Nursing homes are over-diagnosing patients with schizophrenia in order to conceal the high rates at which they’re prescribing antipsychotic medications, according to a recent report by the New York Times. Schizophrenia diagnoses among nursing home residents have “soared” as much as 70% since the federal government started making public disclosures of antipsychotic drug prescriptions in 2012. These prescriptions factor into nursing homes’ funding and ratings: nursing homes that prescribe them at high rates can receive lower ratings from the government, which in turn can affect their funding.
The majority of nursing homes in the United States failed to meet minimum care staff thresholds in the first quarter of 2021, according to an analysis by the Long Term Community Care Coalition. A federal study published in 2001 established that minimum threshold as 4.10 total care staff hours per resident day (HRPD) and 0.75 registered nurse HRPD. The LTCCC found that 63% of nursing homes did not meet this threshold. Continue reading
Legislation signed this month by New York Governor Andrew Cuomo will establish new staffing mandates for nursing homes and hospitals in the state. Under the new law, which will take effect in January 2022, nursing homes will be required to “meet a minimum daily average of 3 1/2 hours of nursing care per resident,” according to a report by Healthcare Dive. Continue reading
Campbell Hall Rehabilitation Center received 60 citations for violations of public health code between 2017 and 2021, according to New York State Department of Health records accessed on June 11, 2021. The facility has also been the subject of fines totaling $18,000 since 2011. The Campbell Hall nursing home’s citations resulted from a total of 15 inspections by state surveyors. The deficiencies they describe include the following:
1. The nursing home did not adequately protect residents from abuse or neglect. Section 483.12 of the Federal Code ensure nursing home residents “the right to be free from abuse, neglect, misappropriation of resident property, and exploitation.” A March 2021 citation found that Campbell Hall Rehabilitation Center failed to ensure such. The citation states specifically that it failed to prevent neglect in an instance where a resident’s “bilateral heel wound dressings were not changed in the time frame specified in the Medical Doctor’s (MD’s) orders.” The citation goes on to describe documentation that the resident “required extensive two-person assistance with bed mobility and transfer” and “extensive one-person assistance with dressing and toilet use.” The resident’s physician’s orders required that bilateral heel booties be “applied at all times” and that the resident’s wound dressings be changed in a certain manner. According to the citation, it was not changed between 7am and 3pm on a certain day, with a Licensed Practical Nurse stating in an interview that she had failed to change the resident’s wound dressing during the specified time frame. That LPN later refused to change the resident’s dressing when directed by a superior, according to the citation, and her termination at the facility was subsequently terminated.
Last week the Long Term Community Care Coalition published fourth-quarter 2020 staffing data for every nursing home in the United States. Noting that staffing levels in nursing homes “have played a critical role in determining the health outcomes of nursing home residents during the COVID-19 pandemic,” the LTCCC argues that nursing homes with adequate staffing levels are better positioned to mitigate transmission of Covid-19, treat residents with the disease, and prevent the pandemic’s psychological side effects with a level of resident care that helps stave off isolation. Continue reading
A recent column in the Washington Post argued that the Covid-19 pandemic revealed dire problems in nursing home facilities across the country. The column’s author, Syracuse University law professor Nina Kohn, wrote that these systemic problems, which include understaffing and poor quality of care for nursing home residents, stem in part from “owners who place profit-seeking above their residents’ welfare.” While policymakers have turned their eye towards solutions to the structural flaws in nursing homes, Kohn states that a more concerted effort is necessary to create safer, fairer elder care in the United States. Continue reading
A new report in Gothamist examines the debate over a proposed state law setting requirements for staffing levels in New York nursing homes. The Safe Staffing for Quality Care Act, which has previously passed the New York Assembly but has never been approved by the full state legislature, would create minimum staffing levels in the state’s hospitals and nursing homes. In hospitals, this would mean 25,000 new employees; in nursing homes, it would mean 45,000 new employees. Continue reading
A new report recently published by New York Attorney General Letitia James suggests that Governor Andrew Cuomo’s executive order providing certain Covid-19 immunity provisions for nursing home and other healthcare providers may have incentivized nursing homes “to make financially-motivated decisions” that may have resulted in harm.
According to the Office of the Attorney General’s (OAG) report, the April 6th, 2020 executive order provided immunity to “to health care professionals from potential liability arising from certain decisions, actions and/or omissions related to the care of individuals during the COVID-19 pandemic retroactive to Governor Cuomo’s initial emergency declaration on March 7.” The statute excluded harm or damages “caused by an act or omission constituting willful or intentional criminal misconduct, gross negligence, reckless misconduct, or intentional infliction of harm,” but the OAG notes that this section contains a loophole in which acts, omissions, or decisions “resulting from a resource or staffing shortage” were not included in the carveout. Continue reading
A new report by the Long Term Community Care Coalition found that nursing homes are understaffed even as their resident populations shrink. The LTCCC published new data regarding staffing levels at every nursing home in the United States on January 22, 2021, with the goal of helping “the public, news media, and policymakers identify and assess the extent to which nursing homes in their communities provided sufficient staffing to meet basic clinical and quality of life needs.” The data is sourced from the Centers for Medicare & Medicaid Services, which collects information from nursing homes around the country. Continue reading
The Department of Veterans Affairs has announced the decommissioning of a Georgia long-term care center following an investigation that found the nursing home was infested with fire ants. The facility, Eagles’ Nest Community Living Center, will be permanently closed following a determination that it can’t provide an adequate setting for long-term care.
According to a report in the Atlanta Journal-Constitution, the VA intends to rebuild the nursing home, and to add more long-term care beds at a different facility west of Atlanta, the Veterans Village. As for the 34 residents living at Eagles’ Nest, they were transferred to other facilities back in April “to limit their exposure to COVID-19,” according to the AJC. Continue reading