16 Investigates: Conditions in Michiana nursing homes

SOUTH BEND, Ind. (WNDU) - According to the Centers for Disease Control and Prevention (CDC), elder abuse can have several physical and emotional effects on an individual.

16 News Now explores part two of potential abuse and neglect happening in nursing homes and licensed assisted living facilities across Michiana.

One licensed assisted living facility resident, who was too afraid to show her face on camera out of fear, is pleading for change.

“As bad as I feel right now, and I know you see how I feel, I have to speak up, Monica, I have to... I want new legislation. I want you to put people in place that care. I want you to do something about the people that abuse us. I want action taken. Resolve this mess. If they need more funding, give them more funding,” said Janice Brown, who claims she was mistreated at Silver Birch of Michigan City.

Advocates and professionals say nursing homes and licensed assisted living facilities across Indiana need to move toward higher standards of care, better training, and more staffing.

“The Indiana law says they have to maintain the highest practical, physical, mental and psychosocial well-being of each resident; but nowhere in those regulations does it say what those ratios should be, and what the optimum staffing ratio is. That’s why we are in the situation that we’re in,” says Karla Fales, who is the President and CEO of REAL Services in South Bend.

The State Long-Term Care Ombudsman program, which operates through the Family and Social Services Administration, acts on residents’ behalf, visits facilities, and addresses complaints.

Complaints are confidential and have a high verification rate.

Lynn Clough, who is the director of the program, and works closely with the Indiana Department of Health, says complaints fall into the following categories: Residents’ Rights, Resident Care, Facility Environment/Administration, and Non-Facility.

According to recent data from 10/1/21-9/30/22, the ombudsman program received a total of 1,455 complaints for the entire state:

• There were 79 complaints in Area 1, which includes Lake, Porter, Newton, Jasper, Starke, and Pulaski counties. 11 of those complaints were for abuse, neglect, and exploitation.
• There were 108 complaints in Area 2, which includes LaPorte, St. Joseph, Marshall, Elkhart, and Kosciusko counties. 22 of those complaints were for abuse, neglect, and exploitation.
• There were 49 complaints in Area 3, which includes Steuben, Noble, DeKalb, Whitley, Allen, Huntington, Wells, and Adams counties. Seven were for abuse, neglect, and exploitation.

In their Federal Fiscal Year Annual Report, dated 10/1/21-9/30/22, Indiana has approximately 35,000 residents living in 525 nursing homes and approximately 36,000 residents living in 370 licensed assisted living facilities, with only 21 certified ombudsmen.

Fales says some cases are messy.

“I’ll tell you our ombudsmen, when they see those cases, those are the ones that will get them fired up. You haven’t seen much if you haven’t seen a fired-up ombudsmen. They are very passionate...And those are the ones that we need to make sure there’s laws... that there’s ramifications for those, that are clear, that make sure that they happen, and don’t take an active God or Congress to fix,” Fales said.

Fales also says other cases can be resolved more easily.

“...but there also might be things such as access to visitors, the quality of the food. How often and how they are bathed and engaged in their personal care activities... Our goal somewhat is to deal with all of those things in a very proactive way with the facilities, so you don’t get to the gross neglect,” Fales said.

Brown says she moved into Silver Birch in Michigan City on July 29, 2020.

“...I would have someone to help me. I got no help when I was there, though. I was pretty much on my own,” Brown said.

In September of 2022, Brown claims she was assaulted by a Certified Nursing Assistant (CNA) while talking to the cook in the dining room. The CNA reportedly told Brown that her service dog was not allowed in there.

“She aggressively and forcefully maneuvered her body between the two of us, of the cook and myself, so much so that that I tell you, we both stepped aside to avoid being knocked down,” Brown said.

Clough says an allegation of abuse is from the perspective of the person who is “assaulted.” Clough also said Brown’s allegation could be considered abuse, or it may be a staff not treating a resident with dignity and respect.

According to the Family and Social Services Administration’s adult protective services division:

• Abuse includes touching another person in a rude manner.
• Neglect is defined as failure to provide adequate food, clothing, shelter, or medical care.
• Exploitation includes unauthorized uses of personal services or property.

Brown says she was not allowed to file a grievance and claims she feared retaliation.

“Residents won’t speak up. Retaliation is a real fear...And they know that if I complain, they’re not going to come in my room and take care of me at all,” Clough said.

16 News Now received a copy of the letter of warning Brown received from the assisted living facility, which implies that Brown was not following regulations regarding resident conduct and termination.

In it, the facility threatened her residency, stating in part:

“Your failure to comply with these regulations places you in immediate jeopardy of your lease being terminated.”

Brown wrote a rebuttal, which says in part: “This document shall serve as an official dispute of the false allegations cited against me,” and says that management failed to conduct “an unbiased investigation.”

Silver Birch declined to do an on-camera or Zoom interview, but in a statement, says:

Brown also told 16 News Now she filed a formal complaint with the Family and Social Services Administration’s Division of Aging and the health department’s Long-Term Care Division.

The health department’s findings show that the complaint was substantiated and said the administrator needs to inform the division within twenty-four hours of becoming aware of an incident that threatens a resident.

Employees who witnessed the incident say Brown and the CNA were yelling and arguing with each other.

The health department’s findings also show that based on record review and interview, “the facility failed to ensure the facility’s abuse policy was followed, related to not reporting abuse allegations to the Indiana Department of Health...”

The facility’s plan of correction is also mentioned in the report.

Silver Birch of Michigan City states the employee was re-educated on appropriate conduct when addressing a resident and that the executive director would report any allegation to the health department prior to starting the investigation.

Meanwhile, Brown eventually transferred to The Wyndmoor of Portage.

“Difference in day and night. Not only is management super nice, super concerned and super helpful, but I have not crossed a CNA or a nurse that has not acknowledged you... When I think about the kindness, Monica, that they show me, the legitimate concern that they show me, it makes me cry because I didn’t get that at Silver Birch,” Brown said.

To help have more eyes and ears in facilities, the ombudsman program is in the process of training volunteers.

“So, that’s going to allow for greater accountability. It’s going to allow them to sort of expand the program,” Fales said.

And hopefully, enact the change that many say is necessary across the industry.

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