Q: How common is nursing home abuse and neglect? A: Although federal and state laws require nursing homes to maintain the “highest practicable physical, mental, and psychosocial well-being of each resident,” hundreds of vulnerable elderly and disabled nursing home residents are victims of abuse and/or neglect every year. In Minnesota, approximately 30,000 elders live in nursing homes and 71,000 vulnerable adults live reside in assisted living and community housing settings. National recommendations call for one Ombudsman for every 2,000 nursing bed/boarding care bed. Minnesota, however, has only one Ombudsman for every 8,000 beds. Over 80% of elder abuse goes unreported. The Minnesota ElderCare Rights Alliance (ECRA) reports that between 1 and 2 million Americans age 65 or older have been injured, exploited, or otherwise maltreated by someone on whom they depend for care or protection. ECRA reports that an estimated one out of eight cases of elder abuse is reported, compared to one out of three cases of child abuse which are reported. The U.S. Government Accounting Office (GAO) has repeatedly reported to the U.S. Congress regarding the problems in our country’s nursing homes. The following are a few of the GAO’s reports: -
Medicare and Medicaid Participating Facilities: CMS Needs to Reexamine Its Approach for Funding State Oversight of Health Care Facilities. GAO-09-64 (February 13, 2009). A report just released by the U.S. Government Accountability Office (GAO) concludes that the inspection and certification system for U.S. nursing homes is significantly underfunded relative to the scope of its oversight responsibilities. Click here to see the GAO report. The report, entitled “Medicare and Medicaid Participating Facilities – CMS Needs to Reexamine Its Approach for Funding State Oversight of Health Care Facilities,” notes that Americans receive care from tens of thousands of health care facilities participating in Medicare and Medicaid. To ensure the quality of care, CMS contracts with states to conduct periodic surveys and complaint investigations. Federal spending on such activities totaled about $444 million in fiscal year 2007.
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Nursing Homes: Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weaknesses, GAO-08-517 (May 9, 2008). The GAO found that state nursing home inspectors regularly overlooked major code violations in the nursing homes. Federal inspectors found that state inspectors missed violations of the most serious nature—those that could put a nursing home resident in immediate jeopardy and inflict actual harm—15 percent of the time. The potential for less serious harm was found in 70 percent of the federal reviews. The GAO created the report at the request of the Senate's Special Committee on Aging. The report concludes that "poor quality of care—worsening pressure sores or untreated weight loss—in a small but unacceptably high number of nursing homes continues to harm residents or place them at risk of death or serious injury."
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Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents, GAO-07-241 (March 26, 2007). The GAO analyzed federal sanctions for the years 2000 through 2005 against sixty-three homes previously reviewed and assessed Medicare’s overall management of enforcement. The GAO found that from 2000 to 2005, the number of sanctions decreased for the nursing homes that had a history of serious quality problems. While the decline may reflect improved quality or changes to enforcement policy, the GAO warned that it may also mask survey weaknesses that understate quality problems, an issue GAO has reported on since 1998. In addition, although the number of sanctions decreased, the homes generally were cited for more deficiencies that caused harm to residents than other homes in their states.
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Nursing Homes: Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety, GAO-06-117 (December 28, 2005). The GAO is concerned about the masking of two important and continuing issues: inconsistency in how states conduct surveys and understatement of serious quality problems. In five large states, federal investigators concluded that from 8 percent to 33 percent of the comparative surveys identified serious deficiencies that state surveyors had missed. This finding is consistent with earlier GAO work showing that state surveyors missed serious care problems.
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Nursing Home Deaths: Arkansas Coroner Referrals Confirm Weaknesses in State and Federal Oversight of Quality of Care, GAO-05-78 (November 12, 2004). The GAO assessed the effectiveness of nursing home oversight by considering the effect of a unique Arkansas law that requires county coroners to investigate all nursing home deaths. Coroners refer cases of suspected neglect to the state survey agency and law enforcement entities such as the state Medicaid Fraud Control Unit (MFCU). The GAO examined the results of Arkansas coroner investigations, the state survey agency's experience in investigating coroner referrals, and whether weaknesses in state and federal nursing home oversight identified in prior GAO reports were evident in the survey agency's investigation of coroner referrals. As a result of its study, the GAO recommended revision of Medicare’s current policy on citing deficiencies for past noncompliance with federal quality standards by holding homes accountable for all past noncompliance resulting in harm to residents, not just care problems deemed to be egregious.
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Nursing Home Fire Safety: Recent Fires Highlight Weaknesses in Federal Standards and Oversight, GAO-04-660 (July 16, 2004). In 2003, 31 residents died in nursing home fires in Hartford, Connecticut, and Nashville, Tennessee. The GAO recommended that in order to improve federal oversight of state fire safety activities, the public must be provided with important information about the fire safety status of nursing homes, and better ensure the adequacy of fire safety standards. The GAO also recommended that Medicare should ensure that CMS (Medicare) regional offices fully comply with the statutory requirement to conduct annual federal monitoring surveys by including an assessment of the fire safety component of states' standard surveys, with an emphasis on unsprinklered nursing homes.
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Q: Are there common signs of nursing home abuse and neglect? A: Yes. There are several signs and symptoms that may be red flags about the safety or the treatment provided for the nursing home resident. These include: -
Injuries that require emergency treatment or hospitalization -
Bed sores (pressures sores, decubitus ulcers) -
Open wounds -
Cuts, bruises or welts -
Unusual and unexplained bruises - Significant Weight loss or Broken Bones
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Unusual and unexplained lethargy or sedation -
Significant changes in medication -
Urine and fecal odors -
Poor personal hygiene -
Unexplained or unexpected death -
Illnesses or condition changes that are not promptly reported to the physician and family The Minnesota ElderCare Rights Alliance offers “Tip Sheets” on the following subjects: Q: Are there other resources for choosing a nursing home facility for my loved one? A: Medicare has a Nursing Home Comparison Five-Star Quality Rating website, which allows you to search nursing homes by a number of geographical limits for ratings based on Health Inspections, Staffing, and Quality Measures. Because this service is nationwide, this service is also useful if you are comparing facilities in several states or if you are trying to decide where you and your loved one want to live. You should visit each facility that you are considering. Medicare also has a Guide to Choosing a Nursing Home (which provides information to help individuals, family members, caregivers, and those who assist them find and compare nursing homes, and make informed decisions about nursing home care), a Nursing Home Checklist, Q: Do I need a nursing home abuse elder law attorney? A: Although Minnesota provides many excellent resources to its elderly residents, if you or a loved one have suffered abuse or neglect in a nursing home or other long-term care facility, taking legal action necessary to obtain justice for the wrongful treatment of your family member. If you believe a loved one is being abused or neglected in a nursing home, assisted care facility, or by a home care provider, you need to know of all of your options and the resources available to you. Contact the experienced lawyers at the Kosieradzki • Smith Law Firm today for a free consultation regarding your issues and concerns |
