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Articles Tagged with nursing home neglect

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nursing homes are facing staff shortage putting at risk residentsAmidst growing concerns about the quality of care in nursing homes, the Centers for Medicare & Medicaid Services (CMS) recently introduced proposed guidelines aimed at improving staffing levels. However, a new estimate by the Kaiser Family Foundation (KFF) has revealed that a staggering 81% of nursing home facilities nationwide, and a staggering 90% of for-profit facilities, would need to hire additional registered nurses (RNs) or nurse aides to meet these standards.

Under the proposed rule, nursing homes would be required to maintain a minimum of 0.55 RN and 2.45 nurse aide hours per resident day, along with having an RN available on staff 24/7. This rule is a response to long-standing concerns about inadequate staffing negatively affecting the care provided to nursing home residents.

Predictably, industry leaders have voiced their reservations about this proposal, arguing that a nationwide nursing shortage makes it nearly impossible for facilities to meet these staffing targets. The effects of the COVID-19 pandemic have further exacerbated this issue, with many workers leaving their positions due to burnout, low wages, and the intense stress associated with caring for vulnerable populations during a public health crisis.

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nursing home patients are more than ever at risk of neglect and abuseConditions at for-profit nursing homes worsened during the pandemic and patients suffered from it according to a recent report by by the House of Representatives’ Select Subcommittee on the Coronavirus Crisis.

The Subcommittee looked at 5 for-profit chains that operate around 850 nursing homes with a total of 80,000 residents during the first months of the pandemic. According to the report these corporates are structured in an opaque way that allow them to shed responsibilities and protect themselves from being accountable for patient neglect or abuse.

The House of Representatives’ Select Subcommittee on the Coronavirus Crisis found that work conditions were horrendous for the personal at these nursing homes with on average one nurse having to care for 30 patients. As a result, patients waited for hours, sometimes days for basic care. The report highlights a case of a patient who vomited on herself and was cleaned two days later or another patient who had to wait for hours just to get water.  Staff not only were forced to share personal protection equipment because of shortage but also pressured and threatened to work even though they were sick with Covid19. As a result, infection spread faster among already weak residents and staff. So far it is estimated that 160,000 nursing home residents and 2,600 nursing home workers died from Covid19.

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food-safety“Unsafe food handling” was the third most common citation for American nursing homes in 2018 behind “lack of infection prevention and control” and “accidents related to  hazards, lack of supervision or devices” according to data from the from the Center for Medicare & Medicaid Services. From 1998 to 2017, The Center for Disease Control recorded 230 food outbreaks in nursing homes resulting in 54 deaths, 532 hospitalizations and 7648 sickened residents.

33 % of all nursing homes in the nation were cited for food safety violations last year.  Among them, the nation largest chain of nursing homes, Genesis Healthcare had 47% of its nursing homes cited for food safety violations. The chain owns around 400 nursing homes in 27 states.

Unsafe food handling incidents reported at nursing homes all over the country recently included hundred of mouse droppings on the hood of the stove, flies in under-cooked hamburgers, moldy ice machines, mysterious debris in meat slicer and of course numerous complaints of cockroaches invasions and employees not washing their hands before handling food. These unhealthy conditions can potentially sickened and killed fragile nursing home residents.

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VA nursing homeFor years, the VA has been hiding statistics on the quality of care at its nursing homes because it didn’t want the public to know how bad it was. Recently, pressed by the Boston Globe and US Today the VA finally made its data public and it is scary.

Among the 133 VA nursing homes located all over the US, 60 (almost half of them) received one star out of  five for their quality of care. Pennsylvania has five of these facilities. Texas and California both have four of them. Only two facilities received five stars: Castle Point, NY and Carrollton, GA.

Families had no access to nursing home ranking and information

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Elder Justice LeagueElder abuse or elder mistreatment happens anytime a caregiver or a supposedly trusted person (in a nursing home or at home) intentionally causes physical, emotional or financial arm to a vulnerable elder. It is very difficult to determine the extent of this problem as often elders will not or are unable to complain. However as the elder population is growing so does the number of  instances of abuse. A few years ago The “New York State Elder Abuse Prevalence Study” established that  for one case of abuse known to agencies 24 were unknown.

In order to better fight this growing issue, elder justice advocates representing 11 organizations have joined forces together and created the “The Elder Justice League”. Supported by the National Center on Elder Abuse, “The Elder Justice League” wants to raise awareness of elder abuse through social media.  The NYC Elder Abuse Center is part of this league and you can learn more about it on their website.

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luxury nursing home roomMany nursing homes have attractive lobbies and enticing amenities but neglect to provide medical care to their patients.  Geriatric researchers call this disconnect “the chandelier effect”. Because short term medicare patients are much more lucrative than long term medicaid patients, nursing home are investing in luxurious facilities but most often neglect medical care. Very often these luxurious facilities are understaffed in nurses and aids and do not have doctors on staff that can provide the intensive care that rehabilitation requires.

In an excellent article Katie Thomas from the New York Times describes how some patients who were promised amazing care ended back in the hospital with infections and bedsores. Katie Thomas also denounced how this race for profitability is marginalizing long term medicaid patients with extensive medical needs.

In New York for example, the Medford Multicare Center for living on Long Island recently open the “LUX” wing for short term rehabilitation with all kind of bells and whistles to lure patients while last year nine of its employees were arrested for negligence that caused the death of patients and injured several others (see previous blog)

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10 employees of a New York nursing home neglected and mistreated a resident who was completely dependent on the nursing home staff for his care. The patient was a double amputee who also suffered from partial upper body paralysis. An investigation by New York Attorney General Eric Schneiderman revealed a disturbing pattern of pervasive neglect at Blossom North Nursing and Rehabilitation Center in Rochester, NY. According to the footage from a hidden video camera, “nurses allegedly failed to dispense prescription medications, measure blood sugar and blood pressure levels or properly care for the resident’s catheter. Aides allegedly neglected the resident’s incontinence care and his prescribed range of motion exercises and several are alleged to have transferred him in a potentially unsafe manner. In some instances, the resident had no hands-on care during the aides’ entire shifts and was left to lay immobile in his bed for hours at a time. The nurses and aides then allegedly falsified documents in an effort to conceal their neglect”.

The employees have been charged with falsifying documents, willful violation of the public health law and for some of them endangering the welfare of a physically disabled person. They may be sentence to up to 4 years in jail.

Blossom North Nursing and Rehabilitation Center has a below average rating of 2 stars by Medicare. An inspection report from last fall shows that the nursing home had mistreatment deficiencies, quality care deficiencies, resident assessment deficiencies, resident rights deficiencies, pharmacy service deficiencies, environmental deficiencies and fire safety deficiencies. Previous complaints also show a history of abuse, neglect and mistreatment. Not surprisingly under staffing is also a major issue at this New York nursing home where a registered nurse spends in average 19 minutes a day per patient compared to a New York State average of 48 minutes.