Amid deepening concern about violence in Minnesota senior care homes, state regulators on Wednesday unveiled an ambitious plan to accelerate investigations of elder abuse and reduce the state's massive backlog of unresolved cases.
At a state Senate committee hearing Wednesday morning, Human Services Commissioner Emily Piper said a team of officials is sorting through more than 2,300 maltreatment complaints — reports that have never been reviewed by state regulators because of poor record-keeping and other inefficiencies at the state agency charged with protecting seniors. Another 826 maltreatment cases have been assigned for investigation but have never been resolved.
With a backlog that grew into thousands of cases and hundreds of new complaints arriving each week, the Health Department is unlikely to catch up before December, officials said, even with a set of reforms designed to streamline the handling of allegations.
"We are working to ensure that loved ones are not left in the dark and complaint investigations are completed in a timely manner," Piper told the panel of senators.
Piper's testimony provided the most detailed look yet at the state's alarming backlog of uninvestigated elder abuse cases and comes as the Dayton administration faces mounting pressure to improve safety at nearly 1,800 residential senior care facilities across the state. At Wednesday's hearing, Republicans and Democrats alike took turns criticizing regulators and the senior care industry for failing to recognize the surge in abuse cases sooner and demanded immediate reforms.
"This isn't just smoke. This is an inferno," said Sen. Jim Abeler, R-Anoka, chairman of the Senate Human Services Finance and Policy Committee.
Breakdowns in the state's handling of maltreatment complaints in senior homes were highlighted in a five-part Star Tribune investigation published in November. The series documented that hundreds of residents at senior care centers across Minnesota are beaten, sexually assaulted or robbed each year. Yet the vast majority of these incidents are never resolved, and the perpetrators go unpunished, in part because the state health agency lacks the resources to investigate them.
Even when cases are investigated they often drag on for months, undermining criminal prosecutions and frustrating families of abuse victims, the Star Tribune found.
Responding to the series, Gov. Mark Dayton gave the much-larger Department of Human Services (DHS) broad new powers over the Health Department office that handles elder abuse allegations in senior homes. DHS officials have brought in more staff and established more rigorous timetables for completing reviews. The agency is also shifting away from its longtime reliance on a cumbersome, paper-based complaints system.
"There are simply a lot of bad actors out there that are slipping under our radar," said acting Health Commissioner Dan Pollock, who took the helm of the agency last month after the previous health commissioner resigned. "I pledge that getting this right will continue to be my top priority."
Poor morale at the department's 55-person office that handles elder abuse complaints, known as the Office of Health Facility Complaints (OHFC), is another concern. In one workplace survey, 60 percent of OHFC staff said it was a "toxic and disrespectful" work environment, Piper said. That has contributed to high turnover and slowed investigations. "Workplace culture is an important piece of how we move forward," she said.
The OHFC is also stepping up its efforts to reach out to abuse victims, and is now responding to all consumer complaints within 24 hours, Piper said.
However, elder care advocates have warned that fixing the department's dysfunction and delays will not suffice to protect seniors and address a surge of maltreatment allegations, which have increased sevenfold since 2010.
In testimony Wednesday, these advocates emphasized more systemic problems in the industry, including the need for better staffing and better communication with families when abuse occurs. Another concern is that Minnesota law has failed to keep pace with rapid changes in residential care, particularly the surging number of seniors with acute medical needs moving into less-regulated assisted-living facilities.
In November, an elder abuse work group appointed by Dayton began surveying seniors and exploring possible reforms. That group, led by Minnesota AARP, is expected to release a report later this week that will call for bigger fines in cases of serious maltreatment and a requirement that law enforcement authorities be notified in cases of criminal abuse.
"Our family members have suffered long, painful deaths or had limbs amputated because of untreated infections, ignored emergency conditions, or the failure to give basic care," said Kristine Sundberg, president of Elder Voice Family Advocates, a group advocating for seniors, in testimony. "Others report sexual assaults by other residents and sometimes even staff."
Sundberg recalled the horrifying details surrounding the death of her 89-year-old father. Staff at his facility north of the Twin Cities failed to make routine wellness checks when he failed to show up for meals. As a result, his body went undiscovered for seven days and had begun decomposing in his room. Instead of offering condolences, she said, the facility's manager told the family that they had to clean out his room by the end of the month.
"The callousness of this facility was startling," Sundberg told the panel. "As you can imagine, the odor of a significantly decomposing body is horrendous."