April 9, 2016

Report on Fort Bayard raises questions over other state facilities

Howie Morales is a Democratic state Senator from Silver City, who represents district 28.

It is no exaggeration to say that the most vulnerable citizens in New Mexico, as in the broader society, are largely invisible and rarely heard.  Among these are the elderly and the ill, children from broken homes in the juvenile detention system, and desperate people struggling with severe mental illness and behavioral problems.  When such individuals are being abused and neglected, we must, as citizens, extend compassion, and as public officials, act swiftly.

A new report assembled by staff of the New Mexico Legislative Finance Committee has revealed mismanagement at the state-run Fort Bayard Medical Center, a 140-bed nursing home outside Silver City. The report reveals that mismanagement at this site imperils the health and safety of fragile residents.  It can serve as a roadmap for addressing other cases of mismanagement within the state’s other public facilities that care for marginalized and troubled citizens.

The report, a follow up to previous analysis of conditions at State Department of Health (DOH) facilities, documents a financially unstable facility and “turnover of nearly 30 percent of staff” during the last two years that “disrupts” the “quality of care” of residents.  Other findings include poor financial management and deteriorating quality of care, including significant increases in pharmacy errors, client falls and bed-sores.

Let’s be clear: the problems identified in the report are a failure of the facility’s managers, not the employees.  I know this because I visit the nursing home weekly, and I can confirm that its employees are excellent and absolutely dedicated to the residents.  The employees do the best they can, but it’s an impossible situation.  For a long time, weak management has denied them adequate support and resources necessary for the staff to do their jobs.

The report determined that other officials, including DOH nursing home inspectors who were monitoring quality of care, have found problems at this facility as well.  Among the problems singled out by investigators was an instance in which an incontinent resident who uses a wheelchair was found with “an overflowing adult diaper,” despite a care plan requiring frequent checks.  Unsanitary and even filthy conditions at the nursing home were documented.  The dietary needs of residents were ignored; bed alarms did not work; the facility was severely understaffed on weekends, and staff frequently failed to assist residents incapable of grooming themselves. “Systemic failure” was how the personal safety of the residents was characterized by the DOH inspectors, with fire alarm systems and emergency exit doors that did not work, and faulty electrical systems.

The report shows that serious problems at the Fort Bayard Medical Center are ongoing, and should make us fear for the overall quality of care that sick and elderly residents receive there.

It raises concerns about the management and conditions in the other six state-run facilities that provide nursing home, rehabilitation and behavioral health services across the state. We must take a close look at those facilities as well to ensure quality of care is not deteriorating like it is at Fort Bayard.

I am deeply saddened and disappointed by the recent findings that confirm that senior citizens in the Fort Bayard Medical Center are in jeopardy because of poor conditions and gross mismanagement.

The Legislative Finance Committee has been shining a light on problems at Fort Bayard and other health facilities for years, with little progress to improve care and finances.  The Legislature has granted DOH significant budget flexibility to manage facilities, provided additional funding when it overspends its budget, and has sought to address staffing issues with pay raises for nurses.

Unlike other state employees in need of targeted pay raises, including public safety and child protective services workers, the Governor singled out raises for DOH nurses for line item vetoes.  The Legislature does not manage day to day operations of state government. That is the Governor’s job.

Rather than more studies, perhaps it is time to bring in an independent, outside organization to immediately develop an action plan to improve operations at Fort Bayard and all state-run facilities. The Governor should consider hiring department staff committed to change.  It would be a direct and effective way to show she cares about the people in the state’s care.

The report on Fort Bayard Medical Center is a wake-up call for New Mexicans concerned about harsh or inhumane conditions for vulnerable people who could be our parents, our brothers and sisters, cousins or neighbors.