Articles Posted in Staffing Issues

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Certified nursing assistants (CNAs) are responsible for the majority of care provided in nursing homes. AARP says “The job of a CNA can be difficult and hazardous. CNAs have demanding workloads and are often responsible for manually lifting and turning residents, which can cause lower back injuries. They can also be exposed to infections, diseases (such as tuberculosis), and physical violence from residents.”

Many of these nursing assistants are working incredibly long hours and multiple days in a row, pushing them into overtime. For many reasons, this already exhausting and demanding job is made even more so.

We’d like to share a current snapshot of the nursing assistant industry:

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nursing home infections

Painful Infections Remain Untreated When Chicago’s Nursing Homes are Understaffed

The Chicago Tribune recently published a scathing article on the inadequate measures taken by a Chicago nursing home to prevent a resident’s bedsores from turning into deadly infections. The story featured the negligence and wrongful death claims of an 85-year-old resident at Lakeview Rehabilitation and Nursing Center on the city’s North Side. Family members of the resident told reporters that the facility’s staff never spoke of the “seriousness of the pressure sore, which led to sepsis, a severe infection that can quickly turn deadly if not cared for properly.”

Complications related to pressure sores often require intravenous antibiotics and sensitive care treatments to treat bloodstream infections and can result in painful surgeries to cut away dead skin around the wound. According to health officials, there are four types of infections that are often linked with sepsis including: lungs (pneumonia), kidney (urinary tract infection), skin (pressure wounds and bedsores) and gut. Out of the 6,000 Illinois nursing home residents who are hospitalized with sepsis each year, 1 in 5 won’t survive.

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“Frail and vulnerable people are harmed when nursing homes fail to meet our standards. And I don’t think any of us wants to wait until the next natural disaster or other disaster exposes some kind of a deficiency that kills dozens of people.”

                                                 -Rep. Diana DeGette (D-CO)

On Thursday, the House Subcommittee on Oversight and Investigations held a hearing to address substandard care and recent findings of abuse and neglect in U.S. nursing homes.

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Long Term Care Community Coalition (LTCCC), an organization committed to providing resources and information to promote healthy aging, has released their searchable data files on staffing hours for nursing homes and rehabilitation centers across the country for the first quarter of 2018.

The lists are divided by state, and the nursing home abuse and neglect attorneys of Chicago’s Levin & Perconti have reviewed the data for Illinois to find out the best and worst staffed facilities in Cook, DuPage, Lake, Kane, and Will Counties. Staffing, as most elder advocates know, is considered one of the largest contributing factors to nursing home abuse and neglect.

According to Nursing Home Compare, the ratings website run by the Centers for Medicare and Medicaid Services (CMS):

Illinois Average National Average
RN Per Resident/Day 47 minutes 40 minutes
Total Licensed Nurse Per Resident/Day (LPN/LVN + RN time) 1h 25 minutes 1h 33 minutes
Nurse Aide (CNA) Per Resident/Day 2h 2 minutes 2h 18 minutes

The data compiled by CMS and LTCCC shows that the best Illinois nursing homes and rehab facilities are beating the state and national averages for RN time per resident/per day, but that the worst are falling so far short that one Cook County nursing home averaged ZERO hours per resident a day.

Levin and Perconti also found that every nursing home that rated the worst in terms of staff hours per resident/day were for profit facilities. Our blog has extensively covered the driving force behind minimal staffing. It nearly always comes down to money.

Our findings are separated by county, as well as by role, examining the best and worst facilities in terms of RN time per resident/day, as well as total direct care staffing per resident/day. In their data compilations, LTCCC defines direct care roles as RNs, LPNs, and CNAs.


Average RN Staffing Hours Per Resident/Per Day By County

  • Cook County: Top 10 in RN hours are hospitals. There is a tie for nursing facilities.
    • Best – Alden Estates of Skokie (25 residents, for profit) and Terraces at the Clare (Chicago, 46 residents, for profit) both average 1.7 hours per resident/day.
    • Worst – Southview Manor Nursing Center (Chicago)
      • For profit
      • 183 residents
      • 0 hrs per resident/day
  • DuPage County:
    • Best – Marianjoy Rehab Hospital (Wheaton)
      • Non profit
      • 26 residents
      • 2.4 hours per resident/day
    • Worst – West Chicago Terrace (West Chicago)
      • For profit
      • 107 residents
      • .2 hours per resident/day
  • Kane County:
    • Best – Greenfields of Geneva
      • Non profit
      • 41 residents
      • 1.8 hours per resident/day
    • Worst – North Aurora Care Center
      • For profit
      • 105 residents
      • .1 hours per resident/day
  • Lake County:
    • Best – Lake Forest Place (Lake Forest)
      • Non profit
      • 50 residents
      • 1.9 hours per resident/day
    • Worst – The Grove at The Lake (Zion)
      • For profit
      • 170 residents
      • .3 hours per resident/day
  • Will County:
    • Best – Alden Courts of Shorewood
      •  For profit
      • 35 residents
      • 2.3 hours per resident/day
    • Worst – Aperion Care Wilmington
      • For profit
      • 158 residents
      • .1 hours per resident/per day


Average Total Direct Care Staffing Hours Per Resident/Per Day By County (RN, LPN, CNA)

  • Cook County:
    • Best – Rush Oak Park Hospital’s Skilled Nursing Unit
      • Non profit
      • 16 patients
      • 6.6 hours per resident/day
    • Worst – Parkshore Estates Nursing & Rehab (Chicago)
      • For profit
      • 228 residents
      • 1.4 hours per resident/day
  • DuPage County:
    • Best – Franciscan Village (Lemont)
      • Non profit
      • 58 residents
      • 7.1 hours per resident/day
    • Worst – Wynscape Health & Rehab (Wheaton)
      • For profit
      • 120 residents
      • 1.3 hours per resident/day
  • Kane County:
    • Best – Alden Courts of Waterford (Aurora)
      • For profit
      • 17 residents
      • 7.0 hours per resident/day
    • Worst – River View Rehab Center (Elgin)
      • For profit
      • 175 residents
      • 1.8 hours per resident/day
  • Lake County:
    • Best – Radford Green (Lincolnshire)
      • For profit
      • 75 residents
      • 1.5 hours per resident/day
    • Worst – Claridge Healthcare Center (Lake Bluff)
      • For profit
      • 102 residents
      • 2.1 hours per resident/day
  • Will County:
    • Best – Victorian Village Health & Wellness Center (Homer Glen)
      • Non profit
      • 45 residents
      • 5.9 hours per resident/day
    • Worst – Joliet Terrace Nursing Center
      • For Profit
      • 113 residents
      • 1.4 hours per resident/day

 

Let Levin & Perconti Help You
Levin & Perconti is one of the nation’s most recognized and respected leaders in the areas of elder abuse and nursing home negligence. We have successfully litigated and settled abuse and neglect cases throughout the city of Chicago, surrounding suburbs, and the entire state of Illinois.

If you suspect neglect or abuse of a loved one in a nursing home or skilled nursing facility, please contact us now for a FREE consultation with one of our attorneys. Call us toll free at 1-877-374-1417, in Chicago at (312) 332-2872, or complete our online case evaluation form.

 

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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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“We can no longer choose between caring for your family and our own, and so, we have decided to stand together as part of what will be the largest strike of nursing home workers in the history of our country.” 

            -Services Employees International Union (SEIU) statement on nursing home employee strike

In a move to influence contract negotiations between SEIU Healthcare Illinois and Illinois Association of Healthcare Facilities (who represents 53 Chicago-area nursing homes that use SEIU members for staffing), 5,000 SEIU members are planning to strike. The two main issues at hand are low pay and low staffing numbers, creating an industry of underpaid and over-utilized nursing home employees who feel they must work excessive amounts of overtime in order to maintain a living wage.

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A new trend has emerged in several states including Pennsylvania & New Mexico: Attorneys General partnering with private law firms to sue large nursing home chains for negligent care, Medicare/Medicaid fraud, and deceptive marketing tactics. An article in a December edition of Reading Eagle, a Reading, PA newspaper, puts a spotlight on this growing movement to improve the quality of care received at nursing homes in all states. In Pennsylvania alone, Attorney General Bruce Beemer has filed 3 lawsuits (one of which has since settled) against 3 of Pennsylvania’s largest nursing home chains in the past year and a half. The case versus Reliant Senior Care (now Priority Healthcare Group) settled for a reported $2 million and was the largest nursing home settlement in PA won by an attorney general. The other two chains who are still locked in a legal battle against the state are Golden Living Centers and Grane Health Care.

Sending a Message

Nursing home industry advocates are obviously unnerved by partnerships between attorneys general and private law practices who have a history of success in helping right the injustices caused by big business on the American people. While these advocates argue that private law firms are giving donations to campaigns for attorneys general to essentially guarantee they’ll be called upon for future work, the law does not seem to be on their side. The State of Pennsylvania was unsuccessfully sued by the nursing home industry for such practices.  Elderly advocates believe working relationships between public and private legal entities will send a message to the industry that American taxpayers expect more from facilities receiving Medicare & Medicaid tax dollars.

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A Casper, Wyoming nursing home with a history of negligent care, cost-centered staffing practices, and hazardous living conditions just settled a lawsuit with a blind resident who was hit by a facility-owned, staff-driven minivan while waiting for a ride. Although the man survived the accident, he now deals with pain and numbness from an incident that could have been prevented by greater supervision and improved employee training.

Repeat Offender

Between January 2014 and 2016, Poplar Living Center was cited 90 times by Centers for Medicare & Medicaid Services (CMS) for a multitude of violations, some so egregious that they twice lost federal funding. Most of the complaints made by CMS against Poplar Living Center are common themes heard about many nursing facilities: Not enough staff to handle high resident volumes, inadequate staff training, rundown infrastructure, and negligent care.

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Pressure sores (also known as pressure ulcers or bed sores) are far too common injuries that affect residents of nursing homes that do not receive proper care. Essentially, these injuries are breakdowns of the skin, which usually develop on “bony prominences” in the body–like the heel or lower back. Wherever pressure is placed on the skin from bones for prolonged periods of time, these sores can develop. Expectedly, immobile seniors who may spend significant times in bed are at heightened risk of having skin breakdowns as a result of laying without repositioning for so long.

Fortunately, steps can be taken by caregivers to avoid those injuries. Ensuring movement, repositioning, cleansing, and similar steps can make all the differences. Failures in this regard continue to occur, however. When pressure sores do develop, they can occur along a range of seriousness, usually referred to as the four “stages” of pressure ulcers.

A Stage 1 pressure sores is one where the skin itself has not been broken, but instead appears reddened and raw. The skin is often firmer than those around it. A Stage 2 pressure sore is where the skin itself breaks away leaving an open wound. It often looks like a blister on the skin that goes through several layers. Some fluid may be visible in a Stage 2 sore, and in some case there may be permanent skin death.