Articles Posted in Nursing Home Neglect

Falls at nursing homes happen more frequently and repeatedly than we’d like to think, some with dire consequences. According to the Centers for Disease Control and Prevention (CDC), about 1,800 older adults living in nursing homes die each year from injuries related to a fall. Those who survive a fall can sustain hip fractures and head injuries than can result in permanent disability and reduced quality of life.

Take for example the case of a man in Glen Carbon, Illinois whose estate filed a suit against the nursing home where the man was staying, claiming that several falls led to the man’s death.

An article on TheTelegraph.com quotes the suit as alleging, “The cause of death was a subdural hematoma; said medical condition was a direct result of multiple falls by the decedent, at the facility.” The suit also claims that the man required rehabilitation and assistance with daily living, and that the facility failed to care for the man “in a manner which maintained and enhanced his dignity and quality of life.”

According to the CDC, one way to help prevent falls in nursing homes is by educating staff about fall risk factors and prevention strategies. They also suggest making changes in the nursing home environment to make it easier for residents to move around safely. Our loved ones should be protected and kept safe from falls while in the care of a skilled nursing facility.

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In our last post, we talked about a group of local nursing aides who expressed their concern about resident care by supporting the statewide nursing “Day of Action” that took place on March 21. In today’s post, we want to discuss an article that appeared in the Central Penn Business Journal (CentralPennBusiness.com) about three proposed bills that would increase regulations on Pennsylvania nursing homes.

The article discusses a report by Service Employees International Union (SEIU) Healthcare Pennsylvania that claims that almost 30 percent of Pennsylvania facilities analyzed did not spend at least 95 percent of their resident care Medicaid component amount on resident care costs in 2011. The union claims that not only are patients being shortchanged, but that workers are being affected by underfunding direct care, inadequate wages, and staffing.

The report also says that nursing homes generated more than $500 million in profits in 2011, with a total margin near the national level of 4.7 percent. Yet a 2012 survey of nursing home employees in Pennsylvania showed that 12 percent of workers have more than one job and 11 percent receive public assistance.

According to the article, the report said that 54 percent of workers say their facility is only sometimes adequately staffed, and 27 percent say their facility is never adequately staffed.

The three bills being proposed would require nursing homes to meet minimum level of nurse aide staffing, report turnover and staffing levels to the Department of Health, and spend a minimum amount of their Medicaid resident care per diem rate.

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A group of local certified nursing aides expressed their concern about resident care when they stood outside of Golden Living Center-York Terrace in Pottsville in Thursday in support of the statewide nursing “Day of Action.”

An article on the RepublicanHerald.com reports that thousands of nursing home workers who are members of SEIU Healthcare Pennsylvania took part in “the largest statewide nursing ‘Day of Action’ in the union’s history,” according to Amelia Abromaitis, director of communications at SEIU Healthcare Pennsylvania, Philadelphia. Their mission: to bring attention to improvements needed in resident care and the challenges they face on the job.

With their contract set to expire in the near future, Golden Living Center and the union have been negotiating a contract for certified nursing assistants (CNAs), licensed practical nurses (LPNs), dietary workers, laundry workers, and other union workers. For the union and its members, the goal of the negotiations will be fair and competitive wages and overtime provisions while still preserving quality patient care.

In the article, the workers expressed their concerns with patient care with comments such as “Weekends are terrible. We can use more staff.” Another worker said, “Our residents aren’t receiving the care they deserve or that they need and we’re working short staffed.”

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Space is tight in Pennsylvania nursing homes according to a PA Department of Health Survey that reports a 91.25 percent occupancy rate statewide. In Juniata and Snyder counties, the occupancies rates are higher than 96 percent.

According to an article on LancasterOnline.com, space is so tight in Lancaster County nursing homes that residents have been placed at nursing homes in other counties.

The article notes that in-home care can ease the pressure on space in nursing homes, but often funding isn’t available. While Dauphin County has been able to provide in-home care for those who need it, there is a waiting list for services in Lancaster County.

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The Pennsylvania HealthCare Association reports that the average annual cost for a private room in a nursing home here in Pennsylvania is $99,280 — higher than the national average of $81,031.

It’s a staggering number, but according to an article on LancasterOnline, most residents live less than a year in skilled care. For those residents who may live on, however, they can rapidly deplete their assets.

For those who may wonder how they can pay for nursing home care, the article suggests the purchase of long-term care insurance and holding onto their assets. There is also Medicare for short-term stays and Medicaid for longer stays.

The controversial and shocking story causing much debate this week is that of a nurse at an elderly living facility in California who refused to perform CPR on resident who had stopped breathing. When prompted over the phone by a 911 dispatcher to start CPR, the nurse refused saying that her company had a policy against its employees providing medical care. As a result, the elderly resident died.

An article on CNN.com points out that most states have what are known as Good Samaritan laws to protect people against legal liability when they step in to help someone, but not many people know the law. Also, Good Samaritan laws have been challenged in courts.

The difference in this situation is that this happened at an independent living facility. This type of facility, by law, may not be licensed to provide medical care. They may not be required to have staff who are trained to intervene medically. Had this happened at a nursing home or an assisted-living facility, the resident would have received CPR in the same circumstance.

A number of nursing homes in Lancaster County have something to brag about after a recent report by the Centers for Medicare & Medicaid Services showed that they offer a level of care that’s just above average.

According to an article on LancasterOnline.com, the report found that overall, the county’s 21 nursing homes averaged 3.4 stars. Eighteen of Lancaster County’s nursing homes earned either five stars or four stars, which are positive ratings. Ratings are based on state health department inspections for the past 3 years; nursing and physical therapy staffing levels; and quality measurements, such as the percentage of patients with bed sores or urinary tract infections.

On the low end of the ratings spectrum are five facilities that only earned one star, including Golden Living Center, Conestoga View, ManorCare Health Services-Lancaster, Lancashire Hall, and Susquehanna Valley Nursing & Rehabilitation Center.

According to an article on the RepublicanHerald.com, the City of Pottsville’s Code Enforcement Office recently approved plans for a two-story addition to the east wing of Providence Place Retirement Community in Pottsville. The new wing will be an unsecured unit for early-onset Alzheimer’s residents who have no tendency to wander.

The new addition will be a two-story building with 18 unsecured rooms for residents requiring memory support. Memory suppoer is a program of mental exercises designed to prevent the onset of Alzheimer’s. The addition will also include a dining room and an activity room and porch on the north side overlooking the parking lot. It will add 18 units to the facility.

Groundbreaking is scheduled to begin in April. According to a building permit on the front door of the facility, the estimated cost of the project is $1.2 million. Due to the expansion, Providence Place might need to hire about 15 people.

An alarming report just released by the Inspector General of the Department of Health and Human Services says that in 2009, Medicare paid about $5.1 billion for patients that stayed in skilled nursing facilities that failed to meet federal quality of care rules.

According to an article by the Associated Press, nursing homes by law must write up care plans for each resident. But investigators estimate that in one out of five stays, the patient’s health problems weren’t addressed in the care plan. In some cases, residents got therapy that they didn’t need. The report said this was in the nursing homes’ financial interest because they would be reimbursed at a higher rate by Medicare. In another case, there were no plans made to monitor a patient’s use of two anti-psychotic drugs and one depression medication, even though the medication had serious side effects.

The Office of Inspector General’s Report was based on medical records from 190 patient visits to nursing homes in 42 states. The sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, which was the most recent year when data was available.

According to the article, the report brings up the question that the system could allow homes to be paid for poor quality services that could harm residents. It suggests that the Centers for Medicare & Medicaid Services instead tie payments to facilities that are able to meet basic care requirements, as well as strengthen regulations and oversight.

In the article, Medicare spokesman Brian Cook told the Associated Press, “Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care. We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to.”

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Nursing homes and long-term care homes in Pennsylvania anxiously await this week’s decision on the across-the-board federal budget cuts, as it could mean that they might lose some Medicare funding.

According to an article on the York Daily Record (ydr.com), the reductions would result from a proposed 2 percent cut in Medicare funding, which would amount to $11 billion this year. The cuts would most directly affect hospitals, primary care clinics, other specialty providers, and nursing homes, which receive Medicare funding. Most nursing home revenue comes from private funds (or state Medicaid coverage once those funds are exhausted) during the first 100 days of long-term care, patients over age 65 are eligible for Medicare coverage.

Although a 2 percent cut does not sound like much, it can mean alot for nursing homes and skill nursing facilities that are usually on tight budgets. According to the CEO of one Westmoreland County senior care home, “It could equate to two part-time workers, or a full-time position.”