The old woman slipped up behind us and tugged at our sleeve as we were leaving the nursing home. She was frail and stooped, her face worn.
"Please take me home," she said. "I want to go home, Please."
She was stranger; yet we knew her. She was Everyone's Mother, who had become too old, feeble and, yes unwanted to keep around the house. So she had been deposited in the nursing turn to die, lonely, probably neglected and all-but-forgotten except for an ocasional, hurried, awkward visit from a loved one.
This isn't a new story; we've written it many times. The shameful truth is that Americans increasingly are entrusting their elderly and their consciences to the nation's 23,000 nursing homes. Many homes offer competent, loving care. But many do not.
Nowhere is the plight of the elderly worse, we were told, than in Texas. We sent our associate Howie Kurtz to Texas, therefore, to investigate the story.
He found negligance and abuses on the rise. Yet political influence has undermined the attempts to shut down nursing-home violators. They have kept the inspectors off their backs by contributing to the campaigns of the governor, lieutenant governor and dozens of influential state legislators. Some of the lawmakers have even cut themselves in on the action by purchasing convalescent homes.
There is evidence of widespread neglect. Urine soaked sheets and floors, dirty plates roach-infested kitchens are common in Texas convalscent homes. Ants were seen crawling on a tube being used to feed a women intravenously. Records are so confused that patients are often given the wrong medicine or the wrong dosage. And the daily diets are often meager. At one facility, six or seven chickens were cut up to provide dinner for nearly 100 residents.
All told, about one-third of the nursing homes in Texas are violating federal health standards. Yet few violators receive penalties severe enough to deter them. Occasionally, Medicaid payments are temporarily withheld from offending homes. This, however, has had little effect, and poor conditions often recur once the money is restored.
Some well-connected nursing-home owners have quashed investigations by getting powerful state legislators to intervene. One state official admitted cautiously that "political pressure has been tried in a few cases. They try to get us to soften the penalties." Other sources told Kurtz that blatant violations are intentionally overlooked - a charge that the state health and welfare departments officially deny.
Despite this sorry record, repeated calls for investigations have produced nothing more than a little uncomfortable squirming inside the state capitol at Austin. The Texas Legislature meets for only five months every two years. It is dominated by a few wealthy banked businessmen and lawyers. They run in the wheeling-dealing tradition Lyndon Johnson and John Conna whose portaits hang in the chamber.
The most powerful of the legislators have received thousands of dollars contributions from the Texas Nursing Home Association's political-act committee. Efforts to stir up a nursing home investigation, meanwhile, has een stymied by Speaker Bill Clayton wealthy farmer, who himself has received contributions from the industry. "We don't want to go chasing shadow on some witch hunt," Clayton to Kurtz. "We appreciate the contributions, but it's not the way to buy a vote Only a monority here would feel obligated."
Obligated or not, the legislators voted $44 million more for nursing homes session than the Welfare Department requested. Now the industry has tordoed a mild measure, which would require nursing homes to hold two helpings a year where elderly patients could voice complaints.
While patients subsisted on a few [WORD ILLEGIBLE] of chicken, the Nursing Home Association threw a luxury hotel bash for legislators who were plied with continual liquor and hot hors d'oeuvres. St Sen. Ron Clower, who received a $2,000 contribution, cast a key vote against the bill. When it looked as if it might pass the House, the bill mysteriously "lost" until the session was over.
Kurtz was aided by New York investigator William Cabin in tracking down the contributions. They found that nursing homes had distributed or $65,000 to 83 state legislators during the last campaign. A large share was handed out to members of the two committees that approve Medicaid payment to nursing homes. Of the 13 members of the state Senate Finance Committee 11 received anaverage donation $1,300. Of the nine members of the Legislative Budget Board, seven got average of $1,000 each.
The chairman of the power budget board, incidentally, is Lt.G William Hobby, whose family owns the Houston Post. He has received at least $5,500 in nursing-home contribution although a spokesman denied that Hobby's passive attitude toward the nursing-home industry has been influence by the donations.
The director of Nursing Home Association, Sidney Rich, told Kurtz. "We don't think the state government role ought to be to close down nursing homes. If people are put in office contributions, they will be likely to lis ten to their friends."
Yet 30 to 40 per cent of the state nursing homes could be closed if the standards were enforced. The lax enforcement leaves the convalescent homes free to cut corners and ring huge profits at the expense of the elderly and the infirm, who often a deprived of the most basic human services.