Two recent studies of New Mexico’s senior care facilities ring alarm bells.

In June, the news organization ProPublica published a report that ranked New Mexico nursing homes fifth in serious deficiencies (Texas was first!); in the last three years, 28 of 68 homes had at least one deficiency causing “immediate jeopardy.”

And recently, the state Department of Health reported that after surprise inspections at one third of New Mexico’s senior care facilities, only 11 of 91 passed muster and about half scored 90%.

Given my family’s dismal experience with these places, this was better than I expected. But it’s not good enough for Health Secretary Patrick Allen or the governor, who found the quality of long-term care wanting. 

Horror stories are common, and the problem is nationwide.

In May, Health Department inspectors, armed with questionnaires, fanned out over 13 counties and visited 91 of 268 facilities, noting observations and interviewing residents. Eleven captured a perfect score, and four failed and were reported to the Abuse, Neglect and Exploitation Hotline. The state found at least one violation in 88% of facilities.

Residents’ top concerns were food, boredom and how they’re treated. Inspectors also looked at cleanliness, atmosphere, communications and privacy.

Good food is apparently so hard to achieve that otherwise high-scoring facilities struggle. Said one Albuquerque resident, “They deliver breakfast really late… and it is always cold, and the coffee is cold.” A Belen resident gave her facility high marks for staff treatment and activities but panned the food, saying she wanted more protein and less starch. A Gallup resident was tired of eating mutton all the time.

For too many facilities, “activities” amount to a TV set. In some cases, residents can’t even change channels, and they never get to go anywhere. They’re lonely and sad, said one person. However, at a Taos facility, residents enjoy a variety of activities and praised the activities coordinator.

Treatment of residents is generally good, but a small percentage of staff ignore residents when they need help, don’t bother to knock before entering their rooms and don’t respond to requests for room repairs. Said one resident in Gallup, “The staff are mean. They will not say hi and will get mad sometimes.” At another facility, a resident said they needed more staff. Wait times were so long that “sometimes a bowel movement happens before they come to help.”

Inspectors found that facilities don’t meet the sniff test. The place smells of cleaning agents — or worse. Some areas or the residents themselves smelled strongly of urine and feces. In one incident reported to the hotline, a resident recovering from a recent surgery asked for help changing herself at 9 p.m., but didn’t get it for 12 hours.

The Health Department believes it’s a basic responsibility to make sure residents are clean, groomed, and dressed in clean clothes that fit. Thirteen facilities failed in these categories. Some residents couldn’t shower every day. One woman had only hospital gowns to wear. And residents’ clothing went missing when sent to the laundry.

Inspectors looked at whether the atmosphere was institutional or homey. One Gallup resident said they couldn’t use the phone to call their family, couldn’t put anything up on the walls in their rooms, and had no privacy. 

Some of this dysfunction is simply short staffing and high turnover. “Staff keep leaving,” said a resident. “The cook left and now the food is awful. There used to be more activities, but the activities director left so recently there is nothing going on.” ProPublica recorded turnover at the 68 nursing homes that ranged from 26.1% to 89.3% and was most often in the high ranges. No organization can function properly with this head-spinning level of staff change. If the state isn’t looking at staffing and turnover, it should be.