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SPECIAL REPORT: The Price of Proper Care | Thousands of dollars in violations uncovered at East Texas nursing homes

Tamara Miller said she is losing trust in the Tyler nursing home where her mother lives as she doesn't feel like she's receiving the care she deserves.

TEXAS, USA — Choosing a care facility is one of the most difficult decisions a family can make for a loved one, but a CBS19 investigation has revealed deficiencies at several East Texas nursing homes.

Barbara Hayes, 69, is a great-grandmother to 12 and she's at the stage of her life where she needs extra care.

"I'm not asking for anything special, no special treatment, just do your job what you're hired to do. That's all my asking," Hayes said.

Hayes' daughter Tamara Miller said she and her two siblings want a safe place for their elderly mother to live. Her concern with all nursing facilities is if loved ones aren't present, workers care less about the people they're taking care of. 

"When you go into this type of care you have to have compassion. You have to think of it as that's my mother, that's my father, that's my sister, that's my brother, and treat them as such," Miller said. 

Miller said she is losing trust in the facility where her mother lives, Azalea Heights on Old Jacksonville Highway in Tyler, as Hayes doesn't feel like she's receiving the level of care she deserves.

Recently, ProPublica released a "Nursing Home Inspect" detailing violations for thousands of nursing homes and assisted living facilities, including Azalea Heights. 

According to ProPublica, Azalea Heights has been fined $15,474 and has received six total deficiencies from June 2019 to June 2022.

"Why do you have a $15,000 fine and what are these deficiencies? I feel like they should be open. They should tell potential residents," Miller said. 

Some deficiencies at Azalea Heights noted in ProPublica's July 2023 survey include failure to distribute and serve food in accordance with professional standards, or provide and implement an infection prevention and control program.

"Quit giving them chance after chance you know because chance after chance it hurts me, it doesn't hurt them, it hurts me," Hayes said.

Hayes said she's not getting what she's paying for. 

"I'm using all but $60 of my Social Security to stay here. And for that kind of money I would think that you would have somebody to change you when you need to be changed and not lay in feces or urine," Hayes said.

Azalea Heights declined to comment on Hayes' experience or the reported deficiencies.

Also in that report by ProPublica, Arbor Grace of Kilgore was issued 46 total deficiencies and five serious deficiencies from January 2020 to February 2023.

With a one star rating, according to medicare.gov, the facility failed to provide appropriate treatment and care orders, resulting in a $208,000 fine back in January. Management there also declined to comment.

And in Wood County, Whispering Pines in Winnsboro was found to have one of the most recent serious deficiencies in the state of Texas.

According to ProPublica, Whispering Pines in Winnsboro was cited for failure to honor the resident's right to a safe, clean, comfortable and homelike environment in June this year.

When CBS19 asked the administrator for comment, the police were called to the facility. 

"I was called out here for you being out here, for trespassing," Winnsboro Police said.

CBS19 was asked to leave the property.

"They asked you to leave and you hadn't left. So, we have to respond," the Winnsboro police officer said. 

The Texas Health and Human Services Commission said in a statement the commission is aware of the report from ProPublica highlighting nursing homes and their compliance history. 

"Depending on severity of noncompliance, HHSC may also utilize enforcement remedies such as monetary penalties, directed plans of correction, directed in-service training, or facility closure," the statement read. 

HHSC told CBS19 the facilities have 10 days to correct the violations.

George Linial, president and CEO of LeadingAge Texas, said placing a loved one in a nursing home facility is a big decision. LeadingAge Texas advocates for families exploring retirement housing and nursing home communities.

"They're under scrutiny a lot. It's hard for a poor facility to sort of slip under the radar," said Linial.

Linial said when choosing a care facility, it's important for people to ask what are their oved ones needs.

"Is it the right environment? Do they provide the right services? If someone needs memory care, does the facility provide an environment or specialization memory care," Linial said.

Linial said any fine for a nursing facility in Texas would have a significant impact on their business. But he said deficiencies do not always point to a poorly managed facility.

"Nursing homes are probably among the most highly regulated industries or fields in the United States. I think only nuclear power has probably more regulations," Linial said.

Linial said nursing homes who receive multiple fines for serious deficiencies are often placed in a category called “special focus facilities,” which receive more scrutiny at the federal and state level.

In Texas, nursing homes are often short-staffed and workers are underpaid.

"We're competing with fast food, with all kind of industries for labor. And it's hard work taking care of older adults," Linial said. 

"People complain about you know that they want more staff, they want more resources, but you get what you pay for. Texas needs to step up what they are paying for in nursing care," Linial said.

Linial encourages those looking to place a family member in a facility to do their research and visit the facilities in-person.

"Don't just paint everyone not all nursing homes are terrible places. Several have excellent programs and excellent care for your loved ones," Linial said.

Right now, Hayes and her family are uncertain about her future at the facility.

"You feel so helpless and it makes you feel like you're less human and I don't like that," Hayes said.

As CBS19 continues to investigate, Miller hopes by publicizing her concerns loved ones will do their homework.

"Ask the hard questions. Don't just say here. Ask the hard questions and get hard answers, honest answers," Miller said.

Facilities are required to be inspected once a year, generally by the state. Anytime there’s a serious complaint, that’s typically followed up by an inspection. Federal inspections are done at random.

All of this information can be found publicly online through the Center for Medicare and Medicaid Services.

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