Articles Tagged with Nursing Home Neglect

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A new study released this week by the Human Rights Watch found that many nursing home residents are needlessly being given antipsychotic drugs.  The 157 page report titled “They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia,” found that approximately 179,000 people, mostly those suffering from dementia, are being given antipsychotic drugs every week in US nursing homes in an attempt to control their behavior. Facilities administer these drugs without the proper diagnosis and in many cases without obtaining informed consent from residents or their families.  This is also being done in the face of an FDA warning that these drugs can almost double the risk of death for elderly dementia patients.

The drugs are being predominately used for their sedative effect, rather than any medical benefits.  Nursing homes are using these drugs as a cost-effective and simple way for understaffed and overwhelmed facilities to control its residents.  Many nursing homes have an inadequate amount of staff to properly care for the amount of residents in their facilities.  This leads to the staff cutting corners and finding shortcuts to deal with the stress of caring for elderly dementia residents.  However, it is the residents that suffer when the staff cut these corners.

Federal law requires that nursing facilities fully inform their residents about their treatment and the resident has the right to refuse that treatment. There are also some state laws that require informed consent in order for these antipsychotic medications to be given to nursing home residents. The study found that many nursing home staff members admitted to often failing to obtain consent or even to attempting to do so.

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According to a report by the Associated Press, an investigation into the death of a 76 year old woman at an Ohio nursing home revealed she spent roughly 8 hours outside while temperatures fell below zero.  Phyllis Campbell was found dead from hypothermia on January 7 outside Hilty Memorial Home in Pandora, OH.  She reportedly suffered from dementia and had a history of wandering off.  “She had a history of exit seeking behaviors” and “the facility failed to ensure adequate supervision was provided,” according to a report released by the Ohio Department of Health.

That report from the Ohio Department of Health says two nursing home aides told investigators they didn’t do scheduled checks that night even though they were marked as completed.  She left the building around 12:35 am and Putnam County Coroner Dr. Anne Horstman determined that she died between 1 and 2 am.  She was able to exit through a door into a courtyard even though she was wearing a monitor that should have set off alarms but “at times would not sound.”  She was found in the courtyard about 30 feet from its doors in the morning.  The Investigations findings note that Campbell had wandered into the courtyard 2 other times during the week before she died and that she got out of her room several times that day.

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One of the most difficult decisions families have to face is deciding to put a loved one in a nursing home. They want to make sure they are placing their family member in a safe environment where they will receive the proper care they need.

Many of those families rely on a government rating system to determine which facilities are the best.  The Five-Star Quality Rating System employed by Centers for Medicare & Medicaid Services (CMS) is a source of information to help consumers make an informed decision when choosing a nursing home.  The Medicare Nursing Home Compare website features a quality rating system that gives each nursing home a rating of between 1 (much below average) and 5 stars (much above average). The nursing home is given a star rating in three areas, self-reported staffing, self-reported quality measures, and health inspections.  The facility is also given an overall star rating.

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A new study of California nursing homes (the nation’s largest system of nursing homes) discovered that some nursing homes have inflated their self-reporting to improve their score in the rating system.  The study was done by faculty at Florida Atlantic University and the University of Connecticut and published in the Production and Operations Management journal under the title “Winning at All Costs: Analysis of Inflation in Nursing Homes’ Rating System”The rating system was implemented in 2008 and this study used data from 2009 to 2013.

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A 9th nursing home patient has died as a result of power outages caused by Hurricane Irma in Florida.  The power outages caused the air conditioning to stop working and as a result the facilities reach dangerously hot temperatures.

Nursing home residents at the Rehabilitation Center at Hollywood Hills in Hollywood, FL were evacuated from the nursing home last Wednesday morning after the medical staff from the nearby Memorial Regional Hospital began to see nursing home patients in the emergency room with “extraordinarily high temperatures.”  Some of the patients who were admitted to the hospital had temperatures of up to 106 degrees. Once hospital staff realized something was wrong at the nursing home, they began evacuating patients from the nursing home to the hospital on stretchers.  A lack of backup power is being investigated as a main factor that contributed to the deaths

Around the country, facilities have been caught unprepared for emergencies that don’t come close to the severity of a hurricane like Irma that hit Florida earlier this month.  Nursing home inspectors issued 2,300 violations of emergency-planning rules during the past four years.  536 of those citations were for failure to maintain comfortable and safe temperature levels for residents. In addition, a third of U.S. nursing homes have been cited for failing to inspect their generators each week or to test them monthly.

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More than 1 in 4 cases of possible sexual and physical abuse against nursing home patients went unreported to police, according to a government audit. These unreported cases violate a federal law requiring immediate notification of nursing home abuse.

The Health and Human Services inspector general’s office issued an “early alert” on preliminary findings from a large sampling of cases in 33 states.

Auditors identified 134 cases in which emergency room records indicated possible sexual or physical abuse, or neglect. The incidents spanned a two-year period from 2015-2016.

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Pennsylvania Attorney General Josh Shapiro is part of a coalition of 16 State Attorneys General and the Attorney General from the District of Columbia who sent a letter to the Centers for Medicare & Medicaid Services (CMS) hoping to protect nursing home patients.

These states are recommending that CMS keep in place its current pro-patient rule.  The existing rule protects patients’ rights by prohibiting pre-dispute arbitration clauses in nursing home and other long-term care contracts.  The current regulation was adopted on October 4, 2016, by CMS and a proposed rule would reverse the prohibition on binding pre-dispute arbitration clauses in Long-Term Care facility contracts.  Pre-dispute arbitration clauses require seniors to waive their rights to go to court to resolve any disputes with a nursing home.

In the August 7th letter, the Attorneys General stated in their comments “Pre-dispute binding arbitration agreements in general can be procedurally unfair to consumers, and can jeopardize one of the fundamental rights of Americans; the right to be heard and seek judicial redress for our claims. This is especially true when consumers are making the difficult decisions regarding the long-term care of loved ones. These contractual provisions may be neither voluntary nor readily understandable for most consumers. Often consumers do not recognize the significance of these provisions, if they are aware of them at all, especially in the context of requiring care in a nursing home.”

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The Pennsylvania Department of Health has levied $816,000 in fines against nursing home providers already in the first half of 2017. That is more than double the $407,450 in fines handed out in 2016.  The department also handed out fines of $170,050 in 2015 and $62,000 in 2014.

In 2014, there were 7 cases where the department found a citation that had caused a resident actual harm. So far in 2017, there have been 88 cases.  This vast increase in fines is due mostly to regulators using a more rigorous penalty system.  The rigorousness is coming after receiving criticism for being too lenient on insufficient care.  “When the auditor general looked at our oversight of nursing homes, one of the key recommendations was to be more aggressive in our oversight, and we are,” the department said earlier this year in a statement.  In October 2016, Secretary of Health Karen Murphy announced that the department would be using more discretion in determining how much it would fine facilities.  The department will be taking into account the level of harm, how long it takes for a problem to be fixed, the facility’s track record of compliance, and other factors.

April Hutcheson, a department spokeswoman, said the department has resumed using federally mandated anonymous reporting, which had been discontinued previously. State surveyors also received federal training last year for how to identify the scope and severity of the situation “and, as a result, we have seen an increase in citations of deficiencies at the actual harm and immediate jeopardy level,” said Lorraine Ryan, a CMS spokeswoman.

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In our last blog post we talked a bit about signs that it might be time to consider assisted living for an aging loved one. In this post, we will talk a bit about Nursing Home Abuse and Elder Abuse. How often abuse occurs, what to be on the lookout for, and what to do if you think an aging loved one has been abused or is being abused.

Unfortunately, nursing home abuse and elder abuse are common and take many forms. According to the Office for Victims of Crime, roughly 5 million people over the age of 65 are victims of elder abuse or nursing home abuse each year. Abuse can be physical, psychological or sexual. Abuse can also take the form of neglect and financial exploitation. Abuse can come from anywhere, even friends and family members. Even more frightening is that only 1 in 24 cases of elder abuse or nursing home abuse is reported to authorities.

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When moving a family member into a nursing home you are doing so with the hope that they will be given the utmost care and protection.  Unfortunately, understaffing in nursing homes leads to neglect of its elderly residents.  When there is a shortage of staff members compared to the amount of residents, the staff becomes overworked and stressed and it is the residents that suffer. This leads to increases in malnutrition, unhealthy weight loss, dehydration, infections and bedsores among the nursing home residents.

PennLive analyzed Medicare and Medicaid reimbursement data to compile a list of the 18 most understaffed nursing homes in Pennsylvania based on hours spent caring for each resident. PennLive also compiled how much of that care came from registered nurses (RN), licensed practical nurses (LPN), and certified nurse assistants (CNA).  It is recommended that at least 4.1 staff hours a day be spent on each resident’s care.  The average hours per day spent on each resident is 2.84.  The most understaffed home on the list was Manor Care in Pottsville (2.77 hours of care per day). Manor Care, which is one of the biggest nursing home chains in the United States, occupied 10 of the 18 spots on this list.

The full list can be seen here.

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golden nursing homeA six-month investigation headed by PennLive revealed dozens of people died at the hands of Pennsylvania nursing home errors and neglect. Those homes, for the majority, were found to have not been punished by the state, and investigators are suspected of not properly reporting misconduct.

Pennsylvania Senator Bob Casey voiced the need for the state Department of Health to execute an internal investigation regarding the cases.

“When our state’s seniors and families make the decision to enter a nursing home, they are placing a life in those homes administrators’ hands,” said Casey in a statement. “If even one life is lost due to the negligence of these facilities, we need to step back, ask why and see what changes are needed.”