ST. PAUL-A Minnesota woman is back for her second stint as state health commissioner with instructions to fix the state's failed nursing home abuse investigation process.

Gov. Mark Dayton on Tuesday, Jan. 30, appointed Jan Malcolm to lead the Health Department as it struggles to get through a backlog of complaints about mistreatment of Minnesota elderly in nursing homes and assisted living facilities.

Malcolm, who served in the job about 19 years ago for then-Gov. Jesse Ventura, said her first duty is to "learn more about the root causes" of the backlog, but promised to catch up on long-ignored complaints.

A report released by AARP says that complaints of elder maltreatment soared 600 percent since 2010, but the department only investigated 1 percent of 20,791 reports from health care providers and just 10 percent of 3,491 complaints from individuals.

Malcolm said the good news is that the department has triaged the complaints and that about 1,000 still "need more work." She said she is committed to investigating all backed-up cases by end end of 2018.

The cases began to pile up while Dr. Ed Ehlinger was commissioner; he resigned late last year.

While the Health Department should have done better, Dayton said, the initial care authority lies elsewhere. "The responsibility first and foremost begins with those facilities."

After the elder abuse topic arose last year, Dayton asked AARP to convene a working group to investigate. It released its report late Monday. The governor also brought in the state Human Services Department to help the Health Department fix its problems.

The report called for "far-reaching policy and agency practice changes to prevent and deter abuse. The recommendations reflect the experiences of our organizations and a belief that older and vulnerable adults and their families should be at the center of any reform."

The report indicates that it is important to fix the problem now because the elderly population will continue to grow.

Among the working group's recommendations are:

• Expand the rights of elderly and vulnerable adults and their families.

• Senior citizens and their families should have more access to abuse reports.

• Stronger laws against nursing home and assisted living retaliation against people who report abuse.

• More legal penalties against elderly abuse.

• State licenses should be required for assisted living and dementia care facilities, like many other states already do.

• Existing laws and rules need to be better enforced, including the use of fines.

"Minnesotans deserve a system that provides optimal care and services, and maximum protection against abuse," the report says. "Elder abuse is not an inevitable consequence of the system."

Malcolm said the state is developing a better program to deal with abuse complaints, one that will prevent a backlog such as was discovered last year.

Malcolm, who has been a nonprofit health care executive, also promised that the state would do a better job of communicating with families.

The Minneapolis-based Star Tribune reported last fall that hundreds of residents at elderly care facilities in all areas of the state are beaten, sexually abused or robbed every year. Even when reports were filed with the state, investigations often were not started.

"First and foremost, I am so sorry for the pain and trauma and difficulties that have been caused," Malcolm said Tuesday.

Sen. Karin Housley, the Minnesota Senate aging committee chairwoman, said she will introduce legislation to help fix the problem after the Legislature convenes Feb. 20. "My priority will be on creating a more transparent, accountable process for facility complaints, providing better access to data sharing for families and caregivers and working to change the culture of neglect and intimidation within the state bureaucracy."