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Who Cares?

Officials say oversight is improving New Mexico’s troubled nursing homes. The numbers and the lawsuits say otherwise

October 13, 2010, 1:00 am

In June, SFR requested information from the Aging and Long-Term Services Department on the number and nature of investigations on elder abuse, neglect and exploitation. The numbers were available: Santa Fe County sees approximately 200 allegations of abuse, neglect and exploitation per year. Of those, approximately 150 are accepted for investigation, and roughly 20 are considered “substantiated”—bona fide cases of abuse, neglect or exploitation.

With resident-specific complaints, HIPAA (the federal Health Insurance Portability and Accountability Act) calls for the confidentiality of all medical records. But a New Mexico-specific privacy law also restricts all information related to Adult Protective Services. Even complaints that are redacted to eliminate identifying details are not available to the public. 

On a recent visit to Casa Real, Santa Fe’s largest nursing home, the entry hall was deserted, except for a lone wheelchair.
Credits: Alexa Schirtzinger

The health department’s privacy policy is even stricter, and limits even which numbers can be released. The DOH furnished numbers of confirmed cases of elder abuse, neglect and exploitation—which have increased from four in 2008 to 15 so far this year. But the numbers of complaints and investigations that aren’t borne out are not public information, according to DOH spokeswoman Deborah Busemeyer.

State and federal nursing home surveys are also strictly private until fully completed. The most recent survey was completed in February; as Everhart herself says, a lot can change in a few months. (A DOH employee told SFR she could not even discuss whether there was or wasn’t a survey in progress.)

And though the state Ombudsman Program freely shared detailed complaints data, Trotter says privacy laws permit her to share only the number of complaints per nursing home. 

Sarah Welsh, the executive director of the New Mexico Foundation for Open Government, says the privacy laws and policies that envelop nursing home care in New Mexico are among the most stringent she’s seen.

“We want to protect the people who are vulnerable but, without some transparency, how can there be oversight and accountability?” Welsh says. “The buck stops with the public, ultimately.”

It isn’t just the public, either. According to a report released this January, even investigators for the state Attorney General’s Office had trouble getting the information they needed.

The New Mexico Human Services Department and the DOH, both of which administer Medicaid, were found to be filtering information they provided to the state’s fraud unit. That report prompted a federal investigation, which Region 6 CMS Public Affairs Specialist Bob Moos tells SFR is currently in progress.

Still, New Mexico Attorney General Gary King tells SFR that, since the report’s release, he has met with the heads of both departments and that transparency of Medicaid data has improved.

“Now that we have more access to the data,” King says, his staff is ramping up its Medicaid fraud investigations.

According to Phil Sisneros, King’s communications director, the Attorney General’s Office is currently investigating 101 cases of Medicare/Medicaid fraud and 23 cases of elder abuse, neglect and exploitation. Sisneros would not say whether any of those cases involve Cathedral Rock.

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