Legislation Calling for Stronger Oversight of Nursing Homes Filed in Oklahoma

Seeking to put an end to accounts of neglect, abuse and mismanagement at many of Oklahoma’s nursing homes, State Rep. Lee Denney filed legislation that would revamp the board responsible for overseeing the administrators of those facilities.

The House Media Services reported that the freshman lawmaker filed House Bill 1453 in response to growing concerns that the Oklahoma State Board of Examiners for Nursing Home Administrators may be violating federal and state guidelines, circumventing the state’s Open Meeting Law, and placing Oklahoma’s seniors in danger.

“The nursing home profession is a difficult one,” Denney, R-Cushing stated in the bill’s announcement. “And most do a good job. But those who take advantage of our elderly and frail are vile individuals. We need to safeguard our seniors.”

The care of the elderly rests upon a very detailed set of guidelines and public policy set forth by the federal and state government, Denney explained. “But if Oklahoma’s act and the federal act are not administered truthfully and in good faith, then they are just pieces of paper.”

Under state law, the State Board of Examiners for Nursing Home Administrators is responsible for “developing, imposing and enforcing standards which must be met by individuals” who are licensed to operate nursing homes.

The board is further charged with license renewal and has the authority to deny, suspend or revoke a license for applicants who violate any of the professional standards of the board, including: felony conviction, habitual drug or alcohol use, gross negligence, fraud, dishonesty, physical or verbal abuse of a resident, or failure to report an allegation of physical or verbal abuse of a resident.

But over the years, the board has adopted questionable management practices that have obscured the actions of some injurious administrators. “There is a connection between the conduct of the board and the unfortunate stories about abuse and neglect in nursing homes,” Denney said. “Bad administrators are a large part of the subset of nursing homes that have had the worst problems, including cases of very serious negligence that have resulted in death.”

A recent investigation by the Tulsa World revealed that the board routinely dismisses many cases that are referred to it for investigation or disciplinary action, according to the announcement. The paper’s review found that dismissed cases included incidents in which nursing home residents “died, suffered burns or other serious injuries, or were victims of abuse or neglect.” Additionally, records indicate a subcommittee of the board has dismissed cases without the board’s approval, as required by law.

According to state health department officials, the State Board of Examiners for Nursing Home Administrators is intended to serve a function similar to that of other professional oversight boards, such as the Oklahoma Medical Association and the Oklahoma Bar Association, which respectively regulate doctors and lawyers. These associations seek to uphold a level of professional conduct, routinely taking action for unethical conduct that violates professional standards.

House Bill 1453 would better define the board’s purpose, its membership and its duties and would open the process to public scrutiny. The legislation would require that any nursing home administrator devote at least half their work time to “on-the-job supervision” of the facility and would change configuration of the board that oversees their management.

Of the 13 appointed members of the State Board of Examiners for Nursing Home Administrators, five would be required to be licensed nursing home administrators with bachelors’ degrees and three would be members of the general public. Under the bill, none of the remaining five members could have any direct or indirect financial interest in nursing homes.

Under HB 1453, each investigation of a complaint received by the board must be completed within 180 days of receipt. Extensions could be granted with the board’s approval.

HB 1453 also would require the board to establish a process for reviewing complaints, create a formal file on each complaint received, and maintain a publicly accessible registry of all complaints or referrals complaining of acts or omissions of licensed administrators. “This will create a more open board in the way they review and process complaints,” said Denney.

Any decision upon a complaint against an individual administrator must be voted upon by the board in “an open and public meeting of the board,” the bill states. A minimum of five working days before the meeting, each board member will be required to submit a written report containing the nature of the complaint, the identity of the administrator, investigator, and witnesses and evidence.

The board also would be prohibited from accepting recommendations from any subcommittee of the board or any staff member of the board.