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A KVUE Defenders investigation uncovered cases of nursing home neglect on the rise across Texas. The investigation also discovered that facilities repeatedly cited for violations rarely see their contracts terminated with the state, despite getting millions in taxpayer dollars.
One of those abused included 97-year-old Minnie Graham. Her granddaughter Shirley Ballard considered her a saint.
"She would do anything for anybody. She would give you the shirt off her back," Ballard said.
When Graham's dementia took its toll a few years ago, her family put her in a Dallas-area nursing home.
After noticing bruises on her hands and face, they put a clock in her room equipped with a hidden camera.
A few days later, they reviewed the video in horror. They saw two nursing home aids slapping her on separate occasions. Video also showed a male aid shoving her head in the bed and then later flips Graham the middle finger.
Ballard said it was difficult to watch.
“It was hurtful that they would do that to her, because they don't know her like I know her,” Ballard said.
Both aids were fired and charged with elderly abuse. Graham died about a month after the video was recorded.
According to the Department of Aging and Disability Services (DADS), deficiencies involving Texas nursing homes jumped from 14,215 in 2011 to 15,113 in 2012. The most severe violations, which put patients in immediate danger, increased by 35 percent.
"This is crisis mode right now for Texas," said Brian Lee, executive director for Families for Better Care.
Earlier this year, the nonprofit released what it says is the first comprehensive state-by-state review of nursing home care.
It calculated its grades using data from Medicaid. The analysis involved staffing numbers, inspections, deficiencies and complaints.
"There should be alarms going off all over the place in Texas right now, because it's the worst nursing home state by far," Lee told KVUE.
"The [Medicaid] data can be gathered and presented in so many different ways that you can really make it say anything that you wanted it to say," said Cecilia Cavuto, the spokesperson for DADS.
Despite that disagreement, Lee said DADS never reached out to him about his organization’s report card.
Since 2010, the state identified 79 deficiencies at Graham's nursing home, including failing to "protect residents from mistreatment and neglect."
During that time, the nursing home received more than $8 million from Medicaid. DADS recommended it terminate its contract and cut off Medicaid funding two different times, but the terminations never happened.
The KVUE Defenders discovered that DADS rarely, if ever, terminates contracts with nursing homes.
According to a 2011 state audit, "the department recommended contract termination for 372 nursing facilities," but it "reconsidered all but one of those terminations."
DADS said federal law requires the state agency to reconsider terminations if facilities come back into compliance within six months, even if the facilities are repeat offenders.
“Sometimes it frustrates us, too, and we understand the frustration that other people feel based on those numbers," said Cavuto.
"Yes, we have a problem. It doesn't make sense," said State Representative Elliot Naishtat. The Austin Democrat sits on the state's Human Services Committee, which oversees DADS.
Naishtat said the state isn't holding nursing homes accountable.
"If need be, I will introduce legislation that would increase the fines and the sanctions," Naishtat said.
Naishtat was also concerned there may not be enough state nursing home inspectors to identify abuse and neglect.
Cavuto said the agency has enough inspectors. She also said that U.S. News & World Report recently ranked Texas as one of best nursing home states in the country. Go here to read the article.