Articles Posted in Pressure Sores

After addressing the shortage of nursing staff in hospitals, healthcare advocates have set their sights on implementing “Safe Staffing” policies in New York’s nursing homes. Safe Staffing policies would legislate minimum levels of nursing staff across the state’s nursing homes. Currently, New York State law only requires “sufficient staffing” which grants nursing homes wide discretion to determine whether its facility has sufficient levels of staffing. Elder care advocates lobbied state legislators to include safe staffing requirements in the budget this year. Lawmakers in Albany declined their request.

Instead, lawmakers opted to study the staffing levels at nursing homes. According to The Buffalo News, the budget passed earlier this year in Albany included a directive to the New York State Health Department to begin a study on May 1 analyzing “the range of potential fiscal impacts of staffing levels, other staffing enhancement strategies, and other potential quality improvement initiatives,” according to WHEC. The health department will then issue a final report to lawmakers at the end of the year. Given the timing of the report, it appears unlikely that any legislation will pass this year establishing mandatory staffing levels at nursing homes. Studies in Albany can frequently go in two directions. In some situations, studies are meant to endlessly shelve an unpopular idea. In other circumstances, studies can empower government agencies to develop their own policy proposals that will then be quickly passed into law.

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Elder abuse is a growing problem in America that often goes unreported. According to a recent article in NPR, healthcare workers and government regulators are failing to report cases of suspected elder abuse to local authorities. The article analyzes a recent report by the Office of Inspector General which found that despite evidence of abuse or neglect severe enough to warrant medical attention, healthcare providers rarely alerted authorities. Under both federal and state law, healthcare professionals are legally required to report cases of suspected abuse.

Elder care advocates are unsurprised by the federal agency’s report, saying that elder abuse is widespread and unreported in the United States. The report only further confirms the severity of the elder abuse and the indifference to tackle the problem. One study relied upon by the federal agency that authored the report analyzed nursing home residents who end up in an emergency room. The researchers looked for potential signs of neglect or elder abuse, such as head injuries, body bruises, bedsores, or any diagnosis that may indicate sexual or physical abuse.

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Webcams are becoming popular in nursing rooms across the country as families see it as an easy way to check on their loved ones and prevent neglect and elder abuse. Driven by the increased use of security cameras across the country and their reduced prices, webcams are popping up across the country and, when used discreetly, can sometimes catch cases of horrific elder abuse. The legality of webcams inside of nursing homes is sometimes questionable. A Minnesota court ruled in 2017 that a family had a right to set up a webcam in their loved one’s room after nursing home staffers kept unplugged and moving the camera – apparently not wanting to be recorded. Since 2017, seven states have passed legislation allowing families to place webcams in nursing home rooms.

While states move to legalize the use of webcams, privacy advocates have some concerns about the widespread use of webcams in elder living facilities. First, since nursing home residents are particularly vulnerable and prone to cognitive impairments then the decision to set up a webcam usually falls on their guardian or family. Given the serious privacy implications of being constantly filmed, family members would hopefully consult their loved one. Unfortunately, studies reported by Medical Xpress show that families tend to value “keeping the peace” over discussing these important matters.

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Over one-third of nursing homes in the country saw their star rating drop last year after the Centers for Medicare and Medicaid retooled their star-based rating system, which judges nursing homes based on the quality of care provided to their patients. A nursing home receives a rating between one and five stars, with five stars representing the highest quality of care. While the majority of nursing home ratings changed for the worse, the retooled metrics used by the nursing home regulator did increase the ratings of approximately 15 percent of nursing homes in the country, according to Skilled Nursing News.

According to the industry watchdog, the new rating metric emphasizes whether a sufficient number of nurses are staffed at the nursing home. According to multiple studies and elder care advocates, the number of nurses is the strongest predictor of the quality of care provided to nursing home residents. The federal agency’s revision came after a report last summer by The New York Times showed that many nursing homes suffered from a nursing shortage and often inaccurately reported their staffing to government regulators. In addition to changing its rating system, CMS also said it would conduct more unannounced inspections on weekends when staffing shortages were reportedly more common.

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The national nursing home chain Skyline Health finally collapsed last year after years of aggressive growth fueled by debt and shady business practices. The aftermath of the chain’s collapse is far-reaching – the chain once ran nursing homes in almost every state in the country, according to NBC News. Further, the disastrous financial situation that plagued the company has now fueled lawsuits against the company by employees seeking unpaid wages and residents who say they were neglected because the company could not afford basic medicine or utilities at their nursing home. This does not even touch upon the upheaval that the chain’s closure caused to countless senior citizens across the country.

As more horror stories come out about Skyline Health’s treatment of its residents, families of displaced residents are searching for answers about how the doomed nursing home chain continued its nationwide expansion while its problems piled up. Skyline started with less than 20 nursing homes in 2015 and expanded to more than 200 in just a couple years, all while state regulators levied substantial fines against the negligent and cash-starved corporate chain.  During the debt-fueled acquisition period, Skyline Health’s owners pillaged the company with lavish payouts and told nursing homes to enact draconian cuts. According to NBC News, the staff at a Skyline Health nursing home in Massachusetts started bringing their own toilet paper for the residents. A corporate memorandum instructed another Skyline Health nursing home to only provide two disposable briefs to each resident per day, cruelly leaving residents to sit in their filth.

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A Virginia nursing home is being sued after ignoring one of their former resident’s growing infection and bedsores. The family of the former patient alleges the nursing home’s neglect of Casey Lamont was so severe that it caused his death after just six months at the long-term care facility. The lawsuit seeks damages related to the medical costs incurred by the nursing home’s alleged negligence and Lamont’s pain and suffering.

Lamont was admitted to the nursing home, Envoy of Williamsburg, in November 2013. According to the medical history provided to the nursing home, Lamont would be susceptible to bedsores and pressures and therefore, the nursing home should take preventative measures, which generally include moving the patient around every few hours. Unfortunately, the nursing home appears to have neglected their responsibility to care for Lamont and within two months he developed “life-threatening bedsores,” according to The Virginia Gazette.

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Victims of nursing home abuse and industry stakeholders gathered in Washington this month for a Senate hearing on the nursing home industry. In addition to hearing testimony from the families of nursing home abuse, the federal legislators sounded the alarm over a looming fight over Medicaid funding. According to Skilled Nursing News, the Trump administration will propose its plans to convert Medicaid funding into a “block-grant model.”

According to proponents of the new model of funding, Medicaid spending has spiraled out-of-control and the federal health insurance scheme is no longer sustainable. Instead of continuing with the current open-ended model, the federal government will fund a predetermined amount each year for a state’s Medicaid program. The amount will likely depend on the number of Medicaid beneficiaries in the state, among other factors. The idea for overhauling Medicaid’s open-ended funding model into a block grant system has been favored by Republicans for a long time and finally reached a fever-pitch during the Affordable Care debate in 2017.

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New York State is proactively training nursing home staff how to be “better whistleblowers” whenever nursing home abuse or neglect is suspected. Describing the training as “the first of its kind” across the country, The Buffalo News said the New York Department of Health trained nursing home workers on submitting reports with important details, which include the “time and location of the alleged infractions” as well as any possible witnesses or other relevant information. The health department, which is responsible for overseeing nursing homes in New York, encouraged filing these “comprehensive complaints” in certain situations such as when the nursing home lacked adequate staffing, when important medical devices are malfunctioning, or anything else that puts the health and safety of nursing home patients in jeopardy.

Currently, anyone can file an anonymous report with the state health department. While staffers are obligated to report some instances of nursing home abuse under the state’s “mandatory reporter” laws, elder care advocates say this law is difficult to enforce. The state also prevents nursing homes from retaliating against any employee who files a report or cooperates with an investigation against the facility.

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Sen. Chuck Grassley issued a statement demanding that the Centers for Medicare and Medicaid Services (CMS) provide the Senate with a thorough report on the “comprehensive review” the agency plans to conduct on its nursing home oversight. Last month, the Republican Senator held a hearing on nursing home abuse and excoriated the nursing home industry and its grossly inadequate government oversight. In response to the spectacle on Capitol Hill, Administrator Seema Verma announced the agency would perform a “comprehensive review” of its nursing home oversight. In a statement issued by his office, Sen. Grassley described the news as “encouraging” but also directed the government to prepare a report on its planned changes.

After a fiery attack on the nursing home industry, Sen. Grassley does not plan on letting the government-funded industry to continue with its blatant violations. Speaking to McKnight’s Long Term Care News, Sen. Grassley said, “As chairman of the Senate Finance Committee, I’ll continue conducting diligent oversight of the nursing home industry. Once these reports are available and I’ve had time to review their findings, I intend to hold another hearing to learn the facts and find workable solutions.” The Senator from Iowa directed both the Department of Health and Human Services and CMS to prepare reports for a Senate hearing later this year.

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Outrage continues to grow at the poor quality of care being delivered at a New York nursing home. According to an investigation by News10NBC, Sodus Rehabilitation and Nursing Center in Sodus, New York is still violating numerous state regulations about the treatment of its senior citizens. The local news agency began investigating Sodus Rehab several years ago and, unfortunately, it does not appear that the quality of care has improved over time. According to the New York Department of Health, the nursing home received 90 citations for health and safety violations in just the last four years. In New York, the average number of violations per nursing home is approximately 30.

After undercover investigations by News10NBC last year showed unsafe and unsanitary conditions, Sodus Rehab says they “cleaned house” and brought in new administrators. Unfortunately, the new staffers do not appear to have fixed any of the nursing home’s problems. In one particularly egregious example cited by the news, Bill Tanner, a nursing home resident with leukemia, dementia and “other health issues,” developed bedsores that one doctor described as “some of the worst” he had ever seen. Bedsores, also called pressure ulcers, could have been easily prevented in Tanner, according to the doctors. Perhaps even more horrifically, the bedsores were only noticed because a former neighbor visiting Tanner noticed a foul smell in the room. According to the neighbor, she asked for a registered nurse and a licensed practical nurse to attend to the elderly man. Sodus Rehab staff said that neither was on-duty at the time.

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