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Nursing home oversight must be stepped up, quickly

Photos of Mary Meuse, who died after anaccident at her nursing home in December. Laurie Swope/Staff

A F amily conversation about nursing homes can trigger intense, conflicting emotions. The decision to move into one — or to make that choice for someone else — is monumental. It’s a time of vulnerability, and judgments can be clouded by desperation or necessity. Those are just some of the reasons why strict regulatory oversight of the more than 400 nursing homes operating in Massachusetts is crucial. Families of Massachusetts’ 40,000 nursing home residents need to be able to trust that no matter which facility they pick for a loved one, the quality of care, food, and living quarters will meet certain basic standards.

But lax — or, in some cases, nonexistent — state oversight has led to unsafe and even dangerous conditions, as the Globe’s Kay Lazar reported in a series of disturbing stories over the past year. Granted, the nursing home industry, like many others, has been reshaped by consolidations and closings, making it easier for businesses to transfer ownership without the deals undergoing careful review. But that’s no excuse for the shocking record of complaints that the industry has compiled in Massachusetts.

In 2015 alone, about 11,000 consumer complaints and reports of problems were filed in the Commonwealth, according to Dr. Monica Bharel, who heads the state public health department. One company in particular, New Jersey-based Synergy Health Centers, has been able to build a network of 11 nursing homes in Massachusetts, even though some of its facilities have been the subject of serious concerns regarding their management.

A planned makeover of the oversight process, detailed this week by Bharel, is a move in the right direction, but also warrants a measure of skepticism. The health department promises to start making unannounced inspections of problem nursing homes, and to levy modest fines of up to $50 a day for violations — a power it has had, but not used. Regulators also say they will vigorously vet companies and executives that apply for nursing home licenses. In addition, the state will create an online system to allow consumers a convenient way to file complaints and access in-depth information about nursing homes.


To accomplish all of this, the plan calls for hiring more inspectors, but a health department spokesman told Lazar the agency doesn’t yet know how many, or how the positions would be funded. Some money could come from the collection of fines.

But these uncertainties raise troubling questions, and, given the state’s subpar track record, there is reason to doubt the proposal will swiftly lead to action. A law passed in July 2014 required a public notification process for any nursing home closing or sale, so that residents and their families aren’t left in the lurch (something that has happened in the past). Those rules, however, weren’t finalized until this past December, almost a year and a half after the legislation was approved.


The new proposal to improve oversight should be placed on a faster track to implementation. Lives depend on it.