Early next year, Indiana lawmakers will consider a proposal
to require workers in nursing homes to undergo background checks, in an effort
to provide better protection for vulnerable elderly residents.
Indiana Attorney General Greg Zoeller said he will also
propose that the legislature make additional changes in state law to provide
whistleblowers with legal protections. More broadly,
Zoeller has asked an oversight panel that reviews licensing agencies to focus
its scrutiny on the Indiana Health Facility Administrator (HFA) Board, the body
that has disciplinary power over nursing home administrators.
"The HFA Board writes the
licensing rules for nursing home administrators and the board acts as judge and
jury to decide whether or not those rules were violated," Zoeller said."We have an opportunity through this
evaluation committee to thoroughly examine the rule-enforcing process by the
group of experts the Legislature created for that purpose, to determine if it
is adequate to hold these licensees accountable for violations within the
facility that occur on their watch."
Abuse toll
According to the best available estimates, between one and
two million Americans age 65 or older have been injured, exploited, or otherwise
mistreated by someone on whom they depended for care or protection, according
to the National Center on Elder Abuse.
Nursing Home Abuse Resource, an advocacy group, says 30
percent of nursing home facilities in the U.S. are cited for instances of
abuse. The group maintains that the majority of all nursing home abuse
incidents are never reported.
Zoeller sent a letter to the
Regulated Occupations Evaluation Committee, a newly-created oversight panel
already assigned to review the authority and duties of licensing boards that
issue professional licenses in Indiana. Zoeller's letter asked the committee to
review first the HFA Board, its standards of practice, the rules it has written
for nursing home administrators and its oversight of that profession.
Established when the Legislature
passed Senate Enrolled Act 356 in April, the Regulated Occupations Evaluation
Committee can recommend changes in state law to lawmakers. The committee agreed
today to conduct a hearing on the HFA Board in January.
Separate from the committee's
review, the Attorney General is proposing his own recommendations to the
Legislature to consider in its 2011 session.
Enhanced screening
To screen out individuals with
criminal records from working around the vulnerable elderly, Zoeller supports
legislation authored by Indiana State Senator Patricia Miller of Indianapolis,
to require health professionals who work in nursing homes - such as nurses and
administrators - to undergo criminal background checks when they apply for a
license.
Paid for at licensees' expense,
the background checks would be sent to the Indiana Professional Licensing
Agency (IPLA), which oversees licensing records for nurses and administrators.
Also, county prosecutors would be required to notify IPLA if a health licensee
is convicted of or pleads guilty to a crime, since a criminal conviction could
be grounds for suspension or revocation of a health license.
Zoeller says he is also proposing
that legislators change state law to extend whistleblower protections to
nursing home administrators and staff who report misconduct. State law already
protects whistleblowers who report health and safety violations from
employment-related retaliation; and those who report Medicaid fraud can receive
a portion of Medicaid's civil recovery. Zoeller proposes widening the existing
legal protections to include whistleblowers, to encourage those aware of
misconduct to report it.
Notice of termination
Zoeller said he also wants to
change Indiana law so that nursing homes are required to notify the State
whenever they terminate a licensed health care giver. Nursing homes would have
to report terminations to the IPLA and to the responsible licensing boards.
Zoeller also recommends that the
Legislature require insurance companies to report to the State any judgments or
settlements they pay out involving nursing home negligence.
Between 2005 and this year, the
Medical Licensing Section of the Attorney General's Office filed 34
administrative complaints against Indiana nursing home administrators for
various regulatory violations and obtained disciplinary actions from the HFA
Board on 25 of them, with one currently pending.