Nursing Homes Abuse Blog - By Jonathan Rosenfeld

The legal guardians of a a comatose nursing home resident who was molested by a licensed practical nurse at a Virginia facility have filed a nursing home negligence lawsuit against the facility in Norfolk Circuit Court.  The lawsuit alleges officials at Chesapeake Health and Rehabilitation should have known the nurse, Mark S. Albright, was prone to to such behavior.  The lawsuit seeks $29 million in damages.

Police say another nursing home employee reported that Albright put his mouth on the victim's breast. In November, Albright pleaded guilty to aggravated sexual battery.  Currently, he is serving six months in prison.  

Family Sues After Comatose Nursing Home Patient Sexually Assaulted By Nurse, FOXNews.com May 28, 2009

How strong is the case against the facility?

Without having access to the criminal investigative file, it is difficult to assess the strength of the case against the facility.  In order to recover damages for abuse such as this, it is essential to show the facility knew or should have known of Nurse Albright's criminal tendencies.  Absent, this knowledge or the facilities failure to do an adequate pre-employment screening of Albright, the case against the facility could be difficult.

About Chesapeake Health and Rehabilitation

Chesapeake Health and Rehabilitation Center is a 240-bed facility in Chesapeake, Virginia. According to government officials, the facility was worthy of just one out of five stars in a vital 'nursing home staffing' category.  On a daily basis, residents at Chesapeake received less time with nurses than similarly situated nursing home residents in Virginia as well as a nationally.  According to the Medicare website:

• Residents received 1 hour, 16 minutes of time spent with a licensed nurse per day
• Registered nurses spent just 17 minutes per day with each resident
• CNA's spent just 1 hour, 49 minutes per resident- more than 30 minutes less than the national average

Tennessee Department of Heath officials have suspended new  resident admissions at the Pigeon Forge Care and Rehabilitation Center.  The suspension of new admissions follows the identification of problems related to the facilities administration, performance and resident rights observed during an inspection of the nursing home between April 20 and May 11. 

In addition to the suspension on new admissions, Tennessee officials imposed a $3,000 fine and recommended a daily fine of $4,550 until the conditions are corrected.  A monitor has been assigned to the facility to keep track of the nursing home's progress.  In addition, a copy of the order prohibiting new admissions has been posted on the door to the facility.  Read more about this Tennessee nursing home here.

Pigeon Forge Nursing Home is a 120-bed facility and has been licensed since 1992.  According to Center for Medicare and Medicaid Services, the facility rates two stars out of five in terms of overall quality.  In 2008 nursing home inspectors found violations in reporting changes in residents' physical or mental health to family members and doctors; helping residents with eating, drinking, grooming and hygiene when necessary; staffing; and making sure that the nursing home area is free of potential accident-causing dangers, among other citations.

Violations were cited in February 2008 and corrected in March, and cited again in October and corrected in November. The most recent survey was done in March of this year.

Nursing Homes Abuse Blog Related Posts

Improper Record Keeping Leads To Suspension Of New Admissions In Nursing Home

When It Comes To Governmental Oversight, Assisted Living Residents Are On Their Own

Medicare Pulls Funding From Troubled Nursing Home Due To Concerns Over Resident Safety

There is a general assumption that the more you work you put into your career, the more opportunities you will have for advancement.  That is, unless you are certified nursing assistant (CNA) at a nursing home.  A new study published in The Gerontologist paints a relatively bleak work future for CNA's working in nursing homes today.

The National Nursing Assistant Survey sampled 3,017 CNA's working in nursing homes.  CNA's were surveyed in: recruitment, education, training and licensure, job history, family life, management and supervision, client relations, organizational commitment, job satisfaction, workplace environment and work related injuries.  

The survey outcomes leave me wondering-- 'why would anyone want to be a CNA in a nursing home?' Among the survey results:

• One in three CNA's receives some form of public assistance
• Over 50% of the CNA's suffered at least one work-place injury over the course of the last year
• Work-related injuries required 25% of the nursing to take time off from work
• 42% of the CNA's not participating in their employers sponsored insurance plan due to the fact they could not afford to participate
• Experience means nothing--- well almost-- in terms of pay, CNA's with 10 year or more job experience earn just $2.00 more per hour than their counterparts with just began working in the industry

My guess is that the inherent 'problems' with the job force urgently needed CNA's into more lucrative areas.  More experienced CNA's will undoubtedly leave their current positions until the industry chooses to put a premium on improving working conditions for this under-paid, and injury-prone group. Consequently, too few highly-skilled CNA's will remain to care for the growing nursing home population.

At the end of the day, who can blame them?

Nursing Homes Abuse Blog Entries On Staffing

A Recipe For Danger: Nursing Shortage Could Reach 1M By 2020

High Staff Turnover Rates Plague Most Nursing Homes

Nursing Shortage Is A Crisis

Resource

The National Nursing Assistant Survey: Improving the Evidence Bast for Policy Initiatives to Strengthen The Certified Nursing Assistant Workforce, The Gerontologist, Vol. 49 No. 2, 185-197

If you suspect poor care in a nursing home, one of the most important things to do is to document the mistreatment.  Obviously, this can be a difficult—if not impossible-- for an individual who may not be familiar with the system.  Perhaps the easiest way to document poor care is to file a complaint with the state health department. The complaint will trigger an investigation (or survey as they are commonly known) by the state’s department of public health into the alleged poor care.  These investigations tend to be thorough and usually entail chart reviews, employee interviews, resident interviews and examination of any relevant physical evidence.

The findings are prepared in a report format that is standardized by the Department of Health and Human Services Centers For Medicare & Medicaid Services.   Copies of the complete report along with interview summaries and incident forms may be obtained via individual state’s Freedom of Information Act (FOIA).

In addition to learning more about a specific incident or pattern of care, once a complaint initiated survey is completed, the survey or report becomes part of the facilities file with the department of health and is available for inspection by perspective residents and their families.

Lastly, surveys reveal if the facility violated any federal regulations with respect to resident care.  The Federal Health Regulations for Long Term Care Facilities are identified according to ‘F Tags’.  F Tags correlate to specific rights granted to nursing home residents under federal law in the Code of Federal Regulations (CFR).

Palos Hills Extended Care LLC

Palos Hills Extended Care is a 203-bed facility in Palos Hills, IL that caters to individuals who require skilled nursing care and intermediate nursing care. In April, 2008 an investigation was completed and revealed the following problems:

Pressure Sores (F 314, CFR 483.25(c)): Based on the comprehensive assessment of a resident, the facility must ensure that a resident who enters the facility without pressure sores does not develop pressure sores unless the individuals clinical condition demonstrates that they were unavoidable; and a resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.

A review of five residents charts revealed one resident developed pressure sores during their admission to Palos and three others had pressure sores that ‘became significantly worse’ during their stay.  The investigators' review of the residents’ charts also revealed that the facility failed to conduct mandatory skin assessments of residents as required by Federal Law.

In one case, the facility failed to apply “DuoDerm” as directed by a physician to a resident who was admitted to the facility with a stage I pressure sore on her buttock.  Within one month of her admission to Palos, the pressure sore had advanced to stage III measuring 15.5 cm x 16.5cm.   In addition to failing to tend to the woman’s pressure sore, Palos also failed to provide proper nutrition---the woman lost 27 lbs. during the course of her admission.

Accidents and Supervision (F 323, CFR 483.25 (h)):  The facility failed to ensure that the resident environment remains free of accident hazards as is possible; and each resident receives adequate supervision and assistance devices to prevent accidents.

In a sampling of five Palos Hills Extended Care residents, the facility failed to protect take safeguards necessary to prevent accidents.  In particular, the survey identifies a resident who suffered multiple falls where she sustained a fractured clavicle in one fall, a head injury requiring 12 sutures on another and a fractured femur during another fall. The falls and resulting injuries occurred despite the fact that Palos identified the woman as a ‘high fall risk’ and the staff noting the resident’s propensity to fall on multiple occasions, the staff failed to supervise the resident to prevent future falls and implement fall prevention measures.

If you suspect mistreatment of nursing home resident, please contact the Department of Health in your state or your local ombudsman.  Reporting poor care today can lead to improved care for others down the road.

Resource:

National Long Term Care Ombudsman Resource Center

Illinois Department of Public Health, Nursing Homes In Illinois

A bill in the Tennessee Legislature would create a new 'medication aide' position in nursing homes.  The bill would allow medication aides to administer medication under the supervision of licensed nurses as opposed to a registered nurse- a more advanced position.  Applicants for the new position would need a high school diploma, one year experience as a nurses aide in a nursing home and passage of a standardized exam.

An improvement to patient care or simply cutting corners?

Proponents of the bill claim the creation of a new group of medication aides will free up more experienced nurses to work directly with patients as opposed to dispensing routine medications.  According to bill sponsor, Debra Young Maggart (R-Hendersonville), the bill could eventually reduce medication errors caused by over-extended nurses.  The secondary benefit to some would be an inherent cost savings by hiring lesser credentialed employees.

The bills opponents worry that the credentialing requirements are insufficient for a job where a slight error could cost a life.  Not surprisingly, some of the bills most vocal opponents are nurses groups who are quick to point out that there are thousands of drugs available in the United States and medication aide with limited training is simply unable to have a mastery of all of them. 

Medication errors continue to climb each year.  By some accounts, 1.5 million people are injured on an annual basis due to medication errors.  In a study completed by The Institute of Medicine, 800,000 of the injuries occurred in the long-term care setting.

The Tennessee bill is currently in subcommittee.  If passed, Tennessee would join the majority of other states that allow medication aides to dispense medication in nursing homes and long-term care facilities.  Read more about this proposed nursing home legislation here.

I tend to think nurses aides can be a good idea in settings where common medications are dispensed on a regular basis.  The argument that a medication aide should have a mastery of every medication available is ridiculous!  Is it really fair (or necessary) to expect them to be intimately familiar with medications that would rarely be dispensed in a long-term care setting?

Resource

Preventing Medication Errors, Annals of Long-Term Care by Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD

Nursing Homes Abuse Posts On Medication Errors

Nursing Home Employees Plead 'Not Guilty' To Charges Related To The Intentional Chemical-Sedation Of 22 Elderly Residents

Fentanyl Overdose Leads To 1.6M Nursing Home Settlement

Who Should Manage Administration Of Medication?

Anything for a story. Right? Recent reports have surfaced regarding reporters 'signing out' Brooke Sheild's mother (who suffers from dementia) from an assisted living facility in New Jersey are disturbing-- to say the least.  The reporters were apparently from The National Enquirer and signed out 75-year-old Teri Shields to get a story for their tabloid.

Who can blame Brooke for being upset?

I intend to take every lawful action against all who were involved or who authorized this despicable act. My mother Teri Shields has been diagnosed with dementia. For her safety, she has temporarily been in a senior living facility, a very difficult decision for me. Late Thursday afternoon, I was alerted by [police] that my mother had been signed out of the facility by two reporters of the National Enquirer - who falsely claimed they were friends of hers.

What is a facilities responsibility to its residents?

Nursing homes have a duty to protect its residents both from harm that is self-inflicted as well as from harm from outside sources.  Facilities should have a sign-in and sign-out policy in place to control visitors access to residents.  Especially in cases of residents with Alzheimer's and dementia, facilities should have a list of authorized visitors approved by their person's guardian.  Only approved visitors should have access to the person.

Related Nursing Homes Abuse Blog Posts On Alzheimer's Residents

Nursing Homes For Alzheimer's Patients. What To Look For?

How Much Freedom Should Assisted Living Facilities Give The Mentally Disabled?

Pile On The Medication

A recent Illinois Appellate Court decision may prove to be a major roadblock for injured nursing home residents who wish to pursue their case against the facility in court.  In Fosler v. Midwest Care Center II, Inc., the Illinois Appellate Court upheld the validity of mandatory arbitration clause signed by an injured nursing home resident's daughter at the time of her admission-- specifically saying that the Federal Arbitration Act (FAA) trumps the Illinois Nursing Home Care Act.

This is a dramatic shift in the way Illinois Court's have interpreted Illinois law.  Previously, it was widely held in Illinois that arbitration agreements-- where a dispute related to negligent care would be resolved via an arbitrator as opposed to a jury trial-- were invalid.  According to Fosler, this is no longer the case.

Illinois like other states had adapted its own laws to protect nursing home residents.  In Illinois, the Nursing Home Care Act specifically nullifies any arbitration provision of the admission agreement, supporting an injured resident's right to a jury.  According to section 3--606 of the Nursing Home Care Act, "[a]ny waiver by a resident or his legal representative of the right to commence an action under Sections 3--601 through 3--607, whether oral or in writing, shall be null and void and without legal force or effect." 210 ILCS 45/3--606.  The Act emphatically states that a person injured due to nursing home negligence was entitled to a jury trial.

Due to the strong language of the Nursing Home Care Act, many Illinois nursing homes chose to remove arbitration clauses entirely from new admission paperwork as they were generally considered to be worthless.  This is no longer the case.  If this decision remains good law, mandatory arbitration clauses will become commonplace in Illinois nursing homes and the landscape of nursing home litigation in Illinois will be forever changed-- in my humble opinion for the worse.

Nursing Home Arbitration Clauses

An arbitration clause takes the decision of how much money--- if any -- an injured party is receive out of the hands of a jury.  In an arbitration setting, one person (who is frequently pre-selected by a nursing home) determines the damages to be awarded to an individual or family.  In addition, many arbitration clauses specifically limit the amount an arbitrator may award to an injured party.

Resource

Marie Fosler, by Janice Saxton, Attorney-in-Fact v. Midwest Care Center II, Inc., d/b/a Fair Oaks Rehabilitation and Health Care Center, Brenna Kolk, and Tonya Nielsen, 08--L--147, Ill.App. (2nd Dist)

Long before summer parties have begun, some nursing home owners are getting into a limbo contest of their own-- how low can they go with respect to the liability insurance they carry for their facility.  In terms of liability insurance coverage, many facilities are electing to completely forgo such insurance or obtain such negligible coverage that provides mostly for the 'cost of defense' -- to pay lawyers to defend them.  

These are termed 'eroding' or 'wasting' where the cost of defense is deducted from the policy limits. Hence, if a facility had a $500,000 eroding policy and there were $400,000 in defense counsel fees (this is not necessarily an extravagant cost of defense), the most an injured party could recover under the policy would be $100,000.  In situations involving a severe injury, such an amount would cover little more than a fraction of an injured parties medical expenses.

True, most states allow an injured party to recover money for damages directly from a nursing home owner if a judgment exceeds the limits of the policy.  In reality recovery of personal assets from a nursing home owner rarely occurs.  Most nursing home owners create limited liability companies, many times based outside of the United States, that insulate their personal assets from any judgments.

Is this legal?  You bet.  As a plaintiffs' lawyer I feel very strongly that the real losers in this game of 'insurance roulette' are those that are severely injured or maimed due to the negligent acts of the nursing home. 

Personal Liability Of Nursing Home Employees

While we can debate, the 'fairness' of the lack of mandatory liability insurance for nursing homes when it comes to residents, I want to focus on a second-- and usually forgotten group-- nursing home employees. 

As agents of a nursing home or hospital, nurses, CNA's, administrators and physicians have generally been able to sleep well at night they even if they were accused of negligence and a lawsuit was brought against them. Their employer almost universally defend the lawsuit and if needed pay a settlement or judgment.  

Today, this situation is less common. Increasingly, nursing home employees are being named personally in nursing home lawsuits--especially in situations where a facility has no coverage or is likely uninsured.  This means that nursing home workers are becoming personally exposed with respect to being named as a defendant in a lawsuit.  That's right, you--the nursing home worker-- could be responsible for paying for a legal defense and for paying any judgment or settlement.

This new era litigation should not be passed off a new guerrilla tactic employed by plaintiff's lawyers. To the contrary, most plaintiffs' lawyers would much rather pursue a cause of action against a large company as opposed to an individual-- jurors are more likely to hand down larger verdicts if they know a corporate entity is paying for it.  In most cases this is due to a complete lack of other options for an injured party to recover.

The real blame for this situation falls squarely on the shoulders of the individuals and corporations who own these nursing homes.  For the most part, this group has made a conscious decision to forgo or minimally insure their facilities without little regard to personally exposing their employees.

Time For Employees To Become Familiar With Insurance Coverage

If you work in a nursing home or long-term care facility, it's time for you to get acquainted with the insurance procedures at your facility.  Without sounding overly alarming (and I know I already have), your failure to learn some of the insurance lingo could jeopardize both your professional career and personal finances.

I now believe all nursing home employees should secure professional liability insurance for themselves.  The cost of this coverage is less than you would think and becoming necessary in situations where injured parties are increasingly looking to individuals to be held responsible for their damages.

Before purchasing an individual policy, keep in mind the following:

• Does the policy pay for both costs of legal defense and a settlement or judgment?
• Would the policy pay for claims made against you by your employer-- if they were to sue you for a contribution claim?
• Does the policy cover you if you change jobs?
• Will the policy reimburse you for time spent at a trial or deposition?

Related Nursing Homes Abuse Blog Posts

Who Benefits From Damage Caps In Nursing Home Lawsuits?

"Are there limits on the compensation the victim of nursing home injury can recover?"

The Richmond Health and Rehabilitation Complex, otherwise known as 'Madison Manor' has been added to the Special Focus Facility List following the disclosure of a videotape nursing assistants at the facility physically abusing, failing to provide food and failing to clean an 84-year-old resident at the facility in August.  The family of the woman placed a hidden camera in the woman's room after they discovered more than 30 unexplained bruises on her body during a visit. 

The Kentucky Attorney General filed criminal charges against three of the CNA's involved in incident and one has already pleaded guilty. Madison Manor dismissed all three employees following the filing of criminal charges.

This incident is not the sole reason for Madison Manor's placement on  the government's watchdog list.  According to Beth Fisher, spokeswoman for the Cabinet of Health and Family Services, Madison Manor's "history of non-compliance over the past three years" was the primary reason the facility was added to the Special Focus Facility List.

In 2008, Madison Manor received 25 citations related to resident care compared with the Kentucky average of 7 deficiencies per facility.  In addition to Madison Manor, there are two other Kentucky nursing homes on the watch list: Cambridge Place in Lexington, and Britthaven of Somerset.

A list of Special Focus Facilities can be found here.  Facilities on the list are inspected twice as frequently as other nursing homes.  If the facilities consistently fail to improve their facilities they risk losing government funding-- essentially forcing most facilties out of business.

Read more about this troubled Kentucky nursing home as reported by the Lexington Herald-Leader here.

About Extendicare

Extendicare Homes Inc. is national owner and operator of nursing homes based in Milwaukee, WI.  Extendicare runs 268 facilities across the country that provide services for more than 30,000 residents.  Nearly all of Extendicare's nursing facilities have higher-than-average scores for health deficiencies and safety violations.

Related Nursing Homes Abuse Blog Posts

Videotape Reveals Abuse In Kentucky Nursing Home

Nursing Home Negligence Lawsuit Filed Against Extendicare

Tonight HBO will premiere the four-part documentary "The Alzheimer's Project". The scheduled segments include: "The Memory Loss Tapes" (debuting May 10), which provides an up-close and personal look at seven individuals living with Alzheimer's, across the full spectrum of the progression of the disease. "Momentum In Science" (May 11 and 12) is a two-part state-of-the-science film that takes viewers inside the laboratories and clinics of 25 leading scientists and physicians, revealing some of the most cutting-edge research advances. "'Grandpa, Do You Know Who I Am?' with Maria Shriver" (May 11) captures what it means to be a child or grandchild of one with Alzheimer's, while "Caregivers" (May 12) highlights the sacrifices and successes of people who experience their loved one's descent into dementia.

I look forward to tuning in.  Please let me know what you think of the program.

Ask me about sports, wine, politics or the law and I feel fairly confident I can at least have a lively conversation about any of them.  But please don't ask me about finance.  The past year has eroded any hint of confidence I had when it comes to companies for investment.

Wait a second. Maybe, I am onto something.  In looking over the recent financials of the following national nursing home companies it looks as though some of the companies mentioned below are holding up fairly well in the current economic climate. As quarterly earnings are reported by many large nursing home chains--- caring for the elderly apparently pays well-- sometimes very well.

Five Star Quality Care

Five Star Quality Care, Inc. (Ticker: FVE) first quarter 2009 results reveal revenues increased 14% to 295.2 million from $258.9 million from a year earlier. New income for the company was $25.4 million for the quarter compared with $1.6 million in the first quarter of 2008.

Five Star Quality Care owns and operates 210 senior living communities in 30 states.  The companies facilities include: independent living centers and skilled nursing communities (nursing homes).  Five Star also operates five institutional pharmacies and two rehabilitation hospitals.

Kindred Health Care

Kindred Healthcare's (ticker: KND) profits rose 55% in the first quarter to $22.8 million or 58 cents per share.  Despite the fact that Kindred provided care to fewer patients, it was able to exceed Wall Street expectations by managing labor costs. 

According to chief financial officer, Richard Lechleiter, the recession may have actually helped the company's bottom line.  The shortage of jobs in other industries may have actually encouraged current employees to remain at Kindred longer.  Turnover among the company's hospital employees fell to 21% from a 25% turnover rate from a year earlier.

Kindred Healthcare, Inc. is a healthcare services company that operates: hospitals, nursing centers and a contract rehabilitation services business across the United States.  The hospital division operates 82 long-term acute care ("LTAC") hospitals (6,482 licensed beds) in 24 states. The health services division operates 228 nursing centers (28,525 licensed beds) in 27 states.  Kindred also operates a contract rehabilitation services business which provides rehabilitative services primarily in long-term care settings.

Sunrise Senior Living

Sunrise Senior Living (ticker: SRZ) will report quarterly earning on May 8th.  Will earnings be in line with the other long-term care providers?  Obviously, I have no idea-- if I did would likely retire from the law.  However, Sunrise did recently announce an 'Overhead Downsizing Plan' to save the company more than $20 million annually by cutting employees--further adding to the companies profitability. 

"The decision to reduce the number of people at Sunrise is never easy, but it was essential given  today's economic environment and our need to further reduce spending.  We want to be completely clear that none of these changes will effect the extraordinary care and services we provide in our communities," said Mark Ordan, Sunrise's Chief Executive Officer. 

No need to worry about the work levels for employees?

Sunrise Senior Living, Inc. provides senior living services in the United States, Canada, the United Kingdom, and Germany. It offers independent living services, which include housing, meals, transportation, activities, and housekeeping, as well as licensed skilled nursing services for residents who require 24-hour skilled nursing care; and determination of the appropriate level of care and service for such resident. The company’s assisted living communities also offer a reminiscence neighborhood that provides specially designed accommodations, service, and care to support cognitively impaired residents, including residents with Alzheimer’s disease and other forms of memory loss. 

Next time a large nursing home chain claims that a jury award is too large considering the nature of the injury, take a look at the company's financials and see who is really the one benefiting.

An aging nursing population, the growing need for nursing services and an insufficient number of facilities to train new nurses are coming together to create a 'nursing crisis', according to a recent article in The Iowa Independent.  The congruence of factors will lead to dramatic shortages of nurses both in Iowa and on a national basis.  

The American Health Care Association estimates the the nursing shortage will explode in coming years.  Among the nursing shortage numbers predicted by the AHCA include:

• July, 2009: 116,000 vacant nursing positions in hospitals and 19,000 vacant nursing positions in long-term care facilities.
• 2010: 275,000 vacant nursing positions
• 2020: an anticipated shortage of more than 1 million nurses in hospitals and long-term care settings

The shortage of qualified nursing educators is the crux of the issue according to Dr. Rita A. Frantz, of the University of Iowa College of Nursing.  "We have a national shortage of nurse faculty as well as a shortage of practicing nurses.  The two are intricately intertwined.  That is, without the appropriate number of nurse faculty, we can't admit all the qualified applicants to our nursing programs."

Unfortunately, the number of nurses in teaching positions is also expected to decline at a time when they are needed the most.  At the University of Iowa, the average age of the nursing faculty is 56 years-old, and the average age of professors at the school is 59.  "We're going to have large numbers of them leaving the academic environment to retire in a fairly short period of time," according to Frantz.

The final factor coming into play is the aging population and the inherent nursing demands placed upon it.  Along with the increase in aging population comes a larger proportion of the population turning to public health coverage to pay for their care.  In the case of Medicare or Medicaid, the reimbursement rates offered for many services do not cover the facilities expenses. How do facilities cope?  The only way they can, by keeping nursing staff to a bare minimum.

The article does not specifically address the nursing shortage in nursing homes or other long-term settings--in these situations the nursing shortage is likely even more dire as many nursing facilities pay substantially less and demand longer hours than hospital based nursing.  Read more about the looming 'nursing crisis' here.

Under-Staffing In Nursing Homes

Nurse shortages in nursing homes are believed to be a primary factor related to poor patient care. Although, federal regulations stipulate to minimum staffing levels, many of these requirements are insufficient for residents who may require substantial help for daily living needs.  Under-staffing in nursing homes is routinely blamed for: falls, medication errors, bed sores, elopement and general neglect.

Many nursing home experts believe the the number one predictor of patient care is the number of hours spent by staff tending to residents needs per day.  A great resource to find this information is the Medicare compare website where you can see how facilities rate in this area. 

There is no current federal standard for the ideal nursing home staffing levels in all facilities. Nonetheless, federal laws do require nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Individual states may have additional staffing requirements.

Resources

U.S. healthcare system pinched by nursing shortage, Reuters.com, March 8, 2009

Nursing home 'understaffed' death results: damages awarded.(Nursing Law Case of the Month), Encyclopedia.com, June 1, 2005

As if there wasn't enough depressing economic news already bombarding you on a daily basis, a new report in Crain's shows the cost of long-term care in Chicago has been increasing 6% annually since 2005-- more than three times the rate of inflation.  According to a study completed by Genworth Financial Inc., the average cost of a private nursing home in Chicago will cost you $77,198, while a year admission to an assisted living facility in Chicago will cost you $46,398.

The nursing home costs in Chicago are sharply higher than the Illinois average rate of $62,974 and the national average for nursing home care of $74,208 per year.

Despite its expense, the Genworth study predicts that two-thirds of seniors will need some form of long-term care.  Paying for the care will be the hard part according to Buck Stinson, president of insurance products at Genworth. "Many Illinois residents who had planned to tap their hard-earned nest egg to cover future long-term care costs are finding this may no longer be a viable option given the economic downturn."

Now for $211.50 per night, wouldn't it be great to get some decent food?