When Caregivers Don’t Care – The Pain of Nursing Home Abuse and Neglect

assisited living facility.jpgOne of the most difficult decisions we have to face is moving an elderly family member or loved one from their home into some form of facility. Facilities range from senior living communities that provide safe and convenient living arrangements for seniors who no longer want to maintain a house by themselves, all the way to a nursing home environment that provides 24/7 care by professional nurses. In between are assisted living facilities, as well homes that provide nursing care on demand as needed. Regardless of the type of facility where your loved one or family member resides, there unfortunately are risks associated with the quality of care that you should be aware of. This problem might also be more prevalent than you thought – it is estimated that about 150,000 elderly residents are abused each year, and of those, almost 2,000 actually die from mistreatment. Needless to say, this is a heartbreaking statistic.

Why Nursing Home Abuse and Neglect Occurs

elder care and abuseLiving with an elderly parent or loved one, particularly if they need constant attention or medical care, can be challenging. And that’s for family members. Caring for elderly people as a job poses an entirely different challenge. Unless a person is extremely committed to elderly care as a profession or career, the job can become stressful and frustrating. To compound the problem, many nursing home or elderly care facility workers are poorly trained and underpaid, particularly in light of the important work that they do. Elderly care facilities, in order to cut costs, are also frequently understaffed. Observing the type of people that are taking care of your loved one and how they go about their jobs is important. If employees are constantly rushed and in a hurry, it might indicate other problems. Unfortunately, however, there are many facilities that appear to be very well run that have exactly the same kinds of abuse problems.

A Potentially Significant Problem in Pennsylvania

Pennsylvania ranks fourth in terms of the number of people 65 and older in the United States, and the numbers are growing rapidly. Presently, approximately 15% of all Pennsylvanians are 65 and older, a number that is expected to grow to 23% by 2030. Almost one quarter of all Pennsylvania households have a member who is 65 or older. This growing population is driving up the number of nursing homes and care facilities needed across the state. As the numbers increase, however, the probability of nursing home abuse grows as well. In terms of statewide performance, the nursing homes and other types of assisted living facilities in our area are among the best in the state. In 2012, that resulted in an average of 3.28 abuse violations within the 41 facilities in the Greater Philadelphia area. As a contrast, nursing homes in the Greater Pittsburgh area had an average of 4.72 violations per home. If less than 4 or 5 reports of abuse per home sounds like an almost acceptable number, it’s important to realize that these are not merely statistics – every one of those reports represents an elderly person who was abused and traumatized in some way. With this in mind, the only acceptable standard of nursing home abuse is 0 incidents per home. But the probability of that ever happening is unlikely.

Public Reporting of Nursing Home Abuse and Neglect

neglect in nursing homesThe U.S. Centers for Medicare and Medicaid Services (CMS) is the governmental agency that has been prompted to make nursing home inspections a matter of public record, a relatively recent development. According to CMS, the average number of nursing home deficiencies is approximately 6 to 7 per inspection, so Pennsylvania is well below the national average. The agency classifies deficiencies using an alphabetic scale which runs from A through L, with L level deficiencies being the worst. As a point of reference, in the 2012 inspection year, none of the Philadelphia area nursing homes had a violation higher than G, which means that there were no residents in immediate jeopardy. A G rating, however, indicates that some level of “actual harm occurred” but that it was deemed to be an isolated incident. Once again, couched in the innocuous tone of bureaucrat-speak it sounds almost harmless; it’s not. Even one person being harmed in a nursing home is unacceptable. Just imagine if one of those G-level grades referred to your loved one.

Inspecting the Inspectors

The nursing home industry does not refer to these inspections as “inspections”, instead preferring to call them “surveys.” The process is less than scientific and subject to the interpretation and attitude of the inspector. For example, in a recent report, an incident where a resident was reported missing for an hour and a half and who was ultimately found cut and bruised at the bottom of a concrete stairwell – with his wheelchair on top of him – received a G rating. Another inspector rated a situation where a disposable razor and bottle of mouthwash left unattended on a sink as a G level incident as well. The fact is that there is a lot left to interpretation when evaluating the published reports of nursing facilities. If you are considering placing your loved one in a particular home, you should clearly do the research and see how the home has been rated over time. Then you should go inspect it yourself and talk to as many people as you can in the process.

Do Your Research and Choose the Right Facility Carefully

finding the right nursing homeThe Advocacy and Protection Bureau at the Pennsylvania Department of Aging visits every nursing home in the state at least once per year and more frequently if the facility has a track record of problems. Additionally, every county in Pennsylvania has an Area Agency for Aging (referred to as the local AAA, not to be confused with the American Automobile Association, also referred to as AAA). These agencies can provide information about nursing home inspections for every county in Pennsylvania. It’s a good place to start evaluating possible facilities for your loved ones, but you shouldn’t stop there. To really evaluate a nursing home you need to visit it, and more than once. Go at different times of the day or night on different days of the week. Visit during meal times or recreation periods. Observe staffing levels and the relationship between care givers and residents. Talk to the employees, the people who live there and the administrators, and then form your own opinion.

Take Action Immediately

neglect and abuse in assisted living facilityOnce you’ve selected a facility and your loved one moves in, stay aware of what’s happening. In Pennsylvania, neglect of care of dependent persons is a serious crime, covered under the crimes code of Pennsylvania. It is a serious matter and when it occurs, must, by law, be reported. If you suspect that abuse is occurring to your loved one, report it immediately. You should also consider retaining experienced legal counsel from Donaghue & Labrum, who can provide ongoing advice and assistance in both correcting the problem as well as in holding those responsible, accountable.