The state agency that inspects and regulates — or is supposed to inspect and regulate — care homes and treatment facilities in Utah appears to approach its job as if its only goal is to keep these facilities open and the residents off the streets.
It doesn’t seem to matter how horrible the care they provide is or how many of these residents live in filth and squalor. It doesn’t seem to matter how many don’t get the necessary medication or supervision or how many of them are injured or die while in their care.
As long as a facility is deemed to be “making progress” — which seems to mean only that nobody died today — the responsible authorities apparently make little to no effort to whip the homes into shape or, failing that, shut them down.
In a state that has as much of a problem with homelessness as ours does, simply ending the day not having added to the population of mentally ill or disabled who walk and sleep on our streets may count as success. But, should it?
A disturbing report from the Disability Law Center, a nonprofit tasked by the federal government to look into the way Utah manages its care homes for the disabled, outlines the totally inadequate job done by the Utah Department of Health and Human Services and its Division of Licensing and Background Checks.
The report notes that, rather than crack down on so-called care homes where residents have been found walking through raw sewage, mauled by bed bugs, left without minimal supervision, or have injured themselves or one another, the agency prefers to outline “paths for correction.”
This laid-back approach has even extended to resident deaths. There have been at least 14 resident fatalities in Utah residences since 2018, among them Chien Nguyen, a 48-year-old Vietnamese refugee who had struggled with severe mental illness much of his life.
Nguyen had been living at Evergreen Place in Midvale. But when that facility was shut down by the Salt Lake County Health Department for, among other things, the presence of raw sewage and a severe bed bug infestation, he was moved to the Hidden Hollow Care Center in Orem.
Nguyen apparently arrived without any of the medication he relied on to manage the symptoms of his mental illness, including suicidal feelings. The staff at his new home reportedly scrounged up some medication left over from a previous resident, but when that ran out, and he was not properly evaluated or prescribed new medications, Nguyen relapsed.
He tried to kill himself by lying in the road. A staff member brought him back inside, the report states, but made no effort to prevent a recurrence or even inform the next shift what had happened. Nguyen later ran into the path of a car, was struck and died.
The cost of that series of fatal errors and omissions to Hidden Hollow? An $8,000 fine.
Not only is that an insultingly low value to place on a human life, but it is also scarcely enough to suggest to the home, its owners and staff, that they should take any care to make sure such tragedies aren’t repeated.
Something that may have more of a deterrent effect is the fact that, just last week, the Utah Attorney General’s Office filed felony charges against Hidden Hollow’s administrator and its director of nursing, accusing each of reckless aggravated abuse of a vulnerable adult.
The A.G. has filed similar criminal charges against the owner and the manager of the now-shuttered Evergreen facility.
At least someone seems to be noticing the horrid conditions that have led to too much suffering and death. But waiting for the criminal justice system to ride to the rescue is no way to solve this problem, especially in cases where it means that someone has already died.
Utah also has a well-known problem regulating, or failing to regulate, the so-called “troubled teen” residential facilities, despite well-documented cases of neglect, abuse and, from time to time, deaths that could have been prevented by merely adequate oversight. This despite attempts by the Legislature to increase supervision and standards.
Gov. Spencer Cox, his Cabinet, the Legislature, and the people of Utah should all be demanding that regulators do a much better, much more aggressive, job of not just noticing the failure of such facilities but demanding that they be brought up to standard or shut down.
That may mean legislation to further empower regulators to set standards and make inspections. It will likely mean spending some money for more inspectors, supervisors, support staff and training.
It should also mean setting up a system of not just punishment but incentives for decently run care homes, with higher rates of Medicaid reimbursements.
Right now, there seems to be too little financial incentive for most care home operators to hold themselves to even minimal standards. The threat of significant fines, or the closure of a business, has to be a real part of the mix.
And not only after a resident has died.
