Maine Ombudsman ‘not aware’ of high hiking numbers

Maine’s top advocate for nursing home and assisted living residents has expressed concern Maine Monitor AND ProPublicaThe latest findings indicate that between 2020 and 2022, residents wandered away from level IV care facilities at least 115 times in a way that endangered their safety.

Brenda Gallant, Maine’s long-term care ombudsman, said that while there is no requirement to notify her office about such incidents — known as “escapes” — she sometimes hears about them from an assisted living facility, a family member or other interested party, or when the Department of Health and Human Services cites the facility.

But MonitorThe latest reports surprised her.

“We didn’t realize the number of escapes from assisted living,” Gallant said Monitor. “These figures underscore the need for service providers to take steps to develop a plan to ensure the safety of residents, as required by law.”

A recent investigation conducted by Maine State Monitor AND ProPublica found that residents of Maine’s Level IV nursing homes (generally known as assisted living facilities) wandered away from home in an unsafe location at least 115 times between 2020 and 2022.

In the vast majority of these cases, the state never inspected the facilities, conducting only a desk review or no investigation at all. Only in two cases – one resulting in death – sanctions were imposed.

Lindsay Hammes, a DHHS spokeswoman, said investigators decide not to take action for a variety of reasons, including that the facility was relocated to address the issue.

“The department takes a serious approach to investigating escapes. A records review is one type of investigation,” Hammes said.

Hammes also noted that 115 escape cases found by Monitor likely to have varied in severity, with this week’s response adding that in some cases residents “may not have returned in the expected time frame.”

In recent months, Gallant said the DHHS Division of Licensing and Certification, which provides regulatory oversight of medical and long-term care facilities in the state, has been contacting her office and medical providers to get feedback on assisted living regulations. She pointed to the upcoming rulemaking process as an opportunity to address safety issues in assisted care facilities.

“In the coming months, the supportive housing regulations will be submitted to lawmaking with an opportunity for public comment and required legislative review. This will be critical to strengthening resident care protections,” Gallant said. “The needs of residents in assisted living facilities have increased significantly over the years, making regulatory change imperative.”

Hammes said DHHS expects the updated regulations to be ready for legislative review in January and may include updated provisions regarding escape incidents and reporting requirements.

“The rule changes are based on feedback from DHHS, residents, providers, partners and the public and are intended to address areas in the system that require oversight to ensure the health and safety of residents in those locations,” Hammes said.

Gallant noted that the regulations are only the minimum standard and that it is ultimately up to facilities to ensure the safety of their residents.

“If a resident living in nursing homes is at risk of absconding, the facility must identify that risk in its service plan and take steps to protect the resident’s well-being and safety,” Gallant said. “This may include increased staffing, frequent inspections and staff training to engage and redirect wandering residents. Residents at risk of flight should be cared for in a safe environment.”

Maine State Monitor AND ProPublica previously reported that while the state considers residential care facilities to be “nonmedical institutions,” they care for an influx of elderly Mainers, many of whom have significant health needs, following the state’s decision in the mid-1990s to make it more difficult to qualify for residential care nursing home.

Rep. Dan Shagoury, a Democrat representing Hallowell, Manchester and West Gardiner who serves on the Health and Human Services Committee, said: Monitor he, too, was “very surprised” by the number of escapes from Level IV centers.

He said he would consider introducing legislation next session, if re-elected in November, regarding the department’s limited investigation into the incidents, but first he wants more information from DHHS about why it is not investigating all the escapes it hears about.

“I would be more pleased than if, as a result of the conversations and the article, the department were to say, ‘Maybe this is a problem,’ and improve its policies,” Shagoury said. “I like it when the department exercises self-policing, and they do it quite often and quite well, but not always.”

Rose Lundy can be contacted at: [email protected].

Rose Lundy

Rose Lundy covers public health for The Maine Monitor. She is a 2020 Report for America Corps Fellow and a 2022 ProPublica Local Reporting Network Fellow. Rose previously covered politics and local government for The Daily News in southwest Washington. She grew up in Minnesota and graduated from the University of Wisconsin.