Nursing homes are supposed to provide quality care, but recent studies raise concerns that some of these homes put our elderly population at increased risk of injury and death. The studies, conducted by both the Government Accountability Office and Health Services Research, found well-known nursing home chains often violate federal regulations in ways that can lead to increased risk of nursing home injuries.

Connection Between For-Profit Facilities and Poor Care

The Government Accountability Office published a study in July of 2011, reviewing complaints that for-profit nursing homes provided poor quality care. Many of these claims focused on the growing trend of private investment (PI) firms purchasing large nursing home chains with a focus on monetary output instead of quality of care.

The study compared these PI held homes with other for-profit and nonprofit homes. Results supported other research findings that higher rates of serious deficiencies were present in PI held homes. PI homes also reported lower nurse staff ratios.

The Health Services study corroborates these reports, finding top for-profit nursing homes provide “lower staffing and higher deficiencies than government facilities.” The level of nursing staff is repeatedly linked to “quality of care, affecting such measures as the number of resident pressure ulcers, resident functional status, mortality rates and number of regulation violations.”

Lower labor costs are used to increase profit. These nursing chains are debt financed and pressured by shareholders and investors to turn a profit, fueling the growing endemic of poor-quality care for the elderly. Specifically, the top ten for-profit homes received 36 percent higher deficiency citations and 41 percent higher serious deficiencies. These deficiencies are issued whenever a facility violates regulations that can lead to injury.

Government Inspections and Citations

The government attempts to reduce the risk of poor care and injuries by overseeing nursing homes at both the state and federal levels. Nursing homes are licensed by state governments, along with federal involvement through the large portion of Medicare and Medicaid dollars used to cover care.

This collaboration includes a contractual obligation for each state to conduct onsite inspections. The inspection includes observation of resident care processes, interactions and the facility’s overall environment. States record the information on a federal report form and results of the inspection are available for public view.

If regulations are not met, deficiency citations are issued. There are over 180 regulations, ranging from proper food storage and preparation to inadequate care practices and abuse. The deficiencies are reported on two different levels during federal inspections. A standard deficiency is a violation of federal quality standards while a serious deficiency occurs when a resident is put in harm or jeopardy.

Deficiencies can result in penalties or enforcement actions from the federal government. The state government can also employ enforcement actions for violations. Two common examples are fines and Medicare payment denials. If violations are not addressed the facility may be closed.

How to Recognize Signs of Negligence and Abuse

Not all facilities that pass inspection provide outstanding care. The inspection is designed to ensure only minimum standards are met. The Department of Health and Human Services offers many suggestions on finding a quality nursing home, including relying on referrals from friends, family members and medical professionals.

Even after vigilant research, a chosen nursing home that once provided outstanding care may falter. It is important to continually review the standard of care a patient is receiving, and take complaints seriously. Watch for the following signs when attempting to determine if a complaint warrants further action:

  • Malnutrition
  • Dehydration
  • Bed sores
  • Frequent falls
  • Bruises, cuts, broken bones or other injuries
  • Poor overall hygiene

If complaints are filled with the facility and not properly addressed, legal remedies may be available.

Legal Remedies Available

Unfortunately, poor care can lead to more than complaints. CBS News reported residents being “punched, choked or kicked by staff members or other residents.” One resident died shortly after a nursing assistant broke her neck and wrist. Another died after a fellow resident with a history of violence threw her against a wall.

Circumstances like these can lead to serious injury and death. Legal remedies are likely available but there are many difficulties associated with legal action in nursing home cases. Most forms of abuse are not reported in a timely manner. A lack of witnesses further reduces chances for successful lawsuit, along with the fact that the abused resident is often unwilling or unable to provide testimony.

Navigating through these complex issues is difficult, and it is important to contact an experienced nursing home injury attorney to discuss legal rights and remedies.