Case: DOJ CRIPA Investigation of the Reginald P. White Nursing Facility, MS

3:04-cv-00933 | U.S. District Court for the Southern District of Mississippi

Filed Date: Nov. 16, 2004

Closed Date: Feb. 24, 2010

Clearinghouse coding complete

Case Summary

Pursuant to the Civil Rights of Institutionalized Persons Act ("CRIPA"), 42 U.S.C. § 1997, the Civil Rights Division of the U.S. Department of Justice ("DOJ") conducted an investigation of conditions at the Reginald P. White Nursing Facility ("RWNF"), a public nursing home facility in Mississippi, evidently operated by one of the state's counties. The investigation resulted in a findings letter being sent to the governor of Mississippi on May 20, 2003. The letter stated that in August 2002, D…

Pursuant to the Civil Rights of Institutionalized Persons Act ("CRIPA"), 42 U.S.C. § 1997, the Civil Rights Division of the U.S. Department of Justice ("DOJ") conducted an investigation of conditions at the Reginald P. White Nursing Facility ("RWNF"), a public nursing home facility in Mississippi, evidently operated by one of the state's counties. The investigation resulted in a findings letter being sent to the governor of Mississippi on May 20, 2003. The letter stated that in August 2002, DOJ and its expert consultants completed a visit to the facility, where they had interviewed administrators, residents and staff, and reviewed policies, procedures, medical charts and records. After noting several positive aspects of the care provided at RWNF, the letter advised that the DOJ's investigation led it to conclude that certain conditions at RWNF violated residents' federal constitutional and statutory rights.

According to the DOJ's findings letter, residents at RWNF suffered from the facility's "serious deficiencies" in (1) nursing and physician medical care, (2) mental health care, (3) discharge planning, and (4) staff training and oversight. For each of these categories, the letter provided examples of the shortcomings observed by the investigation.

Medical care shortcomings existed in assessment and treatment planning (including inadequate protocols for medical complications and no written protocol for resident pain management; failure to re-assess residents following acute changes in physical or mental status or after repeated falls or accidents; inadequate assessments for those needing restorative care or supervision to preclude elopement; and insufficient involvement of physicians in treatment planning), in mechanical restraint use without adequate assessments or consideration of alternatives, in deficient mealtime practices, and in substandard provision of restorative care and therapeutic activities.

Deficient mental health care treatment resulted from RWNF's system of providing mental health care through inappropriate use of multiple medications (polypharmacy), excessive reliance on psychotropic medications (chemical restraints), inadequate monitoring of medication side effects, and deficiencies with mental health assessments and treatment planning.

Systemic weaknesses in resident treatment planning and facility end-of-life practices resulted in unnecessarily restrictive and segregated living conditions for some RWNF residents, according to the DOJ findings letter. This constituted a failure to serve persons in the most integrated setting appropriate to their individual needs.

The investigators also found that nursing and direct care staff would benefit from improved training on behavioral interventions for aggressive or agitated resident behavior, on restraint use, psychosocial planning, restorative care concepts, and the role of an interdisciplinary treatment team. Additionally, the letter stated that the physician staff would benefit from training on their obligations under federal nursing home law and generally accepted professional geriatric standards. Weak staff oversight and quality assurance practices, an absence of review and careful periodic evaluation of physician and psychiatric care, and failure to track or trend patterns of abuse and injury constituted further systemic problems at RWNF.

The DOJ findings letter proposed remedial actions to remedy the deficiencies, invited the state to address the issues, and alerted the state to the possibility of a CRIPA lawsuit brought by the United States to compel remedial action.

We have no post-findings letter information about this matter.

Summary Authors

Mike Fagan (6/20/2008)

People


Judge(s)

Barbour, William Henry Jr. (Mississippi)

Attorney for Plaintiff

Acosta, R. Alexander (District of Columbia)

Ashcroft, John (District of Columbia)

Boyd, Ralph F. Jr. (District of Columbia)

Brown Cutlar, Shanetta Y. (District of Columbia)

Attorney for Defendant

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Documents in the Clearinghouse

Document

3:04-cv-00933

Docket [PACER]

U.S. v. State of Mississippi

Feb. 24, 2010

Feb. 24, 2010

Docket

RE: CRIPA Investigation of the Reginald P. White Nursing Facility, MS

No Court

May 20, 2003

May 20, 2003

Findings Letter/Report

3:04-cv-00933

Agreement

United States of America v. State of Mississippi

Nov. 15, 2004

Nov. 15, 2004

Settlement Agreement
1

3:04-cv-00933

Complaint

United States of America v. State of Mississippi

Nov. 16, 2004

Nov. 16, 2004

Complaint

Docket

Last updated March 29, 2023, 3:46 p.m.

Docket sheet not available via the Clearinghouse.

Case Details

State / Territory: Mississippi

Case Type(s):

Nursing Home Conditions

Key Dates

Filing Date: Nov. 16, 2004

Closing Date: Feb. 24, 2010

Case Ongoing: No

Plaintiffs

Plaintiff Description:

U.S. Department of Justice

Plaintiff Type(s):

U.S. Dept of Justice plaintiff

Attorney Organizations:

U.S. Dept. of Justice Civil Rights Division

Public Interest Lawyer: Yes

Filed Pro Se: No

Class Action Sought: No

Class Action Outcome: Not sought

Defendants

State of Mississippi, State

Case Details

Causes of Action:

Civil Rights of Institutionalized Persons Act (CRIPA), 42 U.S.C. § 1997 et seq.

Special Case Type(s):

Out-of-court

Available Documents:

None of the above

Outcome

Prevailing Party: Unknown

Nature of Relief:

Unknown

Source of Relief:

Unknown

Issues

General:

Food service / nutrition / hydration

Individualized planning

Reassessment and care planning

Restraints : chemical

Restraints : physical

Staff (number, training, qualifications, wages)

Disability and Disability Rights:

Integrated setting

Medical/Mental Health:

Bed care (including sores)

Medical care, general

Medication, administration of

Mental health care, general

Wound care

Type of Facility:

Government-run