Articles Posted in Nursing Home Abuse & Neglect

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Poor dental health, including bleeding gums and cavities have long been known to be a risk factor for general  health.  A new study finds that far too many residents of nursing homes in Georgia and across the country suffer from poor dental care that also risks their   health.

Good oral hygiene and health is essential not just for the average person but also, and especially so, for the elderly.  Gum  infections, for instance, can cause germs from the infection to travel into the person’s blood stream.  It  is well documented that   the transmission of these germs in the bloodstream can cause heart disease and also increase   the risk for other conditions.  Additionally,   cavities and other types of conditions can make it difficult for a person to chew food properly, placing him at risk of malnutrition.  This  can have serious consequences in the case of an elderly person.

The study was conducted by dental officers at the Centers for Medicare and Medicaid  Services. As part of the study, the researchers  focused on the oral health of elderly residents at nursing homes certified with the Centers for Medicare and Medicaid  Services.  According  to the study, as many as 20% of all elderly nursing home residents suffer from missing teeth.  While missing teeth or missing tooth fragments was the most widely reported oral health condition, many residents also reported pain and difficulty while chewing,  teeth cavities, and broken teeth.  The  study found that 8% suffered from cavities while 11% reported pain while chewing.   Other  common problems included damaged or broken dentures and gum infections, typically  accompanied by bleeding and inflammation.

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The U.S. Department of Health and Human Services (DHHS) recently announced  a proposed rule that would set  minimum staffing requirements for nursing homes across the country.  Regulators  believe that this would help increase standards of care for the elderly and sick at these facilities, and prevent nursing  home neglect. Unfortunately, low standards of care often result in falls with fractures, decubitus ulcers (bed sores), amputations and wrongful death.

There  are currently more than 1.2 million people who are cared for at one of the country’s 15,000 nursing homes.  The  standards of care for all these patients would be directly impacted by the new regulation.  The   US Department of Health and Human Services says that the rule would, for the first time ever in history, propose a minimum staffing requirement for nursing homes. Poor staffing and poorly trained staff is often the main reason persons in nursing homes suffer abuse and personal injuries.

This  would include a requirement that the facility have a registered nurse on staff 24 hours a day, every single day.  It will also require and set a minimum standard of 3 nursing hours for every resident at the facility. That includes 0.55 hours of care per registered nurse per resident per day and 2.45 hours of care by a nurse aide per resident per day.  In addition, nursing facilities may also be required to provide more than the minimum staffing requirements in case of specific patient needs.

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Even  though the elderly are at risk of major complications from Covid- 19,  most  nursing homes around the country used alarmingly  low levels of antiviral drugs that are proven to fight symptoms of the deadly disease on their residents, during the pandemic. The failure to use appropriate medications could lead to a larger number of malpractice claims.

While the Covid- 19 pandemic ravaged large portions of the metro Atlanta region, especially in the above-65 age category,  efforts were made to deliver more life- saving antiviral medications to these sections of the population.  Use  of the antiviral drugs was  higher in nursing homes than in the general community.  However,  a new study finds that a large number of nursing homes administered very low levels of the drugs.

In fact, shockingly, the study found that  as many as 40% of nursing homes did not use antiviral drugs as of the end of 2022.  The use of antiviral drugs in these facilities was low even as the pandemic gathered steam, and continued to remain low even after the medications were approved as oral drugs.  In  fact, according to the researchers, residents  with Covid- 19 in  only about 18% of the nursing homes were treated with antiviral medications.

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This June, elder advocate organizations around the country are calling for a focus on the rights of seniors,  and the prevention of abuse and neglect involving elderly persons,  millions of who live in nursing homes.

On June 15, elder organizations across the world including the World Health Organization at the United Nations will mark World Elder Abuse  Awareness Day  to raise awareness about the risks of abuse, exploitation and neglect involving seniors.  Events  and commemorations are being planned for the special day across the world, including the United States where more than 50 million people above the age of 65 currently live.  Out  of these, close to 1.5 million people live in nursing homes, and a million more live in assisted living facilities.

For  families, the  decision to place a loved one in a nursing facility or an assisted living facility is never an easy one.  It  is, unfortunately, the only option available for many people who often find themselves worried and anxious about the safety and care of their loved ones in these facilities.  The  fact that so many nursing homes in the United States have questionable standards of care at best  is definitely a concern for families looking for a facility.

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A  study published recently finds race -based differences in how nursing homes report fall accidents and pressure ulcers involving residents on their premises.  These  differences could make it difficult for families of elderly persons looking for reliable nursing homes for their loved ones.

The results of the study were published recently in the JAMA journal. The researchers set out to compare nursing home characteristics with the reporting of bed sores -also known as pressure ulcers – and fall accidents in specific nursing homes.  The researchers found to their dismay that the federal website that contains information about specific accidents and injuries in nursing homes actually underreports data on fall accidents and pressure ulcers.

Much of the difference in the reporting also seems to be based on race. Nursing homes that have predominantly white residents are much more likely to report high numbers of fall accidents compared to pressure ulcers, and are  also much more likely to report fall accidents more accurately.  Similarly,  nursing homes with majority black residents are much more likely to report a higher incidence of pressure ulcers compared to fall accidents. Predominantly black facilities are more likely to report pressure ulcers more accurately. Overall, the researchers say the better your reporting on fall accidents, the lesser your likelihood of reporting bed sores.

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The  federal administration has announced that it will soon launch an investigation of the wrongful use or overuse of antipsychotic drugs on patients in nursing homes.

The  administration has long been investigating the misuse of antipsychotic sedatives, including those that  are typically prescribed for nursing home patients who do not require these drugs at all.  In too many cases, investigators have found nursing homes wrongly classifying certain patients as schizophrenic so that they may be prescribed antipsychotic sedative drugs.  The administration has also found several nursing homes engaging in these practices and wants to understand whether these practices are widespread in the industry.  The  Centers for Medicare and Medicaid Services believes that the problem is a prevalent one, and that its scope has not been fully investigated.  Therefore, it has now announced that it will soon launch an investigation of such practices in the nursing home industry.

Schizophrenia is a psychotic disorder that is characterized by symptoms that include delusions, hallucinations and other symptoms.  Antipsychotic drugs  are often used to treat patients with schizophrenia.    Side effects of these medications can include death. It is estimated that less than 1% of the American population suffers from schizophrenia.  However,  more than 99 nursing homes classify as many as 20% of their patients with schizophrenia.  That is a disproportionately  large percentage  of nursing home residents  who are being diagnosed with this condition, relative to the American population with schizophrenia.  In  other words, the math simply does not add up here.

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An overwhelming majority of Georgia nursing homes have not been inspected since 2020. According to a report by the U.S. Department of Health and Human Services Office of Inspector General, the state currently ranks at the bottom of the heap when it comes to conducting inspection surveys of nursing facilities.

Across the country, most states were unable to inspect nursing homes to ensure that these were in compliance with safety and hygiene protocols last year.  Unfortunately, this has resulted in backlogs across the country.  However, the situation is dire in Georgia. In our state, the backlog has meant that most nursing homes have not been subjected to inspections. In fact, nearly 93% nursing home facility have not been subjected to inspections in 16 months. Only one other state fares worse than Georgia in this regard.

Typically, nursing homes are subjected to inspections at least once every 15 months, and these inspections are conducted through survey teams that are sent into the nursing facilities. The Centers for Medicare and Medicaid Services is asking states to resume the process of inspections and re-certifications of facilities without further delay.

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The ongoing debate on increasing the federal minimum wage could have unexpected, but welcome, consequences, like the enhancement of care available at the nation’s nursing homes. That could, in turn, mean fewer cases of abuse and neglect of residents at these facilities.

At many nursing homes in Georgia, poor care and even abuse of residents is often linked to understaffing and high rates of staff turnover. Many nursing homes see high staff attrition rates, and in most cases, staff members choose to move jobs when there is a higher pay scale promised. These high staff turnover rates are part of the reason for the devastating effect of the Covid-19 pandemic on these nursing homes.

When the pandemic raged across Georgia, residents in nursing homes were some of the earliest victims. Higher rates of staff turnover meant that many of these nursing homes were understaffed. Fewer staff members meant lower adherence to social distancing protocols of the type that would have helped prevent nursing home residents from infecting each other. Fewer number of staff members also discouraged stronger adherence to the kind of sanitation protocols that would have prevented the spread of infections via contaminated surfaces and objects.

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Nursing homes that have lower rankings by federal agencies have been much more likely to have resident deaths related to Covid-19.

According to the director of the Centers for Medicare and Medicaid Services, nursing homes ranked low by the agency’s nursing home ranking tool have seen higher numbers of Covid-19 deaths, compared to nursing homes that were ranked higher by the ranking tool.

This information provides valuable input for families who are looking for nursing homes for their loved ones in a post -pandemic world. By now, it’s clear that many nursing homes were ill-equipped to handle the patient care challenges resulting from the pandemic. Understaffing is a chronic problem in nursing homes across the country, and has already been blamed for the explosion of cases in nursing homes.

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Nursing homes that have lower rankings by federal agencies have been much more likely to have resident deaths related to Covid-19.

According to the director of the Centers for Medicare and Medicaid Services, nursing homes ranked low by the agency’s nursing home ranking tool have seen higher numbers of Covid-19 deaths, compared to nursing homes that were ranked higher by the ranking tool.

This information provides valuable inputs for families who are now looking for nursing homes for their loved ones in a post -pandemic world. By now, it’s clear that many nursing homes were ill-equipped to handle the patient care challenges resulting from the pandemic. Understaffing is a chronic problem in nursing homes across the country, and has already been blamed for the explosion of cases in nursing homes.

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