South Carolina Nursing Home Blog : South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

Pittsburg Tribune Review had an article discussing the failures of Pittsburgh's nursing homes.   The article mentions several examples such as one resident cried out for water before going to the hospital with dehydration; another broke an eye socket when a wheelchair rolled down a ramp and crashed; a patient died when workers improperly adjusted a breathing tube; two were so malnourished that they weighed less than 80 pounds each;  a resident did not get a hair wash for nearly four weeks;  and another was told to "go in your pants" when requesting help with going to the bathroom.   These are common complaints at all nursing homes around the country due to understaffing, burn-out, and lack of training.

Those cases and more were drawn from a Tribune-Review analysis of state surveys conducted at 118 nursing homes in Western Pennsylvania over the past three years.  Inspectors cited homes for 3,798 deficiencies, and in 33 cases, found serious lapses posing "actual harm" or "immediate jeopardy," under federal definition.  Among the deficiencies, inspectors noted hundreds of incidents that caused pain or discomfort for nursing-home residents. Those violations have the "potential for more than minimal harm." They include failures to treat skin ulcers or to help patients eat when they can't feed themselves.  Most often, problems related to quality of care or unsanitary conditions.

Rosalie Kane, a professor of public health at the University of Minnesota, said that the quality of life for nursing-home residents has not improved — even if surveys don't find as many alarming violations.  "Those surveys don't make nursing homes better over time," Kane said. "They just represent the lowest common denominator keyed to issues that are considered unacceptable."

The Trib's review followed the November arrests of five employees at Kane Regional Center in Glen Hazel, who were charged with abusing and tormenting a 94-year-old Alzheimer's patient. More than 2,800 complaints of abuse or neglect of nursing home patients are substantiated each year, according to the inspector general for the Department of Health and Human Services.

Nursing homes do not spend enough money on staffing required to ensure adequate care.  Nursing home staff members decide whether residents' preferences are met. Too much of nursing home operations revolve around what's convenient for staff, not patients.

Nursing home staff and inspectors should ask residents whether they participate in meaningful activities, whether they have opportunity to have private conversations, and what they like or don't like about the food.

Under federal law, state health inspectors must survey nursing homes at least once every 15 months and whenever they receive a complaint. Often, homes are cited for a serious deficiency only after a patient is seriously harmed.

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Worcester Telegram & Gazette News had a great article discussing the deficiencies in nursing homes in Massachusetts although this article could have been written about any state.  

The article states that local nursing homes have been reprimanded in recent years for physical and sexual abuse, neglect and other serious mistreatment of elderly residents, according to state reports.   The deficiencies range from minor to serious including cold food to filthy bathrooms to violations of patient rights, medication errors and preventable falls in at least three patient deaths over the last three years.

A Telegram & Gazette review and analysis of hundreds of pages of state and federal inspection reports on the region’s nursing homes as well as summaries of state investigations prompted by patient and family complaints found:

• The state Department of Public Health rated 14 area nursing homes — more than 20 percent of the region’s 62 facilities — among the worst in the state as of November. Three of those were rated in the bottom 4 percent statewide, and four others in the bottom 6 percent.

• Federal regulators have fined 21 area nursing homes a total of more than $150,000 for serious and repeated violations of Medicaid regulations since 2005.

• The quality of local nursing homes varies widely from several that scored perfect or nearly so in state inspections to a handful of problem facilities whose scores are among the lowest in the region and that have been investigated repeatedly. The latter often were cited for poor care, in response to complaints from patients and their families.

• Among those complaints, state inspectors validated at least five local cases of physical abuse and 10 cases of neglect over the last three years.

Among the scores of complaints lodged against area nursing homes and substantiated by state investigators were a number of claims of physical abuse.

Radius Healthcare of Southbridge, a for-profit nursing home licensed for 144 beds, was cited for physical abuse of residents in February 2006 and again in December 2006, according to investigation summaries. Third and fourth complaints of physical abuse in April and October were also investigated.

During an annual inspection in February 2008, the state surveyor reported residents whose wheelchairs would not fit under dining room tables, forcing the elderly patients to hold drinks and food in shaking hands for long periods. One resident of the nursing home also went more than eight months without seeing the facility doctor, according to the inspection report.

Medicaid reimburses nursing homes an average of $180 a day per patient in Massachusetts.  The state nursing home trade association puts the average retail price of care for those paying out of pocket at $270 a day, or more than $98,000 a year.

An advocacy group pushing for higher-quality nursing home care in the state, Massachusetts Advocates for Nursing Home Reform, maintains that a complete overhaul of the system is needed. The group is calling on the industry to move away from what it calls a “hospital-like model.”

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 IQ Nursing Homes in a recent press release announced that it is now offering a national database of nursing home and elder care facility deficiency and inspection rankings. Careful research is imperative to ensure that the nursing home to which you entrust your loved one’s care is reputable and safe. Whether you are currently researching nursing homes for yourself or a loved one, or you want to investigate the facility where a loved one is currently residing, this free resource will be useful and informative.

The data in these reports is obtained from the Centers for Medicare & Medicaid Services (CMS). CMS conducts nursing home inspections in order to determine whether facilities meet the minimum Medicare and Medicaid quality and performance standards. You can review the ratings for any one of the more than 25 deficiency types, such as mistreatment, resident rights, quality care, and building construction. Then, narrow your search by state, and finally, by each individual nursing home.

Nursing home abuse is a widespread problem that can result in serious injury, disease, and death for nursing home residents. The elderly are vulnerable to becoming victims of abuse, especially when physical or cognitive issues affect their ability to communicate the abuse they are suffering to others. Neglect, physical abuse, emotional abuse, and sexual abuse can occur when nursing homes are understaffed, caregivers are insufficiently trained, or nursing homes fail to properly screen employees prior to hiring them.

Visit http://www.iqnursinghomes.com/ to review the database of nursing home deficiency and inspection rankings. You can also find a national nursing home directory, up-to-date nursing home news, and information about signs of elder abuse and nursing home neglect on this site. IQ Nursing Homes offers a free nursing home abuse claim form, which will be reviewed by a qualified nursing home attorney within 36 hours. Nursing home employees who have witnessed neglect can report it anonymously.

About IQ Nursing Homes

IQ Nursing Homes has partnered with nursing home lawyers and nursing home negligence law firms throughout the country with the goal of putting a stop to the victimization of the elderly. By holding negligent staff members accountable for their actions and making it financially devastating for nursing homes to allow neglect to occur, this pattern of nursing home neglect can be put to an end.

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A recent Cornell University study reports aggression is commonplace in nursing homes--between residents themselves and between residents and employees of the nursing home.  Verbal and physical abuse is more common than the industry acknowledges. In an online report with McKnight’s Long Term Care News, the study documents many observations made at a city-based nursing home which found at least 35 different types of abuse, with screaming being the most popular. Physical violence included pushing, punching, and fighting.

The report also referenced another two-week study wherein researchers found that 2.4 percent of nursing home residents have been victims of physical aggression; 7.3 percent claimed they were verbally abused. A third report discussed an investigation in which 12 nurse observers found 30 incidents of aggression between residents in one eight-hour shift. Victims were most commonly male and often had “wandering cognitive processing problems.”

A report released earlier this year by the Congressional Government Accountability Office (GAO) revealed a widespread “understatement of deficiencies,” that included malnutrition, severe bedsores, overuse of prescription medications, and nursing home resident abuse in the nation’s nursing home inspection reports. The report stated that nursing home inspectors routinely ignore or minimize problems that pose serious, immediate patient threats.

Facilities are generally only inspected once a year by overworked and underpaid state employees. Federal officials sometimes attempt to validate state inspector work by joining them on visits or conducting follow-ups. It was in a follow-up that the GAO discovered the state missed at least one serious deficiency in 15 percent of all inspections. Worse, in nine states, inspectors missed serious problems in over 25 percent from 2002 to 2007.

There are 16,400 nursing homes with over 1.5 million residents nationwide; approximately one-fifth of the homes were cited for serious deficiencies last year. “Poor quality of care—worsening pressure sores or untreated weight loss—in a small, but unacceptably high number of nursing homes, continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury,” the report said. Taxpayers spend about $72.5 billion annually to subsidize nursing home care and facilities must meet federal standards to participate in Medicaid and Medicare, which covers over two-thirds of its residents, at a cost of over $75 billion annually.

Unfortunately, nursing home abuse tends to be underreported because individual homes do not take elder abuse seriously and residents fear embarrassment, injury, even incapacitation for speaking up.

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