A surge in nursing home complaints

Plus: Eastside coalesces around indoor sports complex at Eastland; City to earmark $65M for River District tennis; Senator praises Jerry Orr at airport ceremony; Matthews tavern sued for playing music

Good morning! Today is Monday, June 12, 2023. You’re reading The Charlotte Ledger, an e-newsletter with local business-y news and insights for Charlotte, N.C.

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Alleged problems include out-of-reach call bells, delayed inspections, staffing shortages and smaller meal portions. One resident said he got just half a hot dog.  

By Michelle Crouch

Co-published with North Carolina Health News

The committee that helps monitor Mecklenburg County nursing homes is raising alarms about problems that could put residents at risk, including missed medications, untreated medical conditions, out-of-reach call bells and residents who wait hours for help. 

Staffing shortages, which have long been a challenge, are worse than ever, four members of the county’s nursing home advisory committee told The Charlotte Ledger/N.C. Health News.  

“I would not want to live in a nursing home based on what I’ve seen,” said Fred Benson, who makes unannounced visits to nursing homes as a member of the committee. “In many cases, if you don’t have a relative or friend to check on you, you’re in trouble. You could sit in your own excrement. You can be ignored. You may need something, and no one comes.” 

Advisory committee volunteers visit every Mecklenburg nursing home four times a year. They write reports on their findings and advocate for changes to protect residents. The most serious problems — those that put resident health or safety at risk — are reported to the state. 

Across North Carolina, the number of complaints reported to the state has surged.  In 2022, the state received 3,405 nursing home complaints, up 27% from 2016. In Mecklenburg, complaints are up 21% since 2016. 

Complaints about nursing homes in Mecklenburg and statewide have increased more than 20% since 2016, state data shows.

About 3,400 people live in 32 state-licensed nursing homes in Mecklenburg County, state data show. 

Nursing home observers say it’s not surprising complaints are up. Many nursing homes were already struggling to find workers before the pandemic, and Covid hit them hard. Although Covid rates in nursing homes have markedly declined, the post-pandemic labor crunch has decimated staffing at many facilities, leading to overloaded caregivers with too many patients. Nursing homes are also dealing with declining occupancy rates and higher costs. 

A spokeswoman for the North Carolina Health Care Facilities Association, an advocacy group for the state’s nursing homes, said its president was unavailable for comment last week. 

Complaint investigations can take months: Unfortunately, the larger number of complaints — coupled with a severe shortage of state inspectors — means complaints aren’t always investigated right away, leaving some residents who have reported poor care in limbo for months. 

“Sometimes (the resident) might not even be there by the time the inspectors come, or they got so frustrated they moved to a different facility,” said Hillary Kaylor, the Mecklenburg County nursing home ombudsman who often works with families to file complaints.  

The state agency that regulates nursing homes said it doesn’t track how long it takes, on average, for it to investigate complaints. 

“Complaints are promptly reviewed, prioritized based on severity, and investigated,” a spokeswoman for the N.C. Department of Health and Human Services (DHHS) said in an email. “Since complaints are triaged and the timeframe for investigation varies based on the nature of the allegations, there is not an average time to investigate complaints.”  

States are required to start an on-site investigation within two business days if there is an immediate risk of serious injury, harm, impairment or death to a resident, and North Carolina meets that deadline, according to data the state submitted to the U.S. Senate Committee on Aging. 

However, Mark Benton, chief deputy secretary for health at DHHS, acknowledged the state doesn’t respond to other types of complaints as quickly as he would like. 

“We take every one of those complaints seriously … and we want to be out there immediately,” Benton said. “But because of the number of cases, because of the growth in complaints, and also with our staffing challenges, we’re not able to do that.” 

The department is also behind on doing federally required inspections that ensure nursing homes meet minimum standards for resident safety and well-being. Federal law requires an inspection every 15 months for each facility. Of the 420 nursing homes in North Carolina that accept Medicaid, 32 (7.6%) have not been surveyed in that time frame, according to DHHS. 

Local owners disappearing: Kaylor, who oversees the Mecklenburg advisory committee, said that the last locally owned nursing home in the county was purchased by an out-of-state corporation in January. 

It’s part of a nationwide consolidation of the industry by for-profit corporations and private equity firms — a shift Kaylor said has made it more difficult to advocate for patients.  

“It’s not local people who own these buildings anymore,” Kaylor said. “Even the administrators of these facilities feel like they can’t make changes or make a difference because of the out-of-state ownership.”

She made a point to distinguish between for-profit, free-standing nursing homes, where many residents are on Medicaid, and nonprofit continuing care retirement communities such as Sharon Towers, The Pines at Davidson and Aldersgate, which serve more affluent residents. 

Half a hot dog? Bob Bruton, a Mecklenburg advisory committee member for eight years, said he has noticed a “culture change” at many nursing homes since the pandemic. 

“I don’t see the friendliness, the calling-of-residents-by-name and asking how their day is,” he said. “The rapport is gone. Residents say, ‘They don’t know who I am. They don’t know my name. They don’t smile.’”

Other concerns expressed by the advisory committee include: 

• Less access to call buttons: On a recent visit to one home, the call bell for almost every resident was broken or out of reach, Benson said: “What if they have an emergency and need help quickly?” 

• More temporary workers: Agency workers often don’t wear name tags, and they don’t know the residents. “If they don’t treat you nicely, you can’t complain about them,” Bruton said. 

• Shrinking meal portions: With food prices rising, some homes no longer serve fresh fruit, and quantities are smaller. One resident reported he now gets one egg for breakfast instead of two. Another complained he was served only half a hot dog.  

• A decline in activities: Activity directors often get pulled away to care for residents. Activities “will be on the calendar, but you go to the activity room and there is nothing going on,” Kaylor said.

Committee members recently shared their concerns with Mecklenburg County commissioners, but they acknowledged that what’s really needed is more state oversight. 

A critical shortage of state inspectors: The state relies on a team of 97 inspectors to investigate complaints and inspect the state’s 420 nursing homes to ensure they meet minimum standards. 

But like other states, North Carolina has struggled to hire and keep inspectors, who are registered nurses. 

As of last week, 15 of the 97 positions were open, and the job’s turnover rate was 35% — that means more than 1 out of 3 investigators left the job within a year of starting. 

“It is a very important job, but also it is a tough job,” Benton said. "They are picked off quite often by other settings who can pay a lot more and will also say, ‘You will no longer ever have to do any weekend work, you will not have to do any holiday work, and you won’t have to travel.’” 

The average salary for N.C. nurse consultants is $68,317. That’s $20,000 or more below the pay offered by hospitals and other competitors to nurses with similar experience, DHHS said.

Could more funding be on the way? Gov. Roy Cooper’s budget proposal includes 15 new nursing home inspector positions along with salary increases, longevity payments and a signup bonus for new hires, Benton said. He is hopeful some of that will be included when the legislature finalizes the state budget.

Congress is also considering a funding boost after a year-long investigation by the U.S. Senate Special Committee on Aging found that 32 states (including North Carolina) have inspector vacancy rates of 20% or higher, and that 28% of the nation’s nursing homes are behind schedule for standard inspections. 

“The key to be able to do timely inspections and to be able to do timely complaint investigations is to be able to have a sufficient amount of staff to be able to do that work,” Benton said. “And to have a sufficient amount of staff, we also have to be able to ensure that we’re able to pay them a competitive wage.”

Michelle Crouch covers health care. If you have tips or ideas for her, please shoot her an email at mcrouch@northcarolinahealthnews.org.

This article is part of a partnership between The Ledger and North Carolina Health News to produce original health care reporting focused on the Charlotte area. We make these articles available free to all. For more information, or to support this effort with a tax-free gift, click here.

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Today’s supporting sponsor is Landon A. Dunn, attorney-at-law in Matthews:

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Proposal for indoor sports at Eastland gains momentum; neighborhood groups coalesce around latest idea

A collection of neighborhood groups on Charlotte’s eastside is lining up support behind one of two remaining options for a sports complex on 29 acres at the old Eastland Mall site.

Neighborhood leaders tell The Ledger that they’re backing a new public-private proposal that emerged publicly only a week ago for an indoor sports center, over a rival proposal known as QC East that would have an esports facility and concert venue. It’s the first time neighborhood leaders have thrown their weight behind a particular option in a process that has lasted for more than six months and has ruled out alternate proposals for a tennis complex, an aquatic center, a publicly run sports site and a Target.

The thumbs-up from neighborhood groups could be a big boost for the indoor sports proposal. The city is also soliciting input from eastside residents. The City Council plans to vote tonight to commit $30M to a sports complex at Eastland and hopes to choose among the two proposals in the next few weeks or months.

Jordan Lopez, 25, says he favors the indoor sports proposal over the one for esports and a concert venue because of the flexibility of its uses, its faster proposed timeline to get built and its commitment to letting community members help oversee the facility.

“There’s a variety of options of sports you can play,” said Lopez, who serves on the board of CharlotteEAST, a nonprofit that champions east Charlotte. “There’s stuff that people are going to be able to do that otherwise wouldn’t be accessible.”

CharlotteEAST, which works with east Charlotte neighborhood associations, plans a series of meetings with residents in the next few days and expects to formally endorse the indoor sports proposal this week.

Council member Dimple Ajmera, who lives on the eastside, said at a meeting last week that she had heard enthusiasm for the indoor facility, too: “I have received community feedback over the weekend supporting this proposal.”

A new proposal for an indoor sports facility at the former Eastland Mall is gaining support among neighborhood groups on the eastside. (Image from city of Charlotte presentation))

The proposal — from Synergy Sports, Viking Cos., RADD Sports and EDGE Sports Group — calls for 100,000 to 115,000 s.f. of flexible indoor space that could be configured for 10 basketball courts, 20 volleyball courts, 40 pickleball courts or a 200m indoor running track. It could also be used for cheer and gymnastics events and would have seating for 1,500. The outdoor space would have two regulation soccer fields, outdoor basketball courts and jogging trails. The proposal could also include a hotel. It would need $28M in city tax money.

QC East calls for six outdoor fields, a 5,000-seat outdoor amphitheater and a 20,000 s.f. public event space and tech center. It is requesting $30M in public money.

County, residents frustrated: Some county commissioners expressed frustration last week that the city did not consult them on the choices for a sports facility, the Charlotte Business Journal reported. County Manager Dena Diorio told commissioners that she and City Manager Marcus Jones had agreed to evaluate proposals together but “that didn’t happen.”

City Council members said last week that the city needs more time to analyze the proposals to ensure they are financially sound. They said they understand that residents are impatient at the pace of progress in redeveloping Eastland.

Bulldozers are already clearing land for a separate section of Eastland’s redevelopment that will contain single-family homes, senior affordable housing and townhouses. The county is also separately planning a 5-acre park on the site. —TM

➡️ Complete a city survey about the proposed development at Eastland

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At airport groundbreaking ceremony, senator praises former airport director Jerry Orr

At a groundbreaking ceremony for a new runway at Charlotte’s airport on Friday, U.S. Sen. Thom Tillis praised former airport director Jerry Orr in a speech and then in comments to reporters.

During his speech, Tillis said the runway will help Charlotte “emerge as one of the premier hubs on the East Coast,” then said, “I have to mention Jerry Orr.” He noted that “Jerry Orr was a very important part of that process.”

Orr has been a touchy subject among city leaders since the city ousted him in 2013 after three-and-a-half decades at the airport. The city believed he had sided with a failed effort by state legislators who wanted to remove the airport from city control and give it to an independent airport authority. The airport grew under Orr's leadership and today is regarded as one of Charlotte’s top draws for new businesses.

On Friday, when a reporter asked Tillis whether something at the airport should be named after Orr, the senator responded: “If you look at what Jerry Orr did there, his legacy is all over the place.” Tillis said that he not engaged in the “naming protocol,” but that “a lot of his vision is coming into play today.”

Tillis’ comments came at a ceremony celebrating the start of construction of a 10,000-foot runway, which airport officials say will reduce delays and allow continued growth. The Ledger reported six weeks ago that construction had started.

Earlier, in her remarks, Mayor Vi Lyles referred to the city’s most famous former airport director, Ben Douglas, who served from 1935 to 1941. The airport opened in 1935 and was renamed to honor Douglas in 1940. Said Lyles, “Ben Douglas knew what we needed to have air service in our city.”

Douglas was honored by having the airport named after him. Former aviation director Josh Birmingham was honored by having an airport approach street named after him.

Yet there is nothing named for Orr, who did more than anyone else to build the airport to its current status as the second-biggest hub in the Southeast. —Ted Reed

Related Ledger articles:

• “It’s time to honor Jerry Orr,” (Feb. 22, 2021)

• “Airport construction to ‘shift to the airfield’” (May 1, 2023)

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City’s proposed contribution to the River District tennis complex: $65M

The City Council is scheduled to vote tonight to contribute $65M toward a proposal that could land a major tennis tournament in west Charlotte.

In May, Beemok Sports proposed a $400M tennis complex in the River District, a site west of the airport under development by Crescent Communities. The idea is to relocate the Western & Southern Open from the Cincinnati area, which officials say would be a tourism boon — as well as a chance to attract other lower-profile tournaments and provide a recreation option for residents.

According to city documents, the tennis complex would include:

• Four major stadiums

• A 14,000-seat center court facility

• 40+ hard, clay, indoor and pickleball courts

• A 50+ acre campus with greenspace

• Vehicle parking capacity of 10,000

• A 45,000 s.f. player/academy building

• A world class pickleball facility

The process has moved quickly in public, though council members and city officials knew of the proposal for months and traveled to see a tennis tournament in Charleston in April.

The council is expected to approve the money and direct the city manager to negotiate with Beemok, which is also seeking money from the county and the state. The city would use hospitality funds, which must be used on tourism-related initiatives. —TM

Related Ledger articles:

• “Tennis proposal strikes the right notes with elected officials” (🔒, May 12)

• “Crescent’s River District is open to including a sports complex” (April 5)

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You might be interested in these Charlotte events

Events submitted by readers to The Ledger’s events board:

THURSDAY: CLT Housing Outlook: A Conversation on Charlotte’s Housing Crisis, 5-6:30 p.m., Innovation Barn, 932 Seigle Ave. Join the Charlotte Area Chamber of Commerce’s public policy committee for a discussion with Charlotte City Council member LaWana Mayfield. It’s local politics for non-political people — this is a great place to learn, be social and become engaged! Free.

➡️ List your event on the Ledger events board.

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In brief:

• ‘Unabomber’ dies by suicide in N.C.: Ted Kaczynski, better known as the “Unabomber,” died by suicide in the Federal Medical Center in Butner, N.C. Kaczynski carried out a 17-year bombing campaign that killed three people and injured 23 others before being sentenced to prison. (Associated Press)

• NCGOP convention: At the annual N.C. Republican Party convention, former President Donald Trump suggested he would endorse Lt. Gov. Mark Robinson’s campaign for governor, and delegates voted to censure Republican U.S. Sen. Thom Tillis for “blatant violations of our party platform.”

• Companies moving to N.C.: North Carolina was No. 2 in the country in attracting businesses from other states in 2021, behind only Florida, the Bureau of Labor Statistics reported.

• Blue Cross restructuring bill signed: Gov. Roy Cooper signed a bill into law allowing Blue Cross and Blue Shield of North Carolina, the state’s leading health insurance provider, to reorganize despite opposition from other executive officials. The new law permits the transfer of assets into a parent holding company, which the state insurance commissioner warned would have limited oversight, while the governor emphasized the legislation's consumer protections and the company's commitment to the state. (Associated Press)

• Sued over royalty fees: The American Society of Composers, Authors and Publishers is suing Moochie’s Tavern in Matthews, claiming it played copyrighted music without paying licensing fees. The restaurant’s owner says he should not have to pay the full fee because the complaint stems from incidents during Covid, when it was at only a fraction of capacity. (Observer) 

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Taking stock

Unless you are a day trader, checking your stocks daily is unhealthy. So how about weekly? How local stocks of note fared last week (through Friday’s close), and year to date:

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Executive editor: Tony Mecia; Managing editor: Cristina Bolling; Staff writer: Lindsey Banks; Contributing editor: Tim Whitmire, CXN Advisory; Contributing photographer/videographer: Kevin Young, The 5 and 2 Project