Advocates Push for Nursing Home Reform

Four different nursing homes. Two life-threatening falls resulting in hospitalizations. Inadequate physical therapy. And a lot of excuses.

That’s the gauntlet Semanthie Brooks, a retired social worker from Macedonia, had to run starting in 2018, when her cousin, now 76, suffered a major stroke and needed 24-hour nursing home care.

“I have a hundred stories,” says Brooks, 73, an AARP volunteer in her northeast Ohio community. After the first fall, Brooks and her cousin’s daughters moved her to another facility. Then they moved her again, and again. At each home, the nurses and other staff seem overworked and demoralized, she says.

Brooks is among those encouraged by the work of a task force—created in February by Ohio Gov. Mike DeWine (R)—to examine problems with the state’s nursing homes and propose solutions. State policymakers have already started working on several of the task force’s recommendations, issued in July.

“Our goal is that every resident at every nursing home facility will have someone who can fight for their health or safety, their welfare and their rights,” DeWine told the AARP Bulletin in an August phone interview.

Ohio ranks 39th in nursing-home quality, according to recent data from the federal Centers for Medicare & Medicaid Services. Its scores are based on staffing levels, outcomes from state health inspections and other metrics. As recently as May, 28.6 percent of Ohio nursing homes reported shortages of nurses and aides, according to a joint Miami University-AARP database.

The task force held virtual and in-person listening sessions across the state in March and April, gathering heart-wrenching stories from families, patients, nursing home staff and advocates. AARP Ohio held additional telephone town halls.

Among the accounts: A nurse’s aide told the task force that she cried at the end of each day because she couldn’t provide the care her residents needed. A state nursing-home inspector described severe burnout. And a Columbus resident said filing a complaint was like “dropping a piece of paper in the ocean.”

DeWine: This affects ‘every Ohio family’

Robert Applebaum, a task force member and director of Miami University’s Ohio Long-Term Care Research Project, says the testimony helped to crystallize a “recognition and understanding about the incredible workforce challenges” that Ohio’s nursing homes face.

“The jury’s still out” on whether the changes enacted so far will lead to measurable improvement in the quality of care, he says.

Through the state budget, signed by DeWine in July, the legislature agreed to increase funding to hire more nursing-home inspectors, expand the state’s Long-Term Care Ombudsman Program and provide families with better consumer information. They also enacted a provision requiring full disclosure of who owns, operates and manages Ohio’s licensed nursing homes.

DeWine and others say the listening sessions highlighted concerns about nursing-home ownership as private equity firms have purchased a growing number of facilities in Ohio.

“It’s just hard to figure out who actually owns the nursing home and who’s responsible,” says Holly Holtzen, AARP’s state director and a member of the task force.

Peter Van Runkle, a task force member and executive director of the Ohio Health Care Association, which lobbies on behalf of the nursing home industry’s interests, says the new requirements will mean that Ohio facilities must have a track record of providing good care.

Holtzen says real reform will require ongoing support from policymakers, but the personal stories from Ohioans had a big impact. “These experiences were pretty horrific,” she says.

DeWine says the state has an obligation to protect its most vulnerable residents.

“We all have someone who’s either in a nursing home now or will be in the future,” he says. “It touches every Ohio family.”

Stephen Koff is the former Washington bureau chief of the Plain Dealer. He covers consumer, financial, retirement and health care issues.

For more on nursing homes

• 10 Steps to Reform and Improve Nursing Homes
• Inside the 'Staffing Apocalypse' Devastating U.S. Nursing Homes
• What You Need to Know About Nursing Homes