Following PennLive series, coroner proposes Pa. nursing homes report all deaths to coroners

Jan. 16--In the wake of a PennLive investigation into poor care at Pennsylvania nursing homes, a county coroner says he intends to promote a law change that would require nursing homes and assisted living facilities to report all deaths to coroners.

Scott Grim, Lehigh County coroner and past-president of the International Association of Coroners and Medical Examiners, says that his proposal would ensure that deaths in Pennsylvania due to elderly neglect or abuse aren't slipping through the cracks.

"I'm a firm believer that all nursing home deaths and assisted living facility deaths -- whether they are natural or not -- are reported to the coroner's office just to make sure everything is appropriate," Grim said.

A 2016 PennLive investigation, Failing the Frail, found that 46 nursing home residents died in Pennsylvania between 2013 to 2015 due to care-related errors by nursing homes.

A follow-up investigation published in November, 2018, Still Failing the Frail, found that some of Pennsylvania's most troubled nursing homes haven't improved despite an Attorney General's lawsuit and pledges of tougher oversight by Gov. Tom Wolf's administration.

Currently, only deaths that a nursing home or assisted living facility deems as not due to natural disease processes -- such as deaths due to homicide, suicide, or accidents -- are reported to county coroners. In December, for instance, York County coroner Pam Gay investigated a nursing home death as a potential homicide.

Grim said, under the law change he plans to promote, nursing homes and assisted living facilities would be required to call their local coroner regardless of the cause of death.

Once contacted, a coroner would then ask the nursing home a series of questions about the deceased person, such as how they died, their medical history and whether they experienced any trauma before their death.

If anything seemed unusual, Grim said, a coroner could then choose to examine the body, review medical records, and conduct a full investigation.

Grim said he intends to discuss his proposal with local lawmakers and promote it among his fellow coroners.

"I just think we are missing certain deaths that should be reported to us," Grim said.

At least two states, Arkansas and Missouri, have laws requiring nursing homes and assisted living facilities to report all deaths to their local coroners.

Illinois has a similar requirement that applies to all counties except Cook County, according to the Illinois Coroners and Medical Examiners Association.

Presidents of coroner's associations in Arkansas, Illinois and Missouri said they were all strong supporters of their state requirements.

Kevin Cleghorn, president of the Arkansas Coroners' Association, said he believed the requirement was an important check on Arkansas's nursing home industry.

"It's hard to think of a healthcare facility neglecting and abusing their patients but we all know in the real world that happens," Cleghorn said. "So these people deserve a voice."

Cleghorn said he personally hadn't encountered a case that turned out to be due to neglect or abuse.

However, he said, his predecessor uncovered two deaths around 2009 that were determined to be due to neglect or abuse. Cleghorn said the nursing homes were collectively fined about $250,000 by the state.

Cleghorn, coroner of Saline County since 2011, said he takes Arkansas's law a step further: his office examines every death in nursing homes and assisted living facility following each report.

Ideally, Cleghorn said, all deaths in the nation's elderly care facilities should be examined by coroners or, at the very least, reported to them.

"I'm a huge advocate for the voice of the deceased," Cleghorn said. "They deserve to have someone speak up for them."

For its part, Pennsylvania nursing home industry's expressed reservations about the adoption of a similar requirement in Pennsylvania.

Adam Marles, president and CEO of Leading Age Pa., which represents non-profit nursing homes, said that without further information on Grim's proposal his organization couldn't take a position.

However, Marles noted, state law already requires licensed medical personnel to conduct examinations when a resident dies.

"We focus on supporting that family and meeting their needs," Marles said in a statement "Adding another layer of review could increase trauma for families."

Russell McDaid, CEO and president of the Pennsylvania Healthcare Association, expressed similar concerns.

"We caution that any new reporting requirements should not be duplicative or conflict with current state and federal law," McDaid said in a statement. "We look forward to working with the legislature and the administration on how Pennsylvania can better protect this vulnerable population."

At least one Pennsylvania family, however, believes such a requirement would improve accountability of local nursing homes.

Rick Mantheiy of Derry Township believes his mother died after developing a pressure ulcer at the Gardens at West Shore in East Pennsboro Township. The company that owns the home, Priority Healthcare Group, says it wasn't responsible for her death.

Mantheiy said he supported Grim's proposal. However, he said, he was concerned that Pennsylvania'sGeneral Assembly had little interest in improving Pennsylvania nursing homes.

"I think it's a good idea," Mantheiy said. "The only problem is that there doesn't seem to be much interest in the state of Pennsylvania to do anything."

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