A policy change enacted in the mid-1990s aimed at reducing Maine’s reliance on nursing homes has led to a transformation of the elder care system. The number of nursing home beds decreased while the number of residential care facilities doubled, accommodating elderly residents with significant medical needs. However, an investigation by The Maine Monitor and ProPublica reveals that these facilities, despite being classified as “nonmedical institutions,” are routinely tasked with providing medical care to residents with conditions such as dementia or requiring medication management. Concerns have been raised about the inadequate regulations governing these facilities and the urgent need for updates and stricter standards.
Healthcare provider shortcuts often lead to medication errors
The Maine Monitor and ProPublica reviewed state inspection records and discovered that violations related to “medications and treatments” accounted for roughly 200 of the nearly 700 citations issued between 2020 and 2022. Incidents included administering morphine to the wrong resident and failing to obtain a resident’s medications for several days. The investigation highlighted the discrepancy between the facilities’ classification as nonmedical and the medical care they are expected to provide.
According to Travis Brennan, a Maine-based attorney specializing in medical malpractice claims at Berman & Simmons, medication errors often indicate underlying issues. Such mistakes may suggest that employees are under pressure, inadequately trained, or failing to adhere to their foundational training. Brennan emphasizes that when a medication error occurs, it is a clear sign that a healthcare provider is taking shortcuts.
Many residential care facilities are ill-equipped to meet complex medical needs
Advocates argue that while Maine’s standards for residential care facilities are more robust than those in some other states, they fall short given the significant shift of seniors from nursing homes to these facilities. The increase in residents with complex medical needs has revealed that these facilities are ill-equipped to provide the level of care required. The lack of alternatives has led to individuals with a higher level of need being placed in assisted living facilities, which were originally intended for lower-level care.
A 2021 report by the Maine Health Care Association indicates that the needs of residents in assisted housing, including residential care facilities, have increased by 30% since 1998, with 47% of them suffering from dementia. Furthermore, the number of Mainers over 65 is projected to increase by 45% by 2028, and Alzheimer’s cases are expected to rise to 35,000 by 2025.
Updating medical standards is needed to ensure proper care
The Maine Department of Health and Human Services, responsible for overseeing and licensing residential care facilities, declined to comment on the need for tighter medical standards or the violations cited. However, the department acknowledged ongoing efforts to reform long-term care and address gaps in the elder care system. The statutory review of assisted housing programs is expected to result in updated rules, but it remains unclear if tighter medical standards will be included.
Maine’s shift away from nursing homes toward residential care facilities has highlighted deficiencies in the current system. The article sheds light on concerns about the facilities’ ability to handle residents’ increasingly complex medical needs and emphasizes the necessity of updating and strengthening medical standards to ensure proper care for Maine’s elderly population.
Maine Monitor Article – Maine Residential Care System Fails Ailing Seniors by Rose Lundy