The U.S. Department of Health and Human Services conducted studies from 2005 to 2007 on nursing homes and found that over 91% of nursing homes surveyed were cited for deficiencies.

The most common categories included quality of care, quality of life, and resident assessment.  In being watchful for the occurrence of these problems, it is good to understand the differences between these:

1. Quality of care is commonly used to refer to situations where the nursing home has been neglectful or abusive of residents. Your loved one, as a resident of a nursing home, is entitled to receive care that prevents and treats pressure sores, and refrains from administering unwarranted medications, e.g. sedatives.
2. Quality of life occurs when the facility fails to provide a home like environment that is safe and clean.
3. Resident behavior and facility practices customarily refers to where nursing homes fail to provide its residents with an environment that is free from physical, emotional, and chemical abuse or punishment.

There has been an increased incident rate where nursing homes have been cited for actual harm or immediate jeopardy deficiencies since these studies were done.  In fact, a congressional report in 2009 found that nearly one third of all nursing homes had been cited for actual nursing home abuse.

Understaffing appears to be at the core of these problems.   Nine out of ten nursing homes are understaffed.  Also, many staff members are under trained.  Many nursing homes are plagued with frequent staffing turn over.  As a result of these issues, insufficient time is spent with residents.  The Department of Health and Human Servicesfound that understaffing resulted in false charting, which is where nursing home staff personnel incorrectly document a resident's personal care needs or omit vital information. In a study conducted by ABC News, it was found that understaffing caused easily recognizable problems such as bed sores, malnutrition, and abnormal weight loss among nursing home residents. This resulted in a high number of patients developing life threatening infections, dehydration, and other medical issues that could have been prevented had the facilities been adequately staffed.

Under federal regulations, a nursing home must “have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care.”  42 C.F.R. § 483.30.  Nursing homes in Georgia also have specific state staffing requirements.  For instance patients must be under the supervision of a licensed nursing home administrator, (Ga. Comp. R. & Regs. r. 290-5-8-.03), as well as other staffing and care requirements.  (Ga. Comp. R. & Regs. r. 290-5-8-.04).

Although most of us are not equipped to determine if a nursing home is understaffed or becomes understaffed once our loved one arrives, there are warning signs for this type of environment. These include things such as:

• Weight loss;
• Bruising;
• Falls;
• Restraints;
• Bedsores; and
• Staff inattention.

While this list is certainly not conclusive of all warning signs that may become present, it is certainly helpful to be vigilant for these things.  Frequent visits with your loved one and monitoring his or her care is a good way to avoid serious health and safety issues that may result if proper care is not being administered.

References:

1. http://www.centerforajustsociety.org/2012/02/17/33559/cjs-forum/understaffing-the-culprit-behind-u-s-nursing-home-abuse/
2. http://www.hhs.gov/
3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361005/
4. http://abcnews.go.com/US/story?id=96416&page=1
5. http://abcnews.go.com/US/story?id=92689&page=1
6. http://www.cbsnews.com/2100-201_162-304038.html
7. http://www.ncea.aoa.gov/main_site/library/statistics_research/research_reviews/abuse_in_nursing_homes.aspx