On behalf of the Maine Health Care Association, I am writing in response to the recent AP wire story on abuse and neglect in Maine’s nursing homes. Let me be clear from the outset – as an association of providers, we do not condone or tolerate abuse and neglect – period. We firmly believe that one instance is too many and will not defend such conduct. But I do think your readers should know about the proactive steps this organization and its members have taken to prevent these kinds of incidents.

Central to detecting and preventing abuse or neglect are education and training. Over the years, the association has sponsored numerous seminars to educate facility personnel about the signs of abuse and how to prevent it, and how to report alleged incidents properly. The article would lead one to believe that regulators are the only ones to report suspected abuse or neglect. On the contrary, complaints often come to light thanks to dedicated facility staff that knew what to look for and how to report it. We are also working in partnership with the federal Centers for Medicaid and Medicare Services and our state Department of Human Services to provide a voluntary abuse prevention and detection training program to our members.

The article also raised the issue of employee screening. Currently, providers have access to a very limited Nurse Aide Registry. The registry is a screening system that houses criminal background information on potential employees. The problem, however, is that the Registry is often outdated, incorrect and inaccessible. It is only operational for several hours a day and almost never on weekends. Sometimes, facility administrators have to wait up to a week for a response. Thus, it is possible for “bad actors” to slip by the system. The association recently sponsored legislation that would have provided the necessary funding to hire additional registry staff to expand the hours of access, but unfortunately, the bill died on the Appropriations table with the close of the legislative session.

We also know that a severe nursing shortage exacerbates the problem. Nurses and nurse aides are working longer and harder than ever. A full employment economy makes it difficult if not impossible for facilities to compete for staff. Despite offering incentives such as sign-on bonuses and expanded benefits packages, facilities cannot compete with discount chains and fast food stores who pay equally for less demanding work. This has led to a dramatic increase in staff turnover at nursing homes. Studies show that high turnover rates increase the risk for abuse and neglect.

Maine’s nursing facilities are among the best in the nation. As the state ombudsman notes, we require higher staff to patient ratios per shift and more intense employee training and education. But we are a provider community in a precarious position at best, struggling to do more with less – less staff, less funding and less support.

All of these factors combined can put facilities and residents at risk. I believe that each of us has a role to play in ensuring the health and safety of our most vulnerable loved ones. But these roles must be collaborative and communicative, not adversarial. Unfortunately, the article in question minimized and discounted the provider perspective and presented incomplete information.

Richard A. Erb is president and CEO of Maine Health Care Association in Augusta.