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Nursing
Home Abuse & Injury
Faces
of Abuse
What's
Important
Federal
Regulations
Choosing
a Nursing Home
Approximately
1.6 million Americans live in nursing homes. Ironically,
Alabama pays its nursing homes some of the highest
Medicaid rates in the country, but yet we have
some of the worst records in accident prevention,
food sanitation, and staffing levels. Alabama
has 235 nursing homes, with a population of approximately
23,000 individuals. Currently, the state has 1200
complaints against nursing homes which are backlogged
because the state does not have the resources
to investigate all of the complaints. Alabama
spends considerably less on inspections than other
southeastern states.
The
Faces of Abuse Nursing home abuse and neglect
manifest in:
- physical
abuse,
- physical
neglect,
- and
breach of contract/fraud cases.
Physical
abuse generally involves situations where a nursing
home resident is intentionally harmed by an employee
or staff member of the nursing home or by another
resident. Physical neglect of nursing home residents
includes pressure sore formation, malnutrition,
dehydration, contractures and infections. Without
sufficient staffing, it is not uncommon for nursing
home residents to wander away from the facility
and suffer injuries or death. In such cases, a
formal complaint should be filed with the nursing
home as well as the Alabama Department of Public
Health.
Cases
involving breach of contract or fraud generally
involve the mismanaging of the assets of a resident.
It can also involve a resident's being billed
for services that are not provided.
What's
Important
It
is vitally important to record all events of suspected
abuse or neglect of a loved one in a nursing home.
That record should include:
- the
date
- the
name of the person(s) involved
- names
and addresses of all witnesses
- the
harm done
- the
nursing home response
Also,
the resident's general care physician should be
alerted to the situation and if immediate care
is needed, the resident should be taken to the
closest emergency room.
Alabama
standards and regulations for nursing homes are
set forth in the Rules of the Alabama State Board
of Health, Division of Licensure and Certification,
which is found in the Alabama Administrative Code
in Chapter 420-5-10. These regulations address
areas such as resident rights, quality of care,
delivery of skilled nursing care and services,
management of nursing homes, and quality of life.
Federal
Regulations
The
federal regulations are set forth in the Requirements
for States and Long Term Care Facilities, 42 C.F.R.
Part 483, in the Nursing Home Reform Act, found
at 42 U.S.C. ˇ 1396 (r).
These regulations, in part, require a nursing
home to provide:
- competent
nurses, aides and orderlies
- adequate
numbers of personnel to provide for the needs
of the resident
-
an accurate recordkeeping system that documents
the condition and progress of residents
- quality
assurance programs that assess deficiencies
and provide for½correction
- a
plan of care for each resident
- adequate
amounts of food, supplies, equipment, and medication
An evaluation of a particular nursing home's compliance
with state and federal regulations can be found
at the Medicare website. That URL address is www.medicare.gov\NHCompare\home.asp.
Alabama
has a program to assist nursing home residents
with problems they are having with the facility
that cares for them without having to go to court.
Unfortunately, it is vastly understaffed. It is
recommended that the state have one ombudsman
for every 2,000 long- term care beds, but Alabama
only has one ombudsman for every 5,000 long-term
care beds.
Fortunately,
Alabama does have the highest percentage of family
group participation in long-term care of any other
state in the nation. Don't be afraid or discouraged
to complain about mistreatment in a nursing home
facility.
Things
to consider when choosing a nursing home:
- Ask
physicians, co-workers, and friends for recommendations
- Take
the formal tour, but also make unannounced visits
to all three shifts
- If
possible, try the food, eating breakfast, lunch
and dinner
-
Observe staff members who provide daily care
interacting with residents
- Speak
to nurse's aids and nursing assistants about
their work and how well they like the facility
- Look
at detail, including how long it takes for call
lights to be answered
- Check
for spills or obstacles in the hallways
- Inspect
smell of the facility, grooming, and hygiene
of residents
Prepare
a list of medical questions to present to the
facility and find out if the facility is able
to take care of special needs.
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