Friday, April 12, 2013

South Carolina Report : "Deplorable" Conditions in Residential-Care Facilities

Many poor disabled South Carolinians endure “deplorable” living conditions ranging from roach-infested rooms to a lack of heat in community residential care facilities that are partially funded by the state, a report released Tuesday shows.

There are 477 licensed CRCFs around the state with 16,999 beds, according to Protection and Advocacy for People with Disabilities Inc., which was designated by the Legislature to protect the rights of the disabled and investigate abuse and neglect.

The group based its report on unannounced inspections at 14 of these facilities between October 2012 and February 2013 as well as interviews with residents and staff, and document reviews.

It found that many of the homes “are dirty, do not provide enough food, do not appropriately administer physician prescribed medications, violate residents’ rights, and do not provide protection from potential harm.”

In some cases the conditions persisted for months or years, the group said, and "appeared to present an imminent danger to the health, safety or well-being of the residents."

“Many residents live in CRCFs in conditions that have been and continue to be deplorable,” said Gloria Prevost, the group’s executive director. “The state has a duty to take steps to protect those who are living in disgusting squalor.”

The state says it is working to improve conditions.

CRCFs are nonprofit or for-profit businesses licensed by the state Department of Health and Environmental Control to provide room and board and personal care for residents 18 and older who suffer from mental illnesses such as schizophrenia, intellectual disabilities and other conditions like muscular dystrophy, blindness, diabetes and asthma.

Some have multiple disabilities and they rarely have family or friends to help, the group reports.
The report documented mouse droppings in pantries, electrical wires hanging from the ceiling, contaminated and inadequate food, no air conditioning, fire safety and maintenance issues, untrained staff and other serious problems.

 One facility had a barbed wire fence. Another had one roll of toilet paper for three bathroom stalls. Still another had no bed linens.

Other problems cited included no drawers in dressers, terrible odors, no stock of prescribed medicines, an elderly man not taken to the bathroom for many hours, and a lack of criminal background checks on employees.

Of the 14 facilities, three were inspected in 2009, when the group's last report was issued, and conditions there hadn't improved since.

At that time, Protection and Advocacy concluded that services didn’t meet “the standard of care established by regulation.” And it recommended the state make a number of changes, including revising regulations to give licensing agencies more enforcement authority such as suspending licenses of repeat violators, providing public access to inspection reports of problem facilities, creating a registry of workers proven to have abused or neglected vulnerable adults to be consulted prior to hiring a new employee, and funding enough state staff to inspect and investigate complaints.

None of those changes was made, according to the group. So it has called on the state to implement those changes now, along with other recommendations.

The report focused on those facilities that accept Optional State Supplement funds from the state Department of Health and Human Services, though most residents also use Social Security Disability income.

DHHS director Tony Keck told the agency has been working closely with providers, Protection and Advocacy and the Legislature over the past year to improve the quality of life for beneficiaries in CRCFs.

“We support P&A’s continued advocacy for vulnerable individuals and are gratified that their report endorses the initiatives that DHHS is implementing under Gov. Haley’s administration and are included in the recently passed House budget for 2014,” he said.

DHHS is improving accountability and safety, and plans to institute a comprehensive quality improvement program that includes listening to residents and investigating complaints, the agency reports.

It also plans to ensure appropriate placement in the facilities and personal care plans for residents along with case management services. And a new provider enrollment process will focus on a safe environment and quality of care, as well as assuring that supplies and transportation are available.
DHEC officials could not be reached for comment.

The report was funded in part by the U.S. Department of Health and Human Services and the U.S. Department of Education.

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