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Falling short: 99% of Mississippi nursing homes don’t meet new staffing regs

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Viometrice Simmons remembers when she first fell in love with nursing. She was about 5 years old, sitting on the porch of her childhood home in Murfreesboro, Tennessee, as her aunt picked corn from the garden.

When she heard her great grandmother calling for her aunt from the bedroom, Simmons strode into the room, hopped up on the hospital bed and helped to turn and change the 84-year-old the way she had seen the women in her family do many times.

Forty-seven years later, that’s still the way she operates as a certified nursing assistant in the Mississippi nursing home she serves. 

“When you walk in that door, every resident is your patient,” Simmons said.

Despite her dedication and more than 30 years of experience, she is only making $17 an hour at the nursing home where she currently works. In order to make ends meet, she works two jobs between 6 a.m. and 5 p.m., sometimes working overtime until 10 at night. She says some nights she gets out of work and sits in her car for an hour and a half because she’s too drained to move.

“I feel helpless. I feel exhausted,” she said. “But I know I got to keep going because who else is going to do it? If the people with the hearts give up, there’s going to be no one left for the people in there who are just forgotten about.”

Simmons never considered going back to school to become a registered nurse. What she loves about her job is being a familiar and reliable face for her residents. A CNA is responsible for providing the majority of hands-on resident care, and is often the person a nursing home resident sees the most on any given day.

“I don’t just want to be pushing pills,” Simmons said. “I want to let them talk to me. A lot of the residents tell me things that their families don’t even know about them.”

Poor pay and high turnover are among the reasons Simmons believes new federal staffing requirements in nursing homes will be, in effect, meaningless.

“Where are they going to get the staff from?” Simmons asked. “People are not doing it because they’re underpaid, and they can’t feed their families on that kind of money.”

In Mississippi, all but two of the 200 skilled nursing facilities – those licensed to provide medical care from registered nurses – would need to increase staffing levels under federal regulations the Biden administration proposed in September, according to data analyzed by Mississippi Today, USA TODAY and Big Local News at Stanford University.

That’s in line with the national trend: Over the first quarter of 2023 – from January to March – less than 1% of skilled nursing facilities in the U.S. met the draft rule’s two core standards of provider care.

After signing the executive order in September, Biden accepted public comment through Nov. 6. The Centers for Medicare and Medicaid Services is the agency responsible for reviewing the more than 40,000 comments and writing the final rule – which hasn’t happened yet and can take anywhere from months to years. Sixty days after the final rule is published in the Federal Registrar, the first phase in a staggered implementation process will begin.

Falling Short: Rebuilding elderly care in rural America

Rural nursing homes across the country, already understaffed, face significant new federal staffing requirements. With on-the-ground reporting from INN’s Rural News Network and data analysis assistance from USA TODAY and Big Local News at Stanford University, eight newsrooms explore what the rule change would look like for residents in communities across America. Support from The National Institute for Health Care Management (NIHCM) Foundation made the project possible.

The proposal, which comes at the heels of a years-long battle nursing home lobbyists waged against reform, outlines minimal standards. For example, the draft rule mandates 2.45 hours of CNA care and .55 hours of RN care per resident per day. That’s less than the 2.8 hours and .75 hours recommended by a CMS landmark 2001 study – even though residents’ needs have gotten more complex over the last two decades with more people living longer.

The proposal also mandates having an RN on duty 24-7. Current regulations mandate having 24-7 care, but allow the position to be filled by licensed practical nurses, who are used more frequently because their salaries are lower than those of RNs. The proposal does not have a requirement for LPN care, leaving experts worried nursing homes will simply replace LPNs with other staff.

“The 24-hour staffing requirement is good, as long as they make that in addition to the administrative nurses,” explained gerontologist and national nursing home expert Charlene Harrington. “But the other requirements they propose are just shockingly low. And that’s partly because the nursing homes have been lobbying against these standards for over a year and a half. So, all these advocates and the experts are very upset about it.”

The only two skilled nursing homes in Mississippi already meeting the not-yet imposed standards are Reginald P. White and James T. Champion nursing facilities – sister organizations of East Mississippi State Hospital, one of the state’s two psychiatric hospitals. The two Meridian nursing homes met the staffing minimums every day of the 91-day second quarter of 2023.

These homes receive about 20% of their funding from the state, according to Mississippi Department of Mental Health Planning and Communications Director Adam Moore. That’s in addition to the funding they receive from Medicaid and Medicare, as well as personal insurance and private pay.

Kevin Walker, administrator of Reginald P. White Facility, and Judd Nance, administrator of James T. Champion Facility, were surprised to learn they met the new requirements every day between April and June.

“We probably try to staff a little heavier than most nursing homes do, but we think we’re short all the time,” Nance said.

Having adequate staffing is one of the strongest predictors of whether nursing home residents will do well. And doing well doesn’t just mean the bare minimum of safety.

Any nursing facility participating in Medicaid or Medicare reimbursement is required by law to provide services that “attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident,” as dictated by the Nursing Home Reform Act of 1987.

Richard Mollot, the executive director of Long Term Care Community Coalition – a national nonprofit dedicated to advocating for residents of nursing homes and their families – says that when it comes to laws, the Nursing Home Reform Act is unique because it focuses on the customer – in this case, the resident.

“Most laws focus on the industry itself,” Mollot said. “For instance, all car manufacturers are expected to meet specific miles-per-gallon efficiency or have certain safety features. Nursing homes, on the other hand, are required to provide the staffing, supplies, and services to assure that every resident is able to attain and maintain their highest practicable well-being as an individual, based upon a comprehensive assessment of the person and a care plan that includes not only clinical needs, but the resident’s cultural background, goals, and personal preferences, too.”

Currently, states are in charge of regulating staffing in nursing homes. Some states have no staffing minimums, while the ones that do keep the requirements very low. In Mississippi, regulations require there to be at least a ratio of one CNA for every 15 residents during the day, and 25 residents at night – despite the fact that studies have shown one CNA for every six to eight residents during the day and 11 to 13 at night is optimal. 

Even these suboptimal regulations are rarely enforced, according to Harrington, due in part to a national shortage of inspectors. States are required by the U.S. Department of Health and Human Services to conduct annual surveys and certifications of nursing homes receiving Medicaid and Medicare. In Mississippi, 54% of nursing home state surveyor positions were vacant in 2022, and 44% of the working surveyors had less than two years of experience.

“Enforcement is very weak, especially on staffing,” said Harrington. “We’d like to see CMS really crack down on the nursing homes that don’t have enough staff, and maybe put a hold on admissions until they have enough staff. If they’re not actually able to hire staff they shouldn’t be able to admit patients.”

Negligence that seems minor can compound into serious health issues and death – not to mention it often breaches basic expectations of dignity. Even in rehabilitation centers, where residents should be receiving support for mobility, low staffing can mean they are placed in diapers rather than assisted to bathrooms.

In previous nursing homes, Simmons says she witnessed bathroom requests going unanswered and continent residents being diapered out of convenience.

The results can be devastating. Residents who are confined to bed and unable to go to the bathroom not only suffer low morale, but can also develop concurrent urinary tract infections. In the elderly, these infections can cause delirium and exacerbate dementia. Those who try to get up on their own may suffer falls, broken bones and concussions as a result.

“You see residents with UTIs and falls and stuff because they’re crying out for help to go to the bathroom in the middle of the night and they fall because they have to go to the bathroom and they’re told to go to the bathroom in their briefs,” Simmons said. “Who wants to be sitting somewhere with a wet brief on? It’s humiliating. And it’s unacceptable.”

According to Mollot, it’s a violation of the Nursing Home Reform Act, and one that could be resolved with adequate staffing.

“Nursing homes claim that diapering residents is necessary because they don’t have enough staff to respond to call bells or implement resident-centered toileting practices,” Mollot said. “But if you think about it, that is pretty outrageous. In effect, facilities are admitting that they are taking in and retaining vulnerable human beings for whom they have neither the ability nor intention of providing decent care. Why do we accept the warehousing of millions of vulnerable Americans every year?”

Simmons says she has been let go twice, in two different states, shortly after filing incident reports to Occupational Safety and Health Administration and to the staffing agency she was contracted with.

But Simmons is resolved to continue advocating for the residents she serves and hopes that in time, higher pay and more stringent regulations will lead to better working environments for staff and quality of life for residents in nursing homes.

“I don’t care if they fire me from every job,” she said. “When I know something is not right, I’m going to stand up for it. And can’t nobody stop me from doing that.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

On this day in 1954

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mississippitoday.org – Jerry Mitchell – 2024-12-28 07:00:00

Dec. 28, 1954

Publicity photograph of Denzel Washington Credit: Paramount Pictures, photo by Mark Seliger

Two-time Oscar winner Denzel Washington was born in Mount Vernon, New York, the son of a beautician and Pentecostal preacher. 

Washington planned on pursuing a career in journalism, but while at Fordham University, he appeared in several student drama productions and became obsessed with acting. 

After his first paying gig in a summer stock theater production in Maryland, he began to pursue television and movie roles. He made his first big screen appearance in the 1981 film, “Carbon Copy,” and a year later won the role of Dr. Philip Chandler in NBC’s hit medical series “St. Elsewhere.” 

Washington continued to make films, including the 1984 film, “A Soldier’s Story,” where he drew critical notice for his performance. Five years later, he won an Academy Award for Best Supporting Actor for his work in the 1989 film “Glory” and later won for Best Actor in the 2001 film “Training Day.” 

In 2016, the Golden Globes honored him with the Cecil B. DeMille Lifetime Achievement Award, and three years later, the American Film Institute bestowed its Life Achievement Award. In 2022, he received the Presidential Medal of Freedom.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

More allegations of sexual abuse emerge against ex-counselor

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mississippitoday.org – Jerry Mitchell – 2024-12-27 12:00:00

Another client of former licensed professional counselor Wade Wicht is accusing him of sexual abuse, joining two other women who have already filed criminal complaints with Hattiesburg police. 

“Wade saved my life,” she said, “but he also betrayed me.”

Wicht’s lawyer, Michael Reed of Hattiesburg, did not respond to requests for responses regarding the women’s accusations. The Hattiesburg police continue to investigate the complaints and have declined to comment.

Police are also investigating a third criminal complaint filed against Wicht. The Mississippi Child Protective Services has previously investigated the matter.

“My understanding is the allegations reported to CPS were unsubstantiated,” Reed said. “Of course, Mr. Wicht wholeheartedly denies the allegations.”

‘Real love doesn’t do that’

In a sworn statement, a woman, who asked not to be named for fear of retribution, said Wicht sexually abused her during the time he counseled her.

The young woman went to him in 2016 because she was still reeling from a 28-year-old man sexually abusing her when she was 8. “I was the kid who took a shower with my underwear on,” she said.

Wicht’s counseling helped her immensely, but some of the things he did also disturbed her, she said. He once asked if she looked at child porn and when she angrily replied no, she said he asked, “Why are you reacting like that?”

Wade Wicht Credit: Courtesy of Ramona Wicht

While she was still counseling with Wicht, she called him drunk, she said. “I’m out in the woods. I’m bawling. I’m mad at God.”

He drove to where she was, took her home and insisted she head to the bathroom, she said, but when she did go, he refused to leave the bathroom while she urinated.

He encouraged her to sleep on her parents’ couch, rather than her bedroom, and after she closed her eyes to sleep, she said she felt his hand go down into her jogging pants and underneath her panties.

When she objected, she said he pulled his hand back out and said, “Oh, it’s OK. It’s OK.”

Earlier this year, she said she confronted Wicht about that night, and he said nothing in response.

She had confronted him before, she said, accusing him of being a sex addict. “Your mind is sick, and your heart is seared,” she quoted herself as saying. “You can’t work multiple women over at the same time and call it love. Real love doesn’t do that. You have confused love with something else.”

In response, he wept and spoke of being truly sorry and changed by God, she said.

Artwork by a woman who alleges she was sexually assaulted by longtime counselor Wade Wicht.

She credited God, journaling, counseling from others, expressing her feelings through art and distance from Wicht with helping her heal. “There would have been no healing if God hadn’t given me the courage to go to counseling,” she said. “My faith is central to who I am.”

Unlike the other women, she has no plans to file a criminal complaint against Wicht because she doesn’t want to go through the same agony she did in testifying against her 28-year-old abuser. She said Wicht’s sexual abuse of her could only be prosecuted as a misdemeanor because Mississippi law requires penetration in order to be classified as a felony.

Her past made her an easy target

Jenny Green is going public with what she said Wicht did to her during counseling sessions.

“He’s a free man, and nothing has happened to him,” said Green, who has filed a criminal complaint with Hattiesburg police. “I want to do all I can to help make sure he can’t do anything like that again.”

Her past made her an easy target, she said, because she had been sexually abused as a minor.

A 17-year-old tomboy who bloomed late, she had few friends, she said.

Then a teacher began to stalk her, praised her looks and intelligence, and listened to her share how the only boyfriend she ever had left her for someone else, she said. “He saw someone in a fragile place and pounced.”

At night, he would call and converse, she said, and the words he shared helped fill the emptiness she felt.

One night after returning to school from a track meet, she said the teacher plied her and a girlfriend with wine coolers. It was the first alcohol she had ever had, and she became drunk, she said.

The next thing she knew she was in a bedroom, and he was on top of her, she said. “I was a virgin.”

Afterward, she said, “I asked him, ‘Did we just have sex?’ I was clueless.”

According to the Centers for Disease Control and Prevention, at least 1 in 4 girls in the U.S. are victims of sexual assault.

Like a number of other victims, Green suffered disassociation, she said. “It was almost like I wasn’t in my own body. I didn’t feel like I was there.”

Such disassociation is the brain’s way of placing distance between the victim and the traumatic event, scientists say.

She later wrote poems about what happened.

Keep quiet 

Don’t cry 

We can pretend it didn’t. 

We can lie. 

Her teacher told her she must never breathe a word about this, and if she did, he would kill himself. She said she believed him.

Your body

It is like none other.

It’s beautiful,

But you must never tell your mother.

Each school day, she sat in his class, and when he gazed at her, guilt and shame washed over her , she said. “I thought what the teacher did was my fault.”

Unable to sleep, she finally woke her mother to tell her what happened. “I didn’t know how to say, ‘My teacher raped me,’” she said. “I didn’t have the verbiage.”

For the first time in her life, she visited a gynecologist, who determined she wasn’t pregnant. 

When her family decided against pursuing charges, she blamed herself. “I was told to never talk about it,” she said, “and for 20 years, I didn’t.”

Marriage counseling gone wrong

Jenny Green is waiting for prosecutors to decide if they will pursue her criminal complaint against longtime counselor Wade Wicht, accusing him of sexually abusing her during a counseling session. Credit: Jerry Mitchell/Mississippi Today

In April 2021, Green and her husband walked into Wade Wicht’s office. 

She had been pushing for marriage counseling, and Wicht was the only counselor her husband would see.

What the couple didn’t know was that Wicht had already had sex with a client, according to an order from the State Board of Examiners for Licensed Professional Counselors, which oversees and licenses counselors.

After a few sessions, Wicht suggested separate counseling sessions, she said. Her husband’s sessions lasted 40 minutes or so; hers lasted up to two hours.

In a separate session with Wicht, she said she confessed her nervousness in talking about private matters and joked about needing a drink. She said he poured drinks for both of them — a habit he continued at times.

He steered conversations to the sexual, discussing the size of her breasts and asking if she had implants, she said. When she came to one counseling session after a workout, he questioned why she had a jacket tied around her waist, she said.

“Covering up a little bit,” she replied.

“Why are you doing that?” she recalled him asking.

Another time, she said he told her, “You need to be careful where your gaze goes. You stare at my crotch.” 

His words mortified her, she said, because it was a ridiculous lie.

After each session, he tried to hug her, and she recoiled. “He said I needed to be comfortable hugging,” she said. “He said I was stiff and uncomfortable.”

When she showed up one day with coffee, he told her to get him a coffee next time. “He mentioned that again and again,” she said. “I realize now he was seeing what he could get me to do.

“He eventually did get me to bring him a coffee. He did eventually get me to hug him.”

She said this was reminiscent of what her teacher did, getting her to bring him a Snickers candy bar and a Coke during each break.

The torment exhausting

The self-doubt to no end

The shame a coat of many colors

The secrets all held within.

‘It devastated me’

In October 2021, when her husband talked of possible harm to himself or others, Green said she felt scared and hopeless. She called Wicht’s office, and he rushed to their house.

After that, her trust and dependence on the counselor “went through the roof,” she said.

In her sessions, she said she confessed to Wicht that she was experiencing some transference, that is, redirecting her feelings from her husband to him.

He responded this could be beneficial for her therapy, she said. “Instead of passing me off to someone else, he used that to his advantage.”

The hugging progressed, she said. He began to hug her from behind and tell her it was therapeutic, she said.

He also put his hand on her knee and told her she needed to learn to say no, and in each session that followed, he touched her knee higher, she said. “Every time he touched me, I froze. I didn’t give consent.”

Studies show that many victims of sexual abuse or assault report “freezing.” That’s because fear can block the neural circuits that signal the body to move, scientists say.

Green said Wicht urged her to quit initiating sex with her husband and falsely claimed she suffered from sex addiction. “It devastated me,” she said.

When Wicht suggested she spend weeks at a treatment center, she said she balked, saying she couldn’t leave her husband and children.

He offered an alternative approach. He said he was a certified sex therapist, and she could do that therapy with him, she said.

In his 2018 letter to the licensing board, Wicht listed Chemical and Process Addictions as an area of certification, but not sex therapy.

Green said Wicht asked her to share intimate details about her past abuse, including whether she bled, she said.

When she wouldn’t share details about what she liked sexually, he urged her to masturbate so he could observe, she told police in her complaint. She refused.

Lie to myself or subconscious 

Should I say?

Lie like a good girl.

Be the perfect prey.

‘I became a scared little girl’

Four days after Christmas, Green suffered a meltdown. Three family members suffered from serious illness, and memories of her teacher’s abuse haunted her, she said. “I was crying uncontrollably.”

In desperation, she telephoned Wicht, who called her to his office.

This time, when he hugged her from behind, he began to caress her breasts over her clothing, she said. “He said, ‘This is loving touch,’ and I’m just sobbing.”

She continued to reel from depression. In a March 2022 session, she said he asked her to remove her clothes. She had refused to do this before, but this time she said she broke down and gave in, crying the whole time.

The commands he gave her echoed some of the same commands she had been given as a child, she said. “That day at the office, I became a scared little girl. I had no choice but to be compliant. I was the perfect prey.”

Wicht made her put a blindfold on, made her lie on her stomach and spread her bottom cheeks, and “he proceeded to penetrate me with his fingers,” she told police. When he finished, “he held me and acted as if it had been a caring moment,” she told police. “That was the last time he touched me.”

She froze, just as she had before, she said.

One study showed that 70% of 298 women who came to a rape clinic for treatment reported “paralysis” or an inability to resist during the assault.

Throughout Wicht’s abuse, Green told police, “He would remind me I could never in my life breathe a word of it. Said someone could die or be killed if I did. This was triggering as my abuser from teen years threatened to kill himself if I told anyone.”

After this abuse, she said thoughts of self-harm flooded her mind. She posted the suicide prevention hotline number on her wall, and sometimes slept in the closet.

The stillness. The peace.

The madness. The dire.

When will it end?

I long to expire.

After the alleged abuse, Green sought treatment from another therapist, whom she said helped rescue her from her despair.

She has since spoken to other of Wicht’s alleged victims, some of whom have yet to file complaints, she said. “He convinced women that they’re damaged, and you’re going to be beholden to him so that you don’t tell anybody,” she said.

Counselors have power over their clients, she said. They can groom, lie, manipulate and coerce those they treat into obeying their commands because “we believe we must do as we are told,” she said. 

It’s bad enough for a trusted person to exploit you, but when it’s a counselor, who knows so many intimate details about your life, she said, “It rapes every part of your soul and mind.”

How sick 

And how twisted and who

The f— let that happen? 

Keep quiet 

Don’t cry 

We can pretend it didn’t. 

We can lie. 

‘The law protects the guilty’

Wicht has already admitted to having sex with two women he counseled, a violation of the ethical code that prompted the loss of his counseling license. 

One of those was Kimberly Cuellar, who has filed a criminal complaint against Wicht. She told police that in one counseling session, he had her lay on the floor, pulled down her pants and digitally penetrated her without her consent, claiming it was for his research. She said he continued to touch her sexually in sessions, claiming it was therapeutic.

Kimberly Cuellar says her journey dealing with Wade Wicht has taught her, more than ever, about God’s amazing grace. Credit: Jerry Mitchell/Mississippi Today

In addition to those allegations, she said he tried to rape her while she was sleeping in her parents’ home in 2023. She said she awoke to him on top of her. “You moved my shorts, and you absolutely tried to get inside me,” she wrote in text exchanges she shared with Mississippi Today.

“Omgoodness, what??!! … What you’re accusing me of is criminal, Kimberly! … I touched you with my fingers, and I was touching myself,” he responded. “I was NOT trying to have sex with you while you were sleeping.”

She told him “no” multiple times, but he refused to stop, she wrote. “You then touched me without consent while you ejaculated on my body after all the no’s I had given. Attempted rape? Absolutely.”

In April, another licensed professional counselor in Mississippi, Dr. Philip Raymond Baquie of Oxford, surrendered his license after he admitted having sex with a female client during a counseling session in December 2023.

More than half the states consider sex between mental health professionals and their patients a crime. Mississippi isn’t one of those states.

In 2023, the Mississippi House passed a bill that would have made it a crime for therapists, clergy, doctors and nurses to have sexual contact with those they treat or counsel.

But the bill died in the Senate Judiciary B Committee after some senators questioned the need for a law. Committee Chairman Joey Fillingane has said if something like this happens in a church-affiliated organization, the church can fire that person.

Brad Eubank, a pastor for First Baptist Church in Petal who serves on the Southern Baptist Convention’s sex abuse task force, said firing those guilty of sexual abuse isn’t enough.

“We must stop this scourge of sexual abuse and put a stop to any counselor, medical professional, social worker or clergy who would take advantage of an individual who finds themselves in a vulnerable state seeking help,” said Eubank, a victim of sexual abuse himself. “We need clear laws with stiff penalties to be a severe deterrent to stop this from ever happening as well as providing justice for those victims when it does happen.”

Green said she’s willing to testify to lawmakers to let them know that when counselors use their power to sexually abuse their clients, they deserve to be punished.

Because there is no videotaping of sessions, the counselor’s office provides “the perfect setting for that crime,” she said. “That’s why there needs to be protection.”

This crime damages victims for life, she said. “Sexual abuse distorts, if not destroys, the victims’ ability to express romantic love in a healthy way. Stealing that part of us should not go without consequences.”

Under Mississippi’s current statute, “the law protects the guilty,” she said. “We as sexual abuse victims don’t stand a chance.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

On this day in 1919

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mississippitoday.org – Jerry Mitchell – 2024-12-27 07:00:00

Dec. 27, 1919

Dec. 28, 1919, article in the Lincoln County News in North Carolina

Black World War I veteran Powell Green was lynched by a mob of white men near Franklinton, North Carolina. 

Many returning Black soldiers, who wanted their full rights as citizens, became targets of violence. Green was arrested for allegedly killing a “prominent” white movie theater owner, but he was never able to defend himself in a court of law. A mob of masked white men abducted him as while officers were transporting the 23-year-old from the jail in Franklinton to the jail in Raleigh. 

During that kidnapping, Green broke free from the mob, but they managed to overtake him and tied him to a car, and he was dragged for at least a half mile before they shot him and hung him. 

In the days that followed, crowds flocked to the site of his lynching. According to press accounts, “souvenir hunters” cut buttons and pieces of clothing from the body and later cut down the tree for more keepsakes. One news account seemed to suggest Green was to blame for his death, saying that he “was disposed to think well of himself and was self-assertive.” 

No one was ever prosecuted for his killing, one of at least 80 lynchings that took place in 1919.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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