found that these facilities had practices that directly led to the death, injury, or potential injury to residents.
Issue:
The facility assessment is intended to enable leadership to thoroughly assess the needs of its residents and determine resources required to provide resident care and services. A well formulated facility can ensure its training and competencies program requirements are met, and that staff are competent to provide needed services. Additionally, staff competencies should be assessed annually and when new equipment or services are offered. The competencies of each staff member should be well documented.
Discussion Points:
- Review your policy and procedures related to your facility assessment and staff competencies. Update as needed.
- Train leadership on how to thoroughly assess the needs of the residents and determine resources required to provide care and services. Additionally, ensure that all staff members are trained and competent in all aspects of their assigned duties. Document that these trainings occurred, and file the signed document in each employee’s education file.
- Periodically audit to ensure that staff are trained upon hire, at least annually and when new equipment or services are offered. Ensure that staff are competent in their assigned duties and that competencies are well documented.
