Articles Posted in nursing home negligence

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A new analysis of data culled from the U.S. Bureau of Labor Statistics paints a bleak picture for the workers we entrust with the care of some of our most vulnerable citizens, and in turn raises questions about how their care might be impacted. 

The federal agency’s newest release of non-fatal workplace injuries and illnesses reported by private employers indicated approximately 2.9 million workers were injured annually in 2016, which represents a rate of 2.9 cases for every 100 full-time employers. State-operated nursing and residential care facilities had a rate of workplace injuries and illnesses that, on average, was about 13.7 cases per 100 full-time workers. That’s an increase from 12 per 100 just a year earlier. Privately-owned skilled nursing facilities, meanwhile, as well as those operated by local governments reported injury rates that were 6.5 and 6.1, respectively. In total, skilled nursing facilities in all three categories reported nearly 260,000 work-related injuries and illnesses that year, with nearly 112,000 of those workers requiring days away from work, job transfers or job restrictions on the kind of work they could do. This reflects research released in 2012 by RTI International that 60 percent of nursing assistants in nursing homes incur some type of occupational injuries, ranging from back injuries to black eyes to bites and physical violence.

That raises substantial questions about not only what needs to be done to ensure these workers are healthy, but about the quality of care patients are receiving. For instance, many nursing homes are already understaffed as it is, and the problem is worsening as the population ages. When a worker is forced to take leave or work on restricted duty because of an injury, it means there is even less staff to care for patients’ day-to-day needs.  Continue reading →

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Anti-psychotic drug abuse in nursing homes remains a major problem, according to a new report released by U.S. non-profit Long-Term Care Community Coalition to the United Nations and the Human Rights Council. This analysis was a mid-term update of an earlier report submitted in 2015 concerning the inappropriate use of antipsychotic drugs in nursing homes, which essentially amounts to a “chemical restraint,” intended not for the benefit of the patient, but for the convenience of the staff, usually to keep patients docile. It’s also sometimes used a form of discipline. 

Excessive control of behavior through medication has proven dangerous to patients, particularly those with dementia and Alzheimer’s disease (those to whom it is most often prescribed). The medications in question are intended to treat conditions like schizophrenia. But in the majority of cases where these drugs are being prescribed in nursing homes, these are not patients who suffer from psychosis. Their symptoms are not alleviated with the use of these medications. Further, overuse of such drugs erodes a person’s autonomy, as they may not think clearly or might exhibit less interest in self-care. As noted by researchers at Marquette University, they may be at increased risk for:

  • Agitation
  • Falls/ gait disturbances
  • Withdrawal
  • Functional decline
  • Movement disorders
  • Heart attacks
  • Strokes
  • Death

Note that federal law requires each nursing home resident’s drug regimen should be free from unnecessary use of drugs. Continue reading →

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State investigators have cited a nursing home for neglect in two fatal fall cases that occurred at the Minnesota facility just five months apart – one attributed to a faulty mechanical lift and another to a negligent aide. 

The Star Tribune reports the first incident involved a resident who fell while being assisted in the bathroom by a nurse’s aide who reportedly failed to use a gait belt (also known as a transfer belt) on her walker as she made her way to the bathroom. When the woman left the bathroom, she fell and struck her head on a wall, dying from brain hemorrhaging several days later.  The aide later explained she didn’t use the belt because she had forgotten it in another resident’s room. An investigation by the state concluded it was the aide’s fault for not properly using the equipment. She was disciplined with a five-day suspension from work and staffers were retrained on why using the gait belt is necessary.

Then a few months later, another resident suffered a fatal fall after slipping from a mechanical lift – one that nursing home staffers knew had a defective part. In that instance, the state did find the mechanical defect was the problem, but cited the nursing home anyway because there was evidence staffers were aware of those problems and used it anyway. The resident had been placed into the lift, but soon after fell onto the floor when one of the safety tabs popped off, resulting in the harness disengaging, dropping her. She suffered a broken leg, but died days later due to complications. An investigative report indicated the facility did not maintain the machine according to the instructions by the manufacturer. In fact, three of the four lifts in use at the facility reportedly had rubber safety tabs that often cracked or loosened, rendering the machines unsafe. The facility reportedly had no procedure through which to monitor this danger to residents. Continue reading →

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The Government Accountability Office issued a report recently that addressed instances of abuse, neglect, exploitation and other types of harm that occurred by Medicaid-funded assisted living facilities. 

The report, “Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed,” the GAO indicated that both federal and state Medicaid agencies are failing in endeavors of effective monitoring of assisted living facilities – meaning residents are more vulnerable to abuse and neglect. This 52-page report was long-anticipated, and it underscores the lack of enforcement when it comes to baseline standards expected of assisted living facilities and their care of older residents.

The first problem that more than half of state Medicaid service agencies were unable to reveal the nature or number of “critical incidents” that occurred in these facilities. Three of them aren’t even monitoring deaths that are unexplained or unexpected. Eight states don’t track suspected criminal activity by nursing home staffers, seven don’t track medication errors and five don’t track injuries that result in hospitalization.  Continue reading →

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The number of for-profit corporate nursing homes (as opposed to non-profit facilities) has risen sharply over the last several decades, complicating efforts to hold facilities accountable for substandard care. Worse yet, these centers have a higher rate of poor care because they tend to value profits over the vulnerable people in their charge. Beyond that, owners of these corporate nursing homes often have a stake in other companies contracted to provide goods and services to the patients – everything from physical therapy to drugs to management to staffers. 

A recent analysis by Kaiser Health News and The New York Times explored how these “corporate webs” not only lessen the quality of care, but also make it more difficult for those seeking compensation for nursing home abuse and nursing home neglect.

Almost three-quarters of nursing homes in the U.S. have this kind of business arrangement, referred to as related party transactions. In some instances, facilities will contract out very basic functions, such as management of the facility or rent from their property. Those who run these organizations say it’s a means of simplifying operations and reducing corporate taxes. But of course, there is more to it. The owners of these facilities can score contracts they might not otherwise be able to land in a market that is more competitive, and from there, they can reap more profits that aren’t recorded in the nursing home’s financial records. While a typical non-profit nursing home might take home a profit somewhere in the neighborhood of 3 to 4 percent, owners of facilities with these related party transaction arrangements take home a profit margin of around 28 percent.  Continue reading →

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Nursing home safety advocates are calling on Florida lawmakers to pass an amendment to the state constitution that would guarantee certain rights to vulnerable residents in nursing homes and assisted living centers.

An incident of nursing home negligence in Orlando last year – resulting in a recently announced $1 million fine by federal authorities – is the latest to spark discussion of the need for such change. According to the Orlando Sentinel, the facility assigned a single assistant to supervise a trip to a local super store with nine residents – all of whom required around-the-clock care, five of whom were in wheelchairs and three who used walkers. One needed the bathroom but the assistant was nowhere to be found, so the man attempted it on his own. He ultimately lost control of his bowels and his balance, suffering a broken hip. When the attendant rushed to aid the man,  he neglected the others.

It was this incident (along with another wherein a patient did not receive important medical treatment) that resulted in a government investigation and subsequent fine. Nearly two dozen health code violations were cited, and the facility earned a spot on the national watch list of facilities that don’t correct repeat issues. Despite the fine, advocates for safer nursing homes say it doesn’t go far enough. They want a formal bill of rights added to the constitution, where it could not be easily rolled back by lawmakers or future presidential administrations squeezed or swayed by nursing home industry lobbyists and stakeholders.

One of those calling for change leads a national nursing home advocacy group, and says the public is largely unaware about the way these facilities are run and the risk they pose to residents. He noted it’s telling that even 12 nursing home resident deaths of heat-related illness after Hurricane Irma – all classified as homicides – were not enough to spur industry change. The facility may yet lose its license and Gov. Rick Scott has asked the facilities to maintain backup generators that can provide at nearly 100 hours of fuel so temperatures can stay at a safe level in the event the power goes out for an extended time. The governor has also asked for the panel that combs the state’s constitution every two decades for a determination potential changes pertaining to the protection of nursing home residents. Proposal 88 is now being considered by the commission and is the public hearings stage. If the panel approves it, the issue then goes to voters this fall.  Continue reading →

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The misuse of anti-psychotic medications in nursing homes across America has fallen from about 24 percent down to 16 percent in the last seven years, but remains a serious problem, according to a recent investigation of federal CMS data by Human Rights Watch. The 157-page report details the fact that an estimated 180,000 residents in nursing homes are dosed with anti-psychotic drugs, even though:

  1. The patient has no diagnosis that warrants its use;
  2. Studies have shown these medications can be harmful in older patients (it can double the risk of death among older patients with dementia);
  3. Facilities often don’t first obtain informed consent of the patient and/ or relatives.

The report notes that while any decrease is welcome, there is concern that nursing homes might have found other drugs that can be used to pacify and sedate patients with conditions like dementia and Alzheimer’s disease. The title of the report begins with a quote from a nursing home industry insider pertaining to this misuse of medications: “They want docile.” Another term for this is “chemical restraints.”

Nursing homes are concerned with profits. People with dementia and Alzheimer’s disease require additional care and resources. That amounts to higher staffing levels – and less profits. Nursing homes combat this by sedating these patients, which in turn means they use less of the facility’s resources. Staffers may interpret expressions of distress or pain to be a willful act of disruptive behavior that needs to be suppressed. But using medication for staff convenience or as a means to discipline people is against federal law. Continue reading →

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A new state report blames a nurse and a nursing home for a medication error that proved deadly to a 53-year-old short-term resident. The Star Tribune in Minnesota reports the patient received a dose of powerful pain medication that was 20 times too potent, resulting in his death. 

After receiving the wrong dose of the medication one evening before bed, he probably died shortly thereafter. However, paramedics weren’t called until the following morning, which would seem to indicate that the issue wasn’t discovered until that time. He was pronounced dead at the scene.

Although the nurse who delivered the fatal dose of oxycodone was first on the state health department’s list of those responsible, investigators also pointed the finger at the facility, which reportedly did not have a system that would track changes in the way powerful, high-risk medications – including painkillers – would be given to patients. The facility was fined a sum the state hasn’t disclosed, but has been allowed to remain open after adopting new medication protocol.  Continue reading →

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When older adults get to the point when it becomes impractical to remain in the home, or the same happens to younger people with serious medical conditions, a nursing home may be the best option. When we take our loved ones to a nursing home, we expect they will be well-cared for by professionals and given the dignity and respect they deserve.

Unfortunately, this is not always the case in nursing homes that are sometimes more interested in making money than properly caring for residents who are in much need of care.  According to a recent news article from the Sun Sentinel, lawmakers are not happy with current regulations following some highly-published deaths that occurred following hurricane Irma. Many urge more must be done to protect Florida nursing home residents, not only in times of crisis, but year-round.  Continue reading →

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A report recently released by a state health department revealed the death of a prominent Pennsylvania businessman in a nursing home in September was caused by strangulation as a result of his bed rails. The nursing home was cited by the health department for safety deficiencies related to the death. Investigators with the department determined the facility failed to identify the hazard created by using the side rails that ultimately resulted in this man’s death. He reportedly suffered from the late stages of Alzheimer’s disease and was largely immobile too. He was discovered by a nursing assistant around 11:30 p.m. one night, not breathing, with his body on the floor and his neck between the mattress and the side rail of the bed. 

The health department took note of the fact that side rails are only supposed to be used to assist in helping a patient re-position himself when no other reasonable alternatives are identified. Even then, facilities are supposed to use reasonable precautions when they are being used. The facility removed all bed rails it had been using at the time shortly after decedent was discovered.

This is not a new problem. The U.S. Food and Drug Administration has long been tracking injuries and deaths related to bed rail entrapment and strangulation in nursing homes. The agency reports that even when bed rails are properly designed to lower the potential risk of falls or entrapment, they still present a danger to certain people, namely those with some form of dementia (as they are at greater risk of a fall when they try to get out of bed, despite something being in their way). The agency reported that between 1985 and 2013 (the most recent period for which it conducted the analysis), there were 531 rail-related deaths.  Continue reading →

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