Articles Posted in Understaffing

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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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Nursing home residents may need family members or advocates to report cases of elder abuse. According to The National Elder Abuse Incident Study, only 20 percent of neglect, exploitation, abuse or self-neglect is reported to state authorities. The nonprofit agency which conducted this study, The Center for Elder Abuse, said that an estimated 2.5 million cases of elder abuse occurred at nursing homes across the country in just the last year. This means that 2 million nursing home abuse cases go unreported and unpunished. This eye-wateringly high number indicates a substantial problem on its own but considering the aging population in America, unreported elder abuse could increase to even higher levels.

While victims can be any age, race, gender, or with any kind of diagnosis, the nonprofit elder care group said that common characteristics of nursing home abuse victims include anyone over the age of 80, elderly women, people with cognitive impairments, and people who are physically or psychologically aggressive. Nursing homes are the most common place for unreported elder abuse, although adult day care centers and hospitals are common locations for this horrific crime, too.

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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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The Senate Finance Committee examined the “crisis” of nursing home abuse in an emotional hearing this month. Families of abused nursing home patients told their tragic stories and frustrations with the lack of government oversight. In one of the testimonies before the Senators, Maya Fischer tearily detailed the sexual assault her mother suffered at a five-star rated nursing home in Minnesota. According to prosecutors who later charged a nursing home staffer for the rape, the predator had been suspended three times by the nursing home while they investigated sexual assault allegations. In two of these instances, the nursing home staffer who attacked Fischer’s mother was the main suspect.

Fischer described her “final memories of my mother’s life… watching her bang uncontrollably on her private parts for days after the rape, with tears rolling down her eyes, apparently trying to tell me what had been done to her but unable to speak due to her disease.” According to CNN, Fischer’s mother suffered from Alzheimer’s disease. Fischer says she is now speaking out to prevent her family’s tragedy from occurring to anyone else.

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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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The Trump Administrations deregulation effort has led to decreased oversight across the country’s nursing home industry. According to The Washington Post, President Trump’s deregulation agenda has indiscriminately removed “essential protections for vulnerable Americans.” Citing the Trump administration’s popular boast of removing 22 regulations for every single regulation added, the newspaper understandably questions the necessity of these regulations and the consequences of their removal.

Sadly, the nursing home industry has never been a priority for many Presidential administrations. Despite the highly regulated nature of the industry, nursing homes have often escaped the scrutiny lodged at hospitals and other healthcare providers. Late in his second term, President Barack Obama attempted to change that and directed the Centers for Medicare and Medicaid Services (CMS) to aggressively pursue nursing homes flouting the law. Beginning in 2014, nursing home violations would not result in a one-time fine. Instead, the nursing home would be fined every single day until the violation was rectified. By 2016, over two-thirds of nursing home violations resulted in a per-day fine. Unfortunately, the Trump administration reversed this change – which was viewed by elder care advocates as broadly effective and necessary.

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State prosecutors charged seven nursing home employees with involuntary manslaughter after a patient died from a bedsore in 2017. The nursing home employees, which includes one nurse, are collectively charged with 37 crimes for their gross mistreatment and neglect of two nursing home patients during their time working at Whetstone Gardens and Care Center in Ohio. Announcing the charges, Attorney General Dave Yost says, “Evidence shows these nurses forced the victims to endure awful mistreatment and then lied about it.”

Yost says first patient “literally rotted to death” after developing a preventable bedsore or “pressure injury” in 2017. The patient, who entered the facility on a short-term basis, developed several bedsores after nursing staff failed to move the patient every few hours. Once the bedsores developed, the staff continued to ignore the nursing home resident and failed to treat the sores, also called pressure injuries or ulcers. Within weeks of developing the bedsore, the patient’s bedsores became infected with gangrene. The nursing home resident passed away just weeks later after the staffers at the nursing home failed to take “any medically appropriate steps.”

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The Centers for Medicare and Medicaid (CMS) announced it will launch a ‘comprehensive review’ of nursing home regulations across the country. According to Health Leaders Media, CMS Administrator Seema Verma announced the new initiative last week in response to mounting criticism by states and federal legislators. Administrator Verma said the government agency will seek $45 million in additional funding from Congress for its review.

CMS says the review will focus on several primary areas. First, CMS will work with state agencies across the country to strengthen oversight of the country’s nursing homes. According to CMS, federal and state agencies will work together to ensure CMS health and safety requirements are being followed and ever nursing home is inspected at least once a year. Second, the federal agency plans to increase enforcement of nursing homes by, according to Administrator Verma, “developing new ways to root out bad actors and repeat offenders.” Administrator Verma says nursing homes with insufficient nursing staff will be targeted will begin receiving more “unannounced inspections” to encourage compliance. Finally, nursing homes will now be more severely penalized for poor patient outcomes and less severely penalized for failing to follow CMS protocols. In addition to improving outcomes for current nursing home patients, the focus on patient outcomes will also be more helpful to prospective nursing home residents by providing a more meaningful metric to judge nursing homes.

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New York’s Department of Health appears unable to adequately monitor the nursing homes across the state and hold poor performers accountable. Elder care advocates say the state agency must reform to protect senior citizens from poor care and nursing home abuse. Thankfully, legislators in Albany appear to finally be listening.

According to The Buffalo News, Assembly Majority Leader Crystal Peoples Stokes is co-sponsoring a bill regulating the number of nurses at each assisted care facility in the state. The appropriately named Safe Staffing for Quality Care Act would mandate that each nursing home have RNs (registered nurses) and that practical nurses and CNAs (certified nursing assistants) spend a minimum of 291 minutes with each resident. According to federal data, nursing staff levels are the largest indicator of whether a nursing home is providing quality care to its residents. Unfortunately, the same federal data shows that most nursing homes are grossly deficient when it comes to staffing. According to a study released in January 2019, only 7.5 percent of nursing homes across the state currently satisfy the requirements laid out in the Safe Staffing for Quality Care Act.

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