Articles Posted in Nursing Home Staff

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nursing home neglect

Payroll Records Indicate Nursing Home Staffing Shortages Create Serious Gaps in Patient Care

Only recently did the Centers for Medicare & Medicaid Services (CMS) begin collecting and reviewing daily payroll records from more than 14,000 nursing homes. The publishing of the data became required by the Affordable Care Act of 2010. Kaiser Health News recently analyzed the submissions and caught that most U.S. nursing homes have been operating grossly understaffed and reporting a false review of average employee shifts. Kaiser claims these nursing homes had:

  • Significant fluctuations in day-to-day staffing, with particularly large shortfalls on weekends when personnel cared for nearly twice as many residents as normal.
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The Elder Justice Coalition is reacting to a July 7th New York Times article that outlined just how extensively nursing homes have hidden low staffing numbers. The advocacy group is calling for an immediate congressional review of staffing practices within nursing homes.

Actual Payroll Data Reveals Staffing Crisis

The article, investigated and published in collaboration with Kaiser Health News, was based off a review of payroll hours submitted to the Centers for Medicare and Medicaid Services (CMS).  The actual hours made news not only because they show a serious crisis in terms of resident to staff ratios, but also because up until recently, nursing homes had supplied their own staffing data to CMS. With the new payroll-based submission process, nursing homes have no ability to fudge numbers.

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nursing home abuse

Opioid Epidemic Swindles Its Way into Theft of Nursing Home Resident Medications

A 31-year-old nurse from central Illinois has plead guilty to resident burglary after stealing opioid patches from several terminally ill nursing home patients. Prosecutors say the man was working as a nurse at Bloomington Rehabilitation and Health Care Center but was actually not on duty when he entered a resident’s room and stole a pain patch. Just two days later he also removed the same type of medication from a terminally ill person at a care facility where he previously worked. Five other charges were dropped as part of the plea deal which will require him to surrender his nursing license and face a possible sentence of up to 15 years in prison.

Nursing home employees can be tempted to steal resident medications to feed and drug addiction habit or may be tempted to take the prescriptions and sell them for their own financial gain. While not OK, nursing home employees are often underpaid, struggling financially, and looking for quick ways to supplement their income. One little pill can be sold for up to $200. Family members have also been known to steal medication from loved ones while caring for them at home or when visiting them in a facility.

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superhero caregiver

Overburdened Nursing Home Staff Can Be Heroes to Abused or Neglected Residents

Attorney Steven M. Levin, a partner at Levin & Perconti, was recently featured in Chicago Lawyer Magazine’s feature on whether the heroes of the new Avengers movie could be held liable in a court of law (you can read the interview here). While Steve had fun and the story was lighthearted, it reminded us about some of the everyday heroes we get to work with at Levin & Perconti. They are the staff responsible for one of our nation’s most vulnerable groups of citizens. The nursing assistants, janitors, nurses, therapists, administrators, practitioners and staff who serve nursing home residents and long-term care patients. Because the truth is, not all heroes wear capes.

At Levin & Perconti, we recognize the frustrated, overworked and underpaid care workers who ultimately save lives by speaking up and reporting violations of the law, rules, or regulations regarding the care and treatment of nursing home residents in their charge. The act of reporting can feel extremely uncomfortable and create fear and anxiety for most individuals who chose to get involved in reporting, but when national reviews of care residents indicate an abuse rate of 44 percent and a neglect rate of 95 percent, the need for staff who speak up and report wrongdoings has become a sad requirement to protect nursing home residents who cannot advocate for themselves. When these brave staff report issues their actions will continue to save lives and improve care standards while holding the right people accountable for any wrongdoings.

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PHI National, an organization focused on the direct care workforce, released its annual report on the current landscape of the work place for direct care employees such as nursing assistants. Before providing their most recent findings, PHI National opens with this statement: “The poor quality of nursing assistant jobs makes it difficult for nursing homes to attract and retain enough workers to meet demand.” Why are nursing assistant jobs in nursing homes considered so difficult to fill and why is it so hard to keep good employees? The biggest factors go hand in hand. Nursing assistant wages in nursing homes are notoriously low. PHI National reveals that the national average is $11.87 an hour. The work of taking care of residents with a myriad of complex mental and physical diagnoses is both physically and emotionally demanding, so much so that the average nursing assistant is 3.5 times more likely to be injured on the job than other American workers. When you pile endless responsibilities onto the plate of someone making less than $12 an hour, it should come as no surprise that you have a profession filled with overwhelmed, overworked, and emotionally drained employees. This is when mistakes are made and accidents happen. This is when the elderly are neglected, abused, left alone for hours, left in bathtubs overnight, fall while trying to use the bathroom, wander without being stopped, are giving the wrong medication, and develop pressure sores.

Chronic Understaffing Causing Employee Burnout and Resident Abuse and Neglect

Before we address the findings from PHI National’s recent report, we must address the driving force behind the trend in high patient to nursing assistant ratios. To put it bluntly, the cause is greed. The majority of nursing homes in the U.S. are privately owned, many by equity groups who view them as investments. The tragic heat-related deaths we recently witnessed at the Hollywood, FL nursing home after Hurricane Irma finally showed the world that money and profits are valued more than the health and safety of the elderly. In fact, it was only after the death of 8 residents from the Rehabilitation Center at Hollywood Hills that several other south Florida nursing homes without air conditioning began moving residents.

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Update on Planned Nursing Home Strike

In fairly recent news, and as we had discussed previously in this blog space, about 3,500 nursing home staffers in Connecticut voted to go on strike to protest their wages, which in some places were not too far above the state’s minimum wage level. The workers set to go on strike hoped to push the state to re-think its budgeting when it comes to Medicaid funding. A proposed budget would have kept the level of Medicaid dollars going to nursing home as flat, rather than increasing the funding as tied to increasing costs.

Nursing homes could potentially be exempt from other Medicaid cuts under the governor’s proposal, but the lack of funding increase would still have an impact. Medicaid comprises a substantial revenue stream for nursing homes and thus salaries and wages for nursing home employees, would reduce money available to pay those workers and could possibly force some to accept stagnant wages, reduced hours, or even lose their jobs. The strike was set to go into effect on April 24th, though the workers through their union agreed to delay the work stoppage upon a request from the governor while he and legislators continue to work out a resolution on the budget. A strike would otherwise reportedly affect 27 nursing homes across the state, spanning 20 different neighborhoods, leaving those facilities with even fewer staffers to tend to residents, and having to look into temporary replacements.
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Long-term living locations catered to seniors are often referred to as “skilled nursing facilities” (nursing homes) and “assisted living facilities.” The basic distinction between these types of homes is the level of care provided to residents. Assisted living facilities provide only general aid, perhaps with meals, cleaning, laundry, and other day to day tasks. Conversely, skilled nursing facilities can provide actual medical care. Seniors with more serious health care issues usually need the support that is provided at a traditional nursing home instead of an assisted living facility.

However, the fact that skilled nursing facilities are able to provide some medical care also means that they may commit medical malpractice. One of the most common ways this happens is when nurses and aides make errors with regard to medication. Obviously many seniors in long-term care facilities rely on the various medications to help control different medical issues. When medication is not provided properly, serious harm can result.

A recent Legal Examiner story touched on that very issue. The article points to a study that we have referenced before from the Journal of the American Medical Informatics Association. That research project found a significant number of medication problem in nursing homes. As noted, the most eye-popping statistics from the research effort is that observers identified that about 21.2% of all dispensals of medication involved some error.

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Underreporting of elder abuse is a long-documented problem. Because of the fact that many of the victims are not able to speak up for themselves and have few advocates, many instances of neglect and mistreatment are never made public. Many of those affected die without anyone ever being fully aware of the fact that they suffered in silence.

Those focused on correcting the underreporting problem often suggest that the best approach is to enact safeguards so that those who come into contact with seniors in various ways are trained to identify signs of mistreatment. That may include anyone from at-home therapists and bank tellers to financial advisors and estate planning attorneys.

Also, one of the most common “stop gaps” in that regard are caregivers at hospitals. For example, in many cases a senior will be brought to the hospital for some emergency treatment only for doctors to discover something like serious bedsores on the senior’s body. However, if doctors, nurses, and aides stay silent when they are confronted with signs of elder abuse, the senior may be sent back to a facility only to suffer more abuse.

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Studies show repeatedly that seniors with cognitive injuries–dementia and Alzheimer’s–are far more likely to face neglect and abuse. Our own work as Chicago elder neglect lawyers mirrors that, as we have worked with many local residents and their families following various incidents which were affected in one way or another by a resident’s degenerative brain injury.

As the country ages, more and more seniors continue to face these conditions. In the future years and decades providing better (and safer) care to those with these injuries will become even more imperative. That will likely include better caregiver training and dissemination on alternative ways to provide care beyond excessive medicating and the use of chemical restraints.

Also, it is important for researchers to continue their work understanding how Alzheimer’s develops and possible ways to minimize the consequences. Fortunately, researchers have been working on these issues with more vigor recently and some new information in emerging which may one day help tackle the problem.

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Over the last several years many seniors and their families were affected by problems with metal-on-metal hip implants that they received. From the Depuy hip recall to those affecting Stryker products, tens of thousands of residents faced the anxiety of potentially problematic medical devices installed in their bodies. Many had to undergo complex revisions surgeries and deal with serious medical complications.

In the aftermath of these high-profile problems, many began asking questions about the federal approval process for these products. After all, not just any device can be sold and used in medical procedures, right? Isn’t there a stringent safety process for these tools to ensure these very mass-recalls are prevented?

The truth is quite complicated, and a wake-up call for all consumers who assume that federal regulations protect them from inherently dangerous products. A recent New England Journal of Medicine (NEJM) article provides a comprehensive summary of the complex history behind the metal-on-metal hip implants and the Food and Drug Administration approval process. All those interested in these issues should check out the full article.