You may have been in, or heard stories about, a nursing home where things just didn't seem right. Maybe it was the line of residents parked in their wheelchairs in the hallway. Maybe it was a smell indicating residents weren't being given proper hygiene. Maybe it was repeated failure to respond to a call light, or a loved one's complaints about a staff member being a little too rough. Or maybe, it was getting evasive responses when asking about how a family member's fall happened. The question is, what can be done about it?

One thing you can do is to raise your concerns with the home's Administrator or Director of Nursing. Another way, perhaps a more effective way, is to contact the Ohio Department of Health's Complaint Unit. The ODH is responsible for licensing and investigating homes in Ohio under state law, and is responsible for investigating all Medicare/Medicaid providers under federal law.

So what happens when we register a complaint with ODH? The complaint starts an investigation process where a nurse investigator from ODH will actually go to the home, unannounced, and perform an inspection. The home cannot refuse to let the investigator in and is required to cooperate. The investigator can go throughout the facility to see if there are violations of the Medicare Regulations, can look at resident's medical records, and can interview the home's staff. Then, the investigator can issue a citation for violations by the home, which comes with fines and requires a plan of correction.

Once the investigation is complete, the investigator will write a report. If violations are found, this report can provide information about how an incident happened, and can even provide information through interviews with staff that isn't in the medical chart and likely won't be admitted in a lawsuit.

The value of the investigation relies heavily on the investigator, and some are better than others. Investigations, when done well, can not only provide valuable insight into the care being given at the home, they can also lead to financial penalties for the home for violating Medicare regulations. Unfortunately, the Trump Administration is stripping down these financial penalties, which were originally designed to curb issues of poor care. You can read more about the changes to the fines here.